Lower Limb Prosthesis

GENERAL INFORMATION:

What is a lower limb prosthesis? A lower limb prosthesis is an artificial (man-made) device to replace all or a part of the lower limb. It may be when all or part of your leg needs to be, or was amputated (removed). A leg may be amputated at the thigh, knee, calf, ankle, or foot. A lower limb prosthesis has different parts depending on how much of your limb remains. It is fit to match your height, weight, and type or level of activity. All types of lower limb prosthesis include a foot and socket. The socket is the part of the prosthesis that connects to the stump. The stump is the end of your lower limb. A pylon is a tube connecting the socket to the foot. A pylon may be used to transfer body weight from the socket to the foot.

What are the types of lower limb prosthesis? Types of lower limb prosthesis depend on the different styles or designs based on the level of amputation. The prosthesis may also be made for use during activities or sports, such as dancing, swimming, cycling, golfing, and climbing.

• For foot or partial foot amputation: Partial foot amputations include removal of the bones in the toes, the long bones in the middle of the foot, or the ankle. The middle bones of the foot, also called metatarsals, are the long bones connected to each of your toes. This type of prosthesis may be made to only replace the part of your foot that is removed. If the prosthesis replaces your entire foot, the ankle part may be moveable for better function. This prosthesis may let you point or twist your artificial foot, or wear shoes with heels. The foot may also have rubber grips to decrease the risk of slipping.
  
  
• For below-the-knee amputation: A below-the-knee amputation is removal of the leg below the knee joint. This type of prosthesis includes a shin part. The shin is made of a metal tube with a socket on top to connect to the stump. It connects to the artificial foot and ankle at the bottom. An outer covering may be placed over the tube to make the prosthesis look natural, and more like a real leg.
  
  
• For above-the-knee amputation: An above-the- knee amputation is removal of the leg at the thigh. This type of prosthesis is made with a thigh, knee, shin, and foot and ankle. It is made of a metal tube with a socket on top to connect to the stump. An outer covering may also be placed over the tube to make the prosthesis look natural. The knee part of the prosthesis is made bendable to allow normal activities, such as walking, sitting, and kneeling.
  
  
• Stubbies: These are special prostheses made of short sockets. Stubbies lower you to the ground to help increase your balance and make you more stable during activities.

What should I do to prepare myself before using a lower limb prosthesis? Walking with your prosthesis on takes extra energy. To prepare for this, caregivers will help you with special exercises after surgery. These exercises help make your bones and muscles stronger. New ways to do work, self-care, and play activities to help you in your daily life may also be taught. You will be fitted with your prosthesis when your wound has healed completely. Once it is made, caregivers will help you learn to walk with the prosthesis to improve your balance.

How should I take care of my skin when using a prosthesis?

• Check your stump every day for redness, blisters, soreness, or swelling. If you see any of these changes, call your caregiver right away. Do not use your prosthesis until your see your caregiver. Stop using the prosthesis if it causes pain, and tell your caregiver.
  
  
• Have regular check-ups with your caregivers. This way, they can see how well you are doing while wearing and using your prosthesis. This also helps them check for normal wear of the prosthesis.

How should I take care of my prosthesis?

• Clean the inside of the socket every day. You may use a damp soapy cloth to remove sweat and dirt, then a clean damp cloth to remove the soap. Dry the socket very well with a dry cloth.
  
  
• Wear your prosthesis as often and for the amount of time advised by your caregiver. You may need to wear your prosthesis all the time during the first few months after you get it.
  
  
• Your prosthesis may need to be adjusted several times before it fits well. Tell your caregiver if you have problems with how it fits. Never try to fix or adjust your prosthesis on your own.

What problems may occur when using my lower limb prosthesis? A lower limb prosthesis that does not fit correctly to your stump may lead to problems. The poor fit causes unequal weight load to your lower limbs. This may cause extra stress or pressure on your other (unaffected) leg, or on your stump. The increased pressure may lead to pain and skin problems. Skin breaks that are not treated can become infected. Over time, this may also make another amputation necessary.

Where can I find more information?

• American Physical Therapy Association
  1111 North Fairfax Street
  Alexandria, VA 22314
  Phone: 1-800-999-2782
  Web Address: http://www.apta.org
  

• The Amputee Coalition of America (ACA)
  900 E. Hill Ave, Ste 285
  Knoxville,, TN 37915
  Phone: 1-888-267-5669
  Web Address: www.amputee-coalition.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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