Minggu, 07 Oktober 2007


Prosthesis - replaces a missing limb or body segment (Orthotic supports a body segment)

Amputations should be considered constructive procedure rather than destructive.

Amputation Levels (for prosthesis fitting):




Transradial (forearm)

junction prox 2/3 & distal 1/3

3cm below biceps insertion

5cm above wrist joint


middle third

4cm below axillary fold

10cm above olecranon


middle third

8cm below pubic ramus

15cm above medial joint line of knee


8cm for every metre of height

7.5cm below medial joint line of knee

level at which myoplasty can be done



  1. retention of WBing surface

  2. bulbous stump assists prosthetic suspension


  1. compromise the choice & siting of joint

  2. bulky appearing prosthesis

Ideal Stump:

  1. Healed, mobile scar

  2. Sensate

  3. Cylindrical or conical shape

  4. Myoplastic procedure

  5. Nerves sectioned under tension

  6. Bone ends bevelled

Elements of a Prosthesis:

1. Socket

  • transmits forces between the stump & the prosthesis in all planes

  • may be proximal, distal or total bearing

2. Means of Suspension

  1. suction socket

  2. suspension belts

  3. neoprene sleeve

  4. elastic stocking

  5. silicone sleeve

3. Joint mechanism (knee)

  1. Stance phase control

    • Simple:

      • aligns the prosthesis so the ground reaction force passes in front of the knee

      • locks in hyperextension; 2 drums lock at 0-15deg.

      • for elderly

    • Mechanical stabilisers

      • braking mechanism activated by the WBing load or hydraulics

  2. Swing phase control

    1. Pneumatic cylinder

    2. Hydraulic cylinder

    3. Intelligent prosthesis - computer adjusts rate of swing to cadence (steps/min)

4. Terminal device (hand / foot)

  • Foot

    1. non-articulated

    2. solid ankle cushoin heel (SACH)

    3. articulated (uniaxial / multi-axial)

    4. energy storing

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