“AMBI” means around.
“PUTATIO” means trimming.
Separation by cutting of a terminal part of the body.
Amputation is done when all other modalities are explored, evaluated and rejected and the evidence suggests that the amputation is the best solution to the patient’s plight.
Socket is the part of prosthesis that encloses the stump and forms union between stump and artificial limb.
Conventional Below Knee Socket: It is indicated in elderly persons with unstable knee and persons with quadriceps weakness. It is fabricated in such a way that there is no pressure over distal tibia, head of fibula or tibial crest. 30% of weight by thigh corset.
• Suspension is the method by which the prosthesis is held onto a person’s residual limb.Example: • Pelvic belt • Supracondylar calf
The harness is attached directly to the socket. Its function is to:
provide stable support of prosthesis
To provide attachment for control cables
To help controlling terminal device and/or the elbow unit through control cables.
Solid heel made of wood or metal
Cushion heel made of rubber heel wedge or alternating layers of soft and hard rubber. This cushion heel compresses during heel strike
simulating plantar flexion.
Molded cosmetic forefoot with or without individual toes.
The articulation at the 'ankle' allows not only inversion-eversion movements but also dorsiflexion (essential for squatting, standing up from prone position, etc.) and a shorter keel helps achieve this.
1. TRANSPHALANGEAL
a. No device.
b. Cosmetic fingers or portion of a cosmetic glove.
2. TRANSMETACARPAL
a. Cosmetic glove
b. Open steel prosthesis shaped like an opposition semicircle
c. Mitt-shaped prosthesis
3. WRIST DISARTICULATION
Disadvantages
a. On prosthetic fitting with wrist unit, the hand is longer than the normal side.
b. Close fitting prevents supination and pronation by 50%
c. Uncosmetic.
Advantages
1. Myoelectric hand can be fitted.
2. If patient accepts, wrist unit with mechanical hand can be fitted.
Prosthesis
1. Passive or cosmetic hand
2. Mechanical hand with Bowden cable operation for hand opening/closing
3. Myoelectric hand can be fitted.
Confusing different terminology used to describe it as braces, splints, calipers, appliances. In 1972 new terminology was developed and put into use. It is described by:
a. Joint it encompasses
b. Abbreviating each joint into single letter
c. By using combination of symbols to describe the orthosis
d. Add up “O” refers to orthosis at the end.
Example
KAFO—Knee ankle foot orthosis
TLSO—Thoracolumbar sacral orthosis.
FUNCTIONS OF CERVICAL ORTHOSIS
1. Positions the head
2. Limits movement in flexion, extension, rotation and lateral rotation
3. Unload the cervical spine by bearing part of weight of skull.
consists anterior corset or straps with two posterior paraspinal uprights to limit flexion and extension and two uprights in mid axillary line to limit lateral bending.
It restricts extension and flexion but allows lateral flexion. It has a lateral oblique upright that restricts lateral bending. It restricts extension by posteriorly directed force from abdominal corset and anteriorly directed force from pelvic
and thoracic band
It consists of:
1. Two thoracic lumbar posterior uprights
2. Pelvic band
3. Interscapular band with chest strap
4. Axillary strap
5. Abdominal corset or straps.
Slings–figure of 8 orthosis:
It is used to support shoulder, elbow and forearm. This helps in preventing subluxation of shoulder in hemiplegia, tetraplegia.
Air-plane splint: It keeps the arm in 90° abduction and allows no movement in the glenohumeral joint. It is made of plastic or metal and it is held to the
chest wall by straps or elastic bandage. Indicated in Erb’s palsy and burns in the axilla.
Dynamic cock up splint for radial nerve palsy
Knuckle bundle splint for ulnar nerve palsy
Indications
1. Perthe’s disease
2. Slipped femoral epiphysis
3. TB hip
4. Fractures of femur with non-union
5. Severe osteoarthritis hip.
