Ortho-prosthesis.pptx

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1. Extension prosthesis

2. Objectives Problems associated with shortening for prosthetic/orthotic management. Socket design criteria

3. Congenital lower-limb deficiencies, which have not been converted by amputation, usually present with shortening as well as deformity and joint defects. It is normal practice to equalize the length by the use of a extension prosthesis, prepared from a cast, which is attached to a platform mounted above appropriate prosthetic components.

4. The provision of a prosthesis for a patient with a congenitally shortened lower limb frequently presents more problems than that for the more commonly encountered amputee. The presence of a reasonably normal foot, although capable of load bearing, may give special difficulties. Often the proximal joints are inherently unstable and will require the support of a total contact socket, yet the relatively large foot produces problems of access to such a socket.

5. Socket design criteria a) If the foot can take weight on the heel pad and also on the heads of the metatarsals, then suitable areas in the socket should be provided to preferentially stress them. The unstable proximal joints will require the general support of a total contact socket to maintain alignment.

6. b) The foot will usually be held in an equinus position within the socket. A system of forces must be provided to hold the heel pad on its seat. c) Provision must be made to allow the foot to gain entrance to the socket yet retain the support of total contact.

7. d) Since ankle movement will be lost within the socket an attempt must be made to provide this function prosthetically. e) The appearance of the finished limb must be acceptable cosmetically especially when fitted to the young and socially active. f) The limb must be durable without being excessively heavy.

8. Review Questions Congenitally shortened lower limb presents more problems than that for the more commonly encountered amputee. (T/F) The proximal joints are inherently stable in congenital shortening of lower limb. (T/F) The foot is held in an equinus position within the socket. (T/F) The extension prosthesis must be durable without being excessively heavy. (T/F)

9. Reference H. J. B. DA Y and J. WRIGHT, A system of extension prostheses, prosthetics and orthotics international, 1977, 1, 8-12. T. J. C. HARTE , An alternative design of extension prosthesis, prosthetics and orthotics international, 1987, 11, 90-92. R. R. HIRONS etal, The prosthetic treatment of lower limb deficiency, prosthetics and orthotics international, 1991, 15, 112-116.

10. Thank You