Prosthetics

Prostheses are prescribed for and custom made to a person who has had a complete or partial amputation of the upper or lower extremity. The absence of a limb can be congenital or acquired; it can be secondary to any number of musculoskeletal, circulatory or “systemic” disorders. An amputation is labeled/named by the level of the surgical or congenital amputation. For example, a below the knee amputation is between the ankle and the knee (this is also referred to as a transtibial amputation).

Over the years your choices for prosthetics have increased tremendously. There are many styles and designs to help us make prostheses that are right for you. Some components are universal to lower extremity prostheses and others are specific to a particular level.

The components that make up each individual prosthesis are chosen based on your preference, height, weight, activity level, and type of activities. The Prosthetist will use this information and discuss with you all the appropriate componentry choices.

Our Team Approach
Our ABC certified Prosthetists use a team approach to help you reach your functional, recreational and vocational goals. We work with you, your family, therapist, doctor, and insurance company to make sure that all realistic goals can be achieved with the help of the appropriate prosthetic componentry.

Lower Extremity Prostheses
Lower extremity prostheses are either endoskeletal or exoskeletal. This refers to the location and type of supporting structure between the amputation and the floor.

• An exoskeletal prosthesis is shaped like the contralateral (opposite) side and is hard the full length of the prosthesis to the top of the foot. The hard material is the supporting structure of the prosthesis and is typically hollow on the inside to save weight.
• An endoskeletal prosthesis is shaped like the contralateral side but is soft from the end of the amputation to the top of the foot. The components between the amputation and the foot are metal (steel, aluminum or titanium) and allow for permanent adjustability in height, and angles. In this system components can be easily changed in or out for different or replacement components.

Types of Lower Extremity Prostheses

• Immediate Post Operative Prostheses (IPOP) are fit directly after surgery. They are generally prescribed when your doctor wants you to get up and start walking right away. It immediately starts to shape and reduce the size of the amputation, as well as reduce the possibility of knee contractures following surgery. This prosthesis can be custom made or custom fit from an off the shelf item. A custom fabricated IPOP is molded over the amputation and appropriate post-surgical bandages and drainage. An adjustable unit is attached to the mold and then a pylon or pipe is the connection between the adjustable unit and the foot. This system is changed as often as the Doctor requests, but generally every 7-10 days until the first prosthesis is prescribed. When the mold is removed the amputation is inspected to make sure that it is healing well.
• A Preparatory prosthesis is generally the first prosthesis that you would be fit with. The components used may be the same as those for a definitive prosthesis but the preparatory/temporary will not include a cosmetic cover, that is to say that the components between the amputation and the floor will be exposed. A preparatory prosthesis is generally prescribed when it is expected that the amputation is going to change significantly and will require the portion that fits the amputation (the socket) to be re-molded to maintain an appropriately fitting and therefore functioning prosthesis.
• A Definitive prosthesis is the prosthesis that is fit after your amputation has undergone reduction in volume and change in shape of the amputation following surgery and/or IPOP fittings. It is fit because the amputation has changed so significantly that the first prosthesis is no longer fitting or functioning appropriately. This prosthesis will be more cosmetic in appearance. The amputation may have reduced enough that the size and shape of the amputated side is closer to that of the unaffected side. It may take time for your body to become accustomed to the components of your prosthesis as your activity level changes. The way that a prosthesis stays on the extremity is referred to as suspension. There are several different ways to suspend a prosthesis. The type of suspension is determined by the componentry choices, style of amputation, patient preference, experience or activity level. The Prosthetist you see will be happy to help you choose the best method of suspension for your prosthesis.