Prosthesis and Crutch walking

PROSTHESIS AND
CRUTCH WALKING
PREPARED BY :-
LITHA THOMAS
Asst. Professor
SNC
By:- Litha Thomas, Asst Prof, Sumandeep Nursing College, SVDU

INTRODUCTION :-
• Prosthesis are typically used to replace
parts lost by injury (traumatic) or
missing from birth (congenital) or to
supplement defective body parts.
• It is a sophisticated tool, designed to
enhance the level of independence
activity and mobility of the patient
Litha Thomas, Asst Prof, Sumandeep Nursing College, SVDU

DEFINITION :-
• In medicine Prosthesis Is An
Artificial Device Extension That
Replaces A Missing Body Part.
• The type of prosthesis depends on
what part of the limb is missing.
• There are four main types of
artificial limbs.
Litha Thomas, Asst Prof,
Sumandeep Nursing College,

TYPES OF PROSTHESIS
• Trans femoral prosthesis
• Trans tibial prosthesis
• Trans radial prosthesis
• Trans humeral prosthesis

Transtibial prosthesis
• A Transtibial prosthesis is an artificial limb
that replaces a leg missing below the knee.
Transtibial amputees are usually able to
regain normal movement more readily than
someone with a transfemoral amputation,
due in large part to retaining the knee, which
allows for easier movement.
• In the prosthetic industry a trans-tibial
prosthetic leg is often referred to as a "BK"
or below the knee prosthesis.

Transtibial prosthesis

Transfemoral prosthesis
• A Transfemoral prosthesis is an artificial limb
that replaces a leg missing above the knee.
• Transfemoral amputees can have a very difficult
time regaining normal movement.
• In general, a transfemoral amputee must use
approximately 80% more energy to walk than a
person with two whole legs. This is due to the
complexities in movement associated with the
knee.
• In the prosthetic industry a trans-femoral
prosthetic leg is often referred to as an "AK" or
above the knee prosthesis.

Transfemoral prosthesis

Transradial prosthesis
• A Transradial prosthesis is an artificial
limb that replaces an arm missing
below the elbow.
• In the prosthetic industry a trans-radial
prosthetic arm is often referred to as a
"BE" or below elbow prosthesis

• Two main types of prosthetics are
available.
a) Cable operated limbs work by
attaching a harness and cable
around the opposite shoulder of
the damaged arm.
b) The other form of prosthetics
available are myoelectric arms.
These work by sensing,
via electrode, when the muscles
in the arm moves, causing an
artificial hand to open or close.

Transradial prosthesis

Transhumeral prosthesis
• A Transhumeral prosthesis is an
artificial limb that replaces an arm missing above
the elbow.
• Transhumeral amputees experience some of the
same problems as trans femoral amputees, due to
the similar complexities associated with the
movement of the elbow. This makes mimicking the
correct motion with an artificial limb very difficult.
• In the prosthetic industry a trans-humeral
prosthesis is often referred to as a "AE" or above
the elbow prothesis.

Transhumeral prosthesis

Direct bone attachment /
osseointegration
• Osseointegration is a new method of attaching
the artificial limb to the body. This method is
also sometimes referred to as exo-prothesis, or
endo-exoprosthesis.
• The stump and socket method can cause
significant pain in the amputee, which is why
the direct bone attachment has been explored
extensively. The method works by inserting a
titanium bolt into the bone at the end of the
stump.

• After several months the osseo
integration to the titanium bolt and an
abutment is attached to the titanium
bolt. The abutment extends out of the
stump and the artificial limb is then
attached to the abutment.

CARE OF PROSTHESIS:-
• Donning and Wearing The Prosthesis
• Care of residual limb
• Treat Swelling and volume fluctuation
• Maintain Heel Height
• Maintain Personal Hygiene
• Daily Cleansing
• Regular Examination
• Socket Care
• Exercise and ConditioningLitha Thomas, Asst Prof,

CRUTCH WALKING
PREPARED BY :-
LITHA THOMAS
Asst. Professor
SNC

DEFINITION
• Crutches are orthopedic devices
created to assist in weight bearing
when a patient has a leg injury or
weakness in the lower extremities.

PURPOSE
• They are used to assist in weight bearing when a
patient has sustained an injury to the leg, knee,
ankle, or foot, such as a fracture or severe sprain.
• Crutches are also used following surgery on the leg,
knee, ankle, or foot.
• Forearm crutches are used to provide stability and
moderate support when a patient has generalized
weakness in the lower extremities, such as for a
patient with cerebral palsy.

Measurement of crutches:
• There are different methods used to measure the length of
the crutches for a patient.
• With the patient lying in bed, measure from the anterior
fold of axilla to the heel of the foot on the same side (with
the shoes on) and add 5 cm.(2 inches).
• While the patient is in a standing position, measure from 5
cm from the anterior fold of the axilla to a point 14 cm (6
inches) lateral to the heel (with the shoes on).
• Substract 40.5 cm or 16 inches from the patients total
height.

Types of crutches
• Forearm crutches:-
• Underarm crutches:-
• Strutters
• Platform
• Leg Support

Parts of crutches
• AXILLARY PAD
• HAND GRIP
• RUBBER TIP

TYPES OF CRUTCH
WALKING
• 4 point
• 3 point gait
• 2 point gait
• Swing through gait
• Swing to gait
• Tripod gait

4 point crutch gait
• Indication:-
Weakness in both legs or poor coordination.
Can bear partial pressure on both legs
• Pattern Sequence:-
(a) tri pod position:-
(b) Right crutch forward
(c) Left foot forward
(d) Left crutch forward
(e) Right foot forward.
• Advantages:-
Provides excellent stabilty as there are
always three points in contact with the ground
• Disadvantages:-
Slow walking speed

3 point crutch gait
• Indication:
Inability to bear weight on one leg. (fractures, pain,
amputations)
• Pattern Sequence:
(a) Tripod position
• (b) Both crutches and the non-weight bearing foot
are placed forward
• (c ) Weight bearing foot is placed forward.
•
Advantages:
Eliminates all weight bearing on the affected leg.
• Disadvantages:
Good balance is required.

2 point
• Indication:
Weakness in both legs or poor coordination.
(a) Tripod Position
• (b) Left crutch and right foot are placed
forward
• (c) Right crutch and the left foot are placed
forward
Advantages:
Faster than the four point date.
• Disadvantages:
Can be difficult to learn the pattern.
•

Swing through gait
• Indications:
Inability to fully bear weight on both legs.
(fractures, pain, amputations)
this gait both crutches are placed ahead
of the patient and the patient then swings through
the crutches and advances to a position in front of
the crutches.
• Advantage:
Fastest gait pattern of all six.
• Disadvantage:
Energy consuming and requires good upper
extremity strength.Litha Thomas, Asst Prof,

Swing to gait
• Indications:
Patients with weakness of both lower
extremities.
Both Crutches are placed ahead of the patient
and the patient then swings forward to the crutches.
• Advantage:
Easy to learn.
• Disadvantage:
Requires good upper extremity strength.

Tripod gait
• Indications:
Initial pattern for patients with paraplegia
learning to do swing to gait pattern.
Advance the left crutch, then the right crutch,
then drag both legs to the crutches
• Advantage:
Provides good stability.
• Disadvantage:
Very energy consuming.

PATIENT EDUCATION
• Crutch walking
• Sitting
• Standing
• Climbing up stairs
• Going down stairs
• Daily maintenance

PRECAUTIONS :-
• Take care on slick or wet surfaces (i.e., the kitchen and bathroom).
• Be careful of throw rugs; they should be taken up.
• Never hop around holding on to furniture; it may slide or fall.
• Keep the crutches near you so they are always in reach.
• Wear low-heeled shoes that will not slip off (i.e., sneakers).
• For the first few days, a strong belt may be worn to allow someone to
assist you.
• Be careful of ramps or slopes, as it is a little harder to walk.
• If falling, throw the crutches out to the side and use your arms to break
your fall. To get up, get into a sitting position. Back up to a stool or low
chair. Put your hands backwards on to the chair. Bend the "good" leg
up. Pull with your hands and push with the "good" leg to get up onto
the chair.
• If not allowed to take weight on the "bad" leg, hop up with the "good"
leg.
• Do not remove any parts from your crutches, including the rubber tips.

Prosthesis and Crutch walking

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