Prosthetic Treatment

Prosthetics is the profession of designing, fabricating and fitting man-made body parts used by a person who is missing a limb due to a war injury, an accident, disease or a birth defect. Prostheses are classified into two basic groups: upper extremity (arms) and lower extremity (legs). Prosthetics Outreach Foundation (POF) has concentrated, to date, with lower extremity prosthetics.

 

A below-knee prosthesis consists of:

  • a rubber or plastic foot

  • a shank/ankle made of plastic or aluminum to connect the socket to the foot

  • an adapter device for connecting the socket to the shank and adjusting angular alignment of the limb

  • a plastic socket, custom fit to each patient's amputated limb

  • a durable cosmetic leg-shaped covering usually made of plastic foam

Prosthetic knees made of aluminum are also available for above-the-knee amputees. The knee component is connected directly to the socket.

 

Steps of Treatment for an Amputee

From surgery to prosthetic fitting and rehabilitation, the new amputee faces a long process. It takes considerable personal strength and commitment to accept being an amputee and to persevere with the rehabilitation process. The quality of the surgical technique and post-operative care can have a profound impact on the comfort and rehabilitation of the amputee.

 

To design and fabricate the prosthesis, a plaster bandage cast is taken of the patient's residual limb. A scanning laser can also be used to measure the limb shape directly. The prosthesis can be produced using manual methods or by automation. Prosthetics Outreach Foundation prefers the automated limb fabrication system known as AFMA: the Automated Fabrication of Mobility Aids. Once the shape of the residual limb is measured, the measurements will be used to shape the socket for the artificial limb. The shaping of the socket is critical to the effective rehabilitation of the amputee. This modification process allows for patient comfort in areas of the socket that will support the forces exerted during walking. Following the completion of the plastic socket, it must be connected to the foot, either using a laminated (exoskeletal) structure or using a system of tubing and attachment fittings (endoskeletal).


 

The socket and foot must be positioned relative to each other (aligned) to allow the amputee to walk with a gait pattern as normal as possible. Alignment of the prosthesis is the second critical step that will allow the amputee an optimal rehabilitation.

 

Cosmetic shaping of the prosthesis is the final step of the fabrication process. For many amputees, a realistically shaped prosthesis is very important psychologically.

 

Following the manufacture of the prosthesis, an amputee will continue with physical therapy and gait training. Vocational skills training may also be necessary if they are unable to return to their previous employment. With the advent of new flexible materials, new socket designs techniques and more functional components, most amputees can return to an active lifestyle.