PROSTHETIC COURSE

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PROSTHETIC COURSE. Bryan Humble CPO/LPO Precision Prosthetics. AMPUTATION LEVELS. TRANS TIBIAL (BELOW KNEE) TRANS FEMORAL (ABOVE KNEE) HIP DISARTICULATION / HEMIPELVECTOMY. TRANS TIBIAL (BELOW KNEE). PHALANGEAL TRANSMETATARSAL LIS FRANC CHOPART SYMES TRANSTIBIAL. SHORT - PowerPoint PPT Presentation

Transcript of PROSTHETIC COURSE

  • PROSTHETIC COURSEBryan Humble CPO/LPOPrecision Prosthetics

  • AMPUTATION LEVELSTRANS TIBIAL (BELOW KNEE)TRANS FEMORAL (ABOVE KNEE)HIP DISARTICULATION / HEMIPELVECTOMY

  • TRANS TIBIAL (BELOW KNEE)PHALANGEALTRANSMETATARSALLIS FRANCCHOPARTSYMESTRANSTIBIAL

    SHORTMEDIUMLONG

  • TRANS FEMORAL (ABOVE KNEE)

    KNEE DISARTICULATIONTRANS FEMORAL SHORTMEDIUMLONG

  • HIP DISARTICULATION / HEMIPELVECTOMY

  • MAJOR COMPONENTSSUSPENSIONLINERKNEE JOINTSSOCKETPYLONFOOT

  • SUSPENSIONSUCTIONSILICONE WITH LOCKSLEEVEPTB CUFFJOINT AND CORSETBELT

  • LINERSSILICONEPELITEC-FLEXHARD SOCKET

  • KNEE JOINTSLOCKINGSINGLE AXISSAFETY4-BARHYDRAULICCOMPUTER CONTROLLED

  • FEETSACHSINGLE AXISMULTI-AXISENERGY STORING (SEATTLE)DYNAMIC RESPONSE (FLEX FOOT)

  • COMPONENT SELECTION MUST MATCH PATIENT AND ACTIVITY LEVEL. *(K-LEVEL)

  • INSURANCE REIMBURSEMENTMEDICARE REIMBURSEMENTMEDICAID REIMBURSEMENTPRIVATE INSURANCEFUNDING SOURCES FOR AMPUTEETEXAS REHABSSDUASA (BARR FOUNDATION)MEDICARE USUALLY ALLOWS ONE PROSTHESIS PER YEAR IF DOCUMENTED AS MEDICALLY NECCESARY.

  • SOCK BALANCINGSOCK BALANCE IS ONE OF THE MOST IMPORTANT FACTORS IN SUCCESSFUL PROSTHESIS USE.1, 2, 3 & 5 PLY SOCKS SUPPLIEDMAINTAIN SNUG FIT AT ALL TIMES.SHORT SOCKS

  • HYGENESTUMPS SOCKS CHANGED EVERY DAYSILICONE LINER CLEANED & DISINFECTED EVERY DAY.

  • SHRINKER USEMUST BE WORN ANYTIME NOT IN PROSTHESIS. (USUALLY IN THE 1ST YEAR OF POST-OP)SHRINKERS MAINTAIN VOLUME CONSISTANCY.

  • GAIT DEVIATIONS & CAUSES(TRANSTIBIAL)HEEL STRIKE TO MIDSTANCEAT MIDSTANCEMIDSTANCE TO TOE OFF

  • HEEL STRIKE TO MIDSTANCEEXCESSIVE KNEE FLEXION

    PROSTHETICEXCESSIVE D.F. OR S.F.STIFF HEELANTERIOR SKT.

    OTHERFLEXION CONTRACTURE(CAUSES)

  • HEEL STRIKE TO MIDSTANCEABSENT KNEE FLEXION

    PROSTHETICEXCESSIVE P.F.SOFT HEELANTERO-DISTAL PAIN

    OTHERWEAK QUADSHABIT(CAUSES)

  • AT MIDSTANCELATERAL THRUST

    PROSTHETICMEDIAL FOOTABDUCTED SKT.SKT. M-L LOOSE

    OTHERLIGAMENTOUS LAXITY @ KNEE(CAUSES)

  • MIDSTANCE TO TOE OFFEARLY FLEXION (DROP OFF)ANT. DISPLACEMENT SKT.POST. DISPLACEMENT OF KEELEX. D.F. OF FOOTSOFT D.F. BUMPERDELAYED FLEXIONPOST DISPLACEMENT SKT.ANT DISPLACEMENT OF KEELEX. P.F. OF FOOTHARD D.F. BUMPER

  • GAIT DEVIATIONS & CAUSES(TRANS FEMORAL) LATERAL TRUNK BENDING ABDUCTED GAIT CIRCUMDUCTION VAULTING SWING PHASE WHIPS FOOT ROTATION @ HEEL STRIKE FOOT SLAP UNEVEN HEEL RISE TERMINAL IMPACT10 UNEVEN STEP LENGTH11 EXAGERATED LORDOSES

  • LATERAL TRUNK BENDING

    PROSTHETICABDUCTED SKT.LATERAL SKT. WALLPAIN D.L. FEMURSHORT TFB

    OTHERWEAK HIP ABDUCTORSABDUCTED GAIT(CAUSES)

  • ABDUCTED GAIT

    PROSTHETICPAIN IN PERONEAL AREALONG TFPVALGUS ALIGNMENTHIP JT. MISALIGNED

    OTHERCONTRACTED HIP ABDUCTORSPATIENT INSECURITY - COMPENSATES WITH WIDE GAIT(CAUSES)

  • CIRCUMDUCTION

    PROSTHETICMECHANICAL

    OTHERINSUFFICIENT KNEE FLEXION (FEAR)(CAUSES)LOCKED KNEETIGHT EXT. ASSISTTIGHT KNEE FRICTION POOR SUSPENSION - CAUSES PISTONING SKT. SMALL EX. PF

  • VAULTING

    PROSTHETICLONG TFP (LOCK, SUSP. FRICTION EX. PF.INSUFFICIENT OR EXCESSIVE KNEE FRICTION

    OTHERINSUFFICIENT KNEE FLEXION (FEAR)HABIT(CAUSES)

  • SWING PHASE WHIPS

    PROSTHETICKNEE JOINT MISALIGNEDTIGHT OR IMPROPER SKT. CONTURE

    OTHERWEAK OR FLABBY MUCULATURE(CAUSES)

  • FOOT ROTATION AT HEEL STRIKE

    PROSTHETICHARD PF CUSHION OR PF BUMPER

    (CAUSES)

  • FOOT SLAP

    PROSTHETICPF BUMPER TOO SOFT(CAUSES)

  • UNEVEN HEEL RISE

    PROSTHETICINS. KNEE FRICTIONABSENT OR LOOSE EXT. AID

    OTHERFORCEFUL HIP FLEXION BY PATIENT(CAUSES)!EXCESSIVE!

  • UNEVEN HEEL RISE

    PROSTHETICEX. KNEE FRICTIONEX. AID TIGHTMANUAL LOCK

    OTHERFEAR / AMPUTEE WALKS WITH LITTLE OR NO KNEE FLEXION(CAUSES)!INSUFFICIENT!

  • TERMINAL IMPACT

    PROSTHETICINS. KNEE FLEXIONTIGHT EX. AIDEXTENSION BUMPER DEF.

    OTHERAMPUTEE FEAR OF KNEE BUCKLING(CAUSES)

  • UNEVEN STEP LENGTH

    PROSTHETICLACK OF FRICTION OR LOOSE EXT. AIDINSUFFICIENT SKT. FLEXION

    OTHERPAIN / INSECURITYHIP FLEXION CONTRACTURE(CAUSES)

  • EXAGGERATED LORDOSIS

    PROSTHETICINSUFFICIENT SKT. FLEXIONINSUFFICIENT SUPPORT - ANTERIOR SKT. BRIM

    OTHERHIP FLEXION CONTRACTUREWEAK HIP EXTENSORSWEAK ABDOMINALS(CAUSES)