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in order cuccurullo > Ch 6 - Prosthetic and Orthotics: Complications and Gait Deviations > Flashcards

Ch 6 - Prosthetic and Orthotics: Complications and Gait Deviations Flashcards

1
Q

What is Follicullitis?

A

Hair root infection resulting from poor hygiene, sweating, poor socket fit, or pistoning

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2
Q

How should Follicullitis be treated?

A

Antiseptic cleanser

Oral antibiotics

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3
Q

How should boils and abscesses be treated?

A

Limited prosthetic use
I&D
Oral antibiotics

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4
Q

What causes epidermoid cysts?

A

Sebaceous glands are plugged by keratin

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5
Q

What causes Choke syndrome?

A

Proximal prosthetic socket being too tight and lack of total contact between residual limb and the socket leads to impairment of venous return

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6
Q

What is seen on exam in acute Choke syndrome?

A

Well-circumscribed indurated area
Weeping/blistering of the skin
Tender to palpation
Prone to cellulitis

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7
Q

What is seen on exam in Chronic Choke syndrome?

A

Skin becomes thickened and hyperpigmented due to hemosiderin accumulation

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8
Q

What is the treatment of Choke syndrome?

A

Relieve proximal constriction
Reduce # of socks
Modify distal end pad
New total contact socket

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9
Q

What is Verrucous hyperplasia?

A

Wartlike skin overgrowth from inadequate socket wall contact with subsequent edema formation

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10
Q

How much is gait speed decreased with a Symes amputation?

A

32%

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11
Q

What causes increased knee flexion at initial contact?

A
  • ↑ Ankle dorsiflexion
  • Excessive anterior displacement of the socket over the foot
  • Excessive posterior displacement of the foot in relation to the socket
  • Too hard heel cushion
  • Knee flexion contracture
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12
Q

What causes increased knee extension at initial contact?

A
  • ↑ Ankle plantar flexion
  • Excessive posterior displacement of the socket over the foot
  • Excessive anterior displacement of the foot in relation to the socket
  • Too soft heel cushion
  • Quad weakness
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13
Q

What causes Delayed, abrupt, and limited knee flexion after heel-strike in a Transtibial amputee?

A

Heel wedge is too soft

Foot is too far anterior

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14
Q

What causes Extended knee throughout stance phase in a Transtibial amputee?

A

Too much plantar flexion

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15
Q

What causes the toes to stay off the floor after heel-strike in a Transtibial amputee?

A

Heel wedge too stiff
Foot too anterior
Too much dorsiflexion

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16
Q

What causes “Hill-climbing” sensation toward end of stance phase in a Transtibial amputee?

A

Foot too anterior

Too much plantar flexion

17
Q

What causes High pressure against patella throughout most of stance phase in a Transtibial amputee?

A

Too much plantar flexion

18
Q

What causes the knee to be too forcefully and rapidly flexed after heel strike or high pressure against anterodistal tibia at heel-strike in a Transtibial amputee?

A

Heel wedge too stiff
Foot too far posterior
Foot too dorsiflexed

19
Q

What causes Hips level, but prosthesis seems short in a Transtibial amputee?

A

Foot too far posterior

Foot too dorsiflexed

20
Q

What causes Drop-off at end of stance phase in a Transtibial amputee?

A

Foot too far posterior

21
Q

What causes Toe off of floor as patient stands or knee flexed too much in a Transtibial amputee?

A

Foot too dorsiflexed

22
Q

What causes valgus knee during stance phase, pressure on distal medial limb and proximal lateral surface of knee in a Transtibial amputee?

A

Foot too outset

23
Q

What causes varus knee during stance phase, pressure on lateral distal limb knee in a Transtibial amputee?

A

Mediolateral dimension of socket too large

Foot too inset

24
Q

What causes Lateral bending of trunk in a Transfemoral amputee?

A
  • Prosthesis too short
  • High medial wall
  • Prosthesis in abduction causing wide-based gait
25
Q

What causes Abducted gait in a Transfemoral amputee?

A
  • Prosthesis too long
  • Too much adduction
  • High medial wall
  • Improperly shaped lateral wall
  • Pelvic band may be positioned too far away from patient’s body
26
Q

What causes Circumducted gait in a Transfemoral amputee?

A
  • Prosthesis too long

* Prosthesis too much alignment stability or friction in knee, making it difficult to bend knee in swing-through

27
Q

What causes Vaulting gait in a Transfemoral amputee?

A
  • Prosthesis too long
  • Socket suspension inadequate
  • Excessive stability in alignment or some limitation of knee flexion
28
Q

What causes Medial whip in a Transfemoral amputee?

A

Excessive external rotation of knee

29
Q

What causes Lateral whip in a Transfemoral amputee?

A

Excessive internal rotation of knee

30
Q

What causes Foot rotation at heel strike in a Transfemoral amputee?

A

Too hard heel cushion or plantar flexion bumper

31
Q

What causes Foot slap in a Transfemoral amputee?

A

Plantar flexion bumper is too soft

32
Q

What causes Uneven heel rise in a Transfemoral amputee?

A
  • Knee joint may have insufficient friction

* Extension aid may be inadequate

33
Q

What causes Terminal swing impact in a Transfemoral amputee?

A
  • Knee friction is insufficient

* Knee extension aid may be too strong

34
Q

What causes Uneven step length in a Transfemoral amputee?

A
  • Insufficient socket flexion

* Insufficient friction at the prosthetic knee or too loose an extension aid

35
Q

What causes Exaggerated lordosis in a Transfemoral amputee?

A
  • Insufficient socket flexion

* Insufficient support from the anterior socket brim

36
Q

What causes Instability of the prosthetic knee in a Transfemoral amputee?

A
  • Knee too far ahead of trochanter-knee-ankle (TKA) line
  • Socket w/ excess flexion
  • Plantar flexion resistance
  • Failure to limit dorsiflexion
37
Q

What causes Drop-off at end of stance phase in a Transfemoral amputee?

A
  • Limitation of dorsiflexion of prosthetic foot
  • Heel of SACH-type too short
  • Toe break of a conventional foot too far posterior
  • Socket too far anterior to foot
38
Q

How often will pediatric amputees need prosthesis or sockets replaced?

A

<5 yo: yearly
5-12 yo: 18 mo
12-21 yo: ~2 years

39
Q

In which amputation population is bony overgrowth MC seen?

A

Acquired amputations in children more than in adults

in order cuccurullo (91 decks)

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