Week 3-TransFemoral Flashcards
(112 cards)
What are the different amputation levels for transfemorals?
Long
Medium
Short
Very Short = Subtrochanteric
What are the different muscle compartments?
posterior
middle
anterior
What is part of the posterior muscle compartment?
Extensors of the Hip & Flexors of the Knee
What is part of the middle muscle compartment?
Adductors
Femoral Triangle
What is part of the anterior muscle compartment?
Flexors of Hip, Flexors of Knee & Extensor of Knee
What is part of the gluteal region?
Gluteus Maximus Gluteus Medius Gluteus Minimus Tensor Fasciae Latae 6 Deep Lateral Rotators
What are the 6 deep lateral rotators?
piriformis,
obtorator internus/externus,
gemellus superior/inferior,
quadratus femoris
What are the socket design goals?
Contouring for functioning muscles
Stabilize skeletal structures
Broad pressure over neuro-vascular bundles
Forces distributed over wide area
What are three important aspects in the design of the quadrilateral socket?
Four well defined walls
Rectangular in shape
Ischial-gluteal weight bearing
What reliefs are required for the quadrilateral socket?
Hamstring tendon
Gluteus maximus
Adductor longus
Rectus femoris
What are three aspects important for the ischial containment socket?
Femur held in adduction
Very intimate fit
Triangular shape
What are the advantages of the quadrilateral socket?
Well documented
Consistent procedure for fabrication
What are the disadvantages of the quadrilateral socket?
Not custom shape
Femur not held in adduction
Lack of support in medial wall
What are the advantages of the ischial containment socket?
Enhanced biomechanical stability
Increased medial wall support
Strong gluteal and hydrostatic loading
Restoration of pelvic-femoral angle
What are the disadvantages of the ischial containment socket?
Too many inconsistent designs
Requires skill to fabricate
What are the advantages of the ischial containment socket over the quadrilateral socket/
Bony lock
Counter force-In Quad socket there is distal pressure while in ischial containment it is distributed
What are the different types of suspension systems for transfemorals?
Suction Silicone Sleeve Silesian Belt Hip joint & pelvic band Suspenders
How does suction suspension work?
Socket and interface are smaller than limb
Patient is pulled into the socket
Valve is screwed in, doesn’t let air in, only out
Positive-negative pressure pump
What are the indications for suction sockets?
Long limbs Stable volume Good skin integrity Good upper limb strength Majority of patients
What are the contraindications for suction sockets?
Patients with volume fluctuation
Short residual limbs
Severe scarring
Upper extremity involvement
What are the indications for silicone suction?
Longer residual limbs
Stable limb volume )can add socks)
No upper limb involvement
What are the contraindications for silicone suction?
Unstable limb volume
Upper limb involvement
Skin sensitivity to material
What are the advantages of silicone suction?
Provides positive suction suspension-can add socks
Does not limit range of motion
Reduces shear forces
What are the disadvantages of silicone suction?
Difficult to don-seal can pinch and create air channel
Skin reaction to material
Rotation Control-due to cylindrical shape