Prosthesis

Dr. Ikram
 Basic Terminology
• Prosthetics is defined as a branch of science that deals
with the study of fabrication and fitment of mechanical
devices that serve as a replacement for a lost of body
part.
• The Prosthetist of today is a highly skilled individual
who has obtained significant educational and
professional standards in the field of Prosthetic
• Prosthesis is the gadget or mechanical device that is
fabricated by the Prosthetist and replace the missing
part of the body. The plural form of Prosthesis is
Prostheses
 Advanatages of prosthesis
• Longer walking distances.
• Full range of joint movement.
• Better sitting comfort.
• No skin problems.
• Stable and safer standing and sitting.
• A sense of the artificial limb belonging to the
body.
• Easy and quick attachment and removal.
 There are Four Main Types of prosthesis

• Transhumeral Prosthesis. A
transhumeral prosthesis is an artificial limb
that replaces an arm missing above the elbow.
...
• Transtibial Prosthesis. ...
• Transfemoral Prosthesis. ...
• Hip disarticulation prosthesis
Classification
 Performance
• Fit – for athletic/active amputees, or those
with bony residua, may require a carefully
detailed fit socket
• Energy storage and return – storage of energy
acquired through ground contact and
utilization of that stored energy for
propulsion.

• Ground compliance – provide stability

• Rotation – ease of changing direction
 Other factors
• Cosmetics
• Cost
• Ease of use
• Size availability
 Amputation
• is the removal of a limb by trauma, medical
illness, or surgery. As a surgical measure, it is
used to control pain or a disease process in
the affected limb, such as malignancy or
gangrene
 Causes of amputation
• Diseases, such as blood vessel disease (called
peripheral vascular disease or PVD),

• diabetes, blood clots, or osteomyelitis (an

infection in the bones).

• Injuries, especially of the arms. ...

• Surgery to remove tumors from bones and

muscles
 Advantages
• A full end bearing stump
• Limited functional loss
• Lets the patient walk for short distances without a
prosthesis
• Proprioceptive properties of the sole of the foot are
kept intact in most cases
• Relatively easy for patient to balance especially on
uneven ground
• The usual psychological aspects of an amputation are
probably reduced because of the limited loss of
function and appearance
 Disadvantages

• General surgical problems of this amputation are,

• Poor wound healing, because of the limited blood
supply
• Distal skin cover must be from the plantar surface and
with no tension
• For the more distal levels there are often problems
with pain and contractures (e.g. varus equinus
deformities)
• Bony overgrowth may become sharp and cause
problems
 Level of Amputation
• Transmetatarsal amputation
• Ankle disarticulation (symes)
• Transtibial amputation
• Knee disarticulation
• Transfemoral amputation
• Hip disarticulation
• Hemipelvectomy
• Transradial amputation
• Elbow disarticulation
 Team
• Physical Therapist;
• Nurse;
• Surgeon both orthopedic and plastic surgeon;
• Social worker;
• Clinical Psychologist;
• Prosthetist
 DISCUSSION OF CHOICE OF
AMPUTATION LEVEL
• It is the responsibility of each team member to communicate their
thoughts to the surgeon regarding the most desirable amputation
level;
• In making this decision, the clinical, physical, social and
psychological assessments will be taken into account, along with
consideration of the prosthetic possibilities;
• As amputation is a final decision and so many healthcare
professionals are involved, a case conference may be the best
setting for discussion to take place.
• However, in an emergency situation, each team member should try
to convey their recommendations (however brief) to the surgeon by
telephone or fax.
• A unified team approach to the individual patient should always be
the goal.
 Preoperative Preparation
• An explanation of why the operation is necessary;
• An explanation of what the operation entails;
• A prediction of how the patient can expect to feel after the
operation, including a description of phantom reactions
and residual limb pain;
• Instructions concerning what to do about the pain
• Reassurance that the pain will pass;
• Introduction to, and explanation of, the local prosthetic
service (provided the pre-operative assessment indicates a
likelihood of prosthetic rehabilitation,
• Realistic information regarding the possible effect of the
operation on the patient's lifestyle
 Psychological problems
• Anxiety
• Depression
• Sexual depression
• Psychosis
• Anger
• Greif
• Euphoria
Partial Foot Prosthetics
•Thanks