Prosthesis

Question 1

PROSTHESIS

Answer 1

A device that replaces the function of a missing part

Question 2

Partial Foot Amputation

Transmetatarsal & tarsometatarsal (Lisfranc)

Answer 2

• Use shoe filler & rocker bar
• Rocker bar for roll over (push-off)

Question 3

Partial Foot Amputation

Chopart (midtarsal amputation)

Answer 3

Preserves calcaneus & talus

Question 4

Partial Foot Amputation

Pirogoff

Answer 4

Vertical section through calcaneus

Question 5

Partial Foot Amputation

Boyd’s amputation

Answer 5

Talectomy; horizontal section through calcaneus

Question 6

Syme’s

Answer 6

ankle disarticulation

Question 6

Transtibial (BKA)

Code: “B-Cy A-Co” (Below knee cylindrical, Above knee, conical)

Answer 6

Short: <20%
Standard: 20-50%
Long: >50%

Ideal stump shape: cylindrical
Contracture: knee flexion

Question 7

Knee disarticulation

Code: “TOT”

Answer 7

Tenoplastic (Kirk, Callender)
Osteoplastic (Gritti-Stokes)
True disarticulation

Question 8

Tenoplastic (Kirk, Callender)

Answer 8

Sectioned femur is covered with quads tendon

Question 9

Osteoplastic (Gritti-Stokes)

Answer 9

Arthrodesis of patella to sectioned femur

Question 10

True disarticulation

Simplest & least traumatic

Answer 10

• Removal of tibia, fibula, patella
• Preserves the distal femoral condyle/epiphysis

Question 11

Transfemoral (AKA)

Answer 11

Short: <35%
Standard: 35-60%
(other references: 33-66%)
Long: >60%*

Ideal stump shape: conical
Contracture: hip flexion & abduction

Question 12

Single BKA/AKA

Answer 12

• AK prosthesis length has greater trim-down
• AK prothesis: ¼-½ inches shorter than the BK for foot clearance
• Scuff (sumasayad): MC in AK prothesis during swing phase

Question 12

Bilateral BKA

Answer 12

Both BK prothesis: 1 inch shorter than the preamputation legs (better balance)

Question 13

Bilateral AKA

Answer 13

• 1° means of ambulation: wheelchair with posterior displaced wheels (2-2.5”)
• Reduces height of patient by 12 inches (Lower COG = more stable)

Question 14

Bilateral AKA

Stubby prosthesis

(young & active individuals)

Answer 14

quadrilateral socket with posterior protruding rocker bars

Question 16

Very short AKA, Hip disarticulation

Answer 16

• Above lesser trochanter
• Removal of femoral head from the acetabulum
• Canadian hip disarticulation prosthesis (CDHP)

Question 17

Hemipelvectomy

Answer 17

• Resection of the lower half of pelvis
• Canadian hip disarticulation prosthesis

Question 18

Hemicorporectomy

Answer 18

• Removal of pelvis, sacrum, coccyx, below L4-L5 level
• Sitting bucket articulated to CHDP

Question 18

Below Knee Prosthesis

Answer 18

Foot-Ankle assembly
Shank
Socket
Suspension

Question 19

Above Knee Prosthesis

Answer 19

Foot-Ankle Assembly
Shank
Knee joint/assembly/mechanism
Socket
Suspension

Question 20

Foot-Ankle Assembly

Articulated Components

Answer 20

• (+) mechanical ankle joint
• Advantage: adjustable
• Axes:
  Single (most common): allows DF, PF
  Polycentric: allows DF, PF, inv, ev, & slight transverse rotation

Question 21

Foot-Ankle Assembly

Non-articulated Components (8 types)

Answer 21

• (-) mechanical ankle joint
• Advantages: lighter and quieter
• Prosthetic foot is directly attached to the shank
• (+) keel (weight-supporting structure inside the prosthetic foot)

Question 22

SACH | Solid Ankle Cushion Heel (**most commonly used**)

Answer 22

Has wooden keel with cushion heel

Question 23

SAFE | Stationary Attachment Flexible Endoskeleton

Answer 23

- Rigid bolt block (stationary attachment) - Flexible keel (flexible endoskeleton) - Heavier than SACH

Question 24

STEN | Stored Energy

Answer 24

- 3 wooden keels & 2 rubber plugs - Heavier than SACH

Question 24

Seattle | **heaviest**

Answer 24

- Has **C-shaped** Delrin keel that acts as a cantilever - Heavier than SACH - modified into a Seattle-lite foot

Question 25

C II | Carbon Copy II

Answer 25

- Has **2 carbon-composite plates** - Lightweight

Question 26

Quantum

Answer 26

- Its keel is in the form of spring module - Lightweight

Question 27

Flex-Walk

Answer 27

- Made up of **carbon-graphite composites** - Lightweight

Question 28

Flex-Foot

Answer 28

- Distal segment similar to flex-walk - Proximal segment extends upward to form as the shank - Longer (“footLONG”), lightweight

Question 29

Foot-Ankle Assembly

Answer 29

Code: SAFE STreets in SEATTLE are **heavy**; Code: “Car Quo Walks Foot kaya **lightweight**"

Question 30

Shank (Exoskeletal)

Answer 30

- Crustacean (has outer shell)

Question 31

Shank (Endoskeletal)

Answer 31

- Central support/pylon - **MC used (AKA & BKA)**

Question 32

Socket

Answer 32

Encapsulates the stump

Question 33

3 Types of Socket

Answer 33

- **Patellar Tendon Bearing (PTB) socket** (most common) - Hard Socket - ISNY socket

Question 34

Patellar Tendon Bearing (PTB) socket | most common

Answer 34

(+) soft insert to help control edema

Question 35

Hard Socket

Answer 35

- (-) soft insert - For patients with good tissue covering & severe perspiration

Question 36

ISNY Socket | Icelandic-Swedish New York socket

Answer 36

- Thermoplastic PTB socket - Advantages: thin to dissipate heat, enhances comfort, translucent & easily modified **(“TETra”)**