Week 5- suspension

pistoning

concern if total contact is not made between residual limb and socket

lots of soft tissue, not a lot of bony locks

what is the major way a TT and TF socket differ?

subarmospheric, mechanical

name the 2 types of suspension in a TF socket

suction, roll-on gel liner, vac assist

types of subatmospheric suctionq

silesian bandage, TES belt, hip joint and pelvic band

types of mechanical suspension in a TF socket

lamination

how is one-way valve incorporated into a suction valve socket design?

suction valve with proper socket design

how to design total suction

hypobaric sleeve, sock & valvae

how to create partial suspension suction

direct skin contact and snug proximal fit

how does skin fit suction liner keep air out?

distal one-way air expulsion valve

how does skin fit suction expel air?

partial

what kind of suction suspension needs some mechanical suspension as well?

larger socket than total suction, easier to don, temporary suspension

how does sock & valve suspension work?

fabric liners with silicone bands

what kind of material do liners that create hypobaric suction use?

silicone bands

where does lubrication need to be applied to a hypobaric socket prior to push-in?

very stretchy, comfort of gel liner with suspension

benefits of seal-in liners

scar tissue, bony prominences

indications for a seal-in liner

eliminates pistoning, improves proprioception, prosthesis feels lighter (due to better suspension)

advantages of suction suspension

longer residual limbs, good skin integrity, balance, hand dexterity

indications for suction suspension

difficult to don

disadvantage of suction suspension

volume fluctuations, short residual limb, severe scarring, UE debilitation

contraindications for suction suspension

shuttle lock, pin lock, lanyard

how does roll on sleeve/gel liner attach to the socket?

silicone, TPE, etc

materials that gel liner may be made of

doesn’t control rotation

why is a pin lock not good for TFs?

stops rotation better, can adjust to volume changes

why is a lanyard better than a pin lock, in TFs?

cushion, wick, seal

kinds of liners needed for liner “system” when using an elevated vacuum

can set level of vacuum, not much movement, can be used with subischial system

advantages of electrical elevated vacuum

whenever clinically feasible, mature limb

primary indication for skin-fit suction

increased proprioception between limb and prosthesis

major advantage of skin-fit suction

volume changes, difficult to don, limited absorption of shear and impact forces

chief limitations of skin-fit suction

firm limb, expected volume changes

primary indication for roll-on gel liner with locking mechanism

easy to don, good suspension, allows for volume changes, absorbs shear and impact forces

major advantages of roll-on gel liner with locking mechanism

distal edema, need hand strength and dexterity, need room for height

chief limitations of roll-on gel liner with locking mechanism

firm limb, expected volume changes

primary indication for roll-on gel liner with hypobaric seal

easy to don, allows volume changes, minimal distal distraction, absorbs shear and impact forces

major advantages of roll-on gel liner with hypobaric seal

need hand strength and dexterity to don

chief limitations of roll-on gel liner with hypobaric seal

mature limb, active, minimal socket displacement

primary indication for roll-on gel liner with vac-assist suspension

excellent suspension, minimal socket displacement

major advantage of roll-on gel liner with vac-assist suspension

bulky, difficult to don, gel liner is fragile, gadget tolerance, manintenance

chief limitations of roll-on gel liner with vac-assist suspension

total elastic suspension

what does TES stand for, in TES belt?

TES

is silesian or TES belt better to use with partial suction?

neoprene

what material is a TES belt primarily made of?

power belt

other common name for TES belt

short residual limb, back-up suspension if patient sweats a lot

indications for TES belt

easy to don, adjustable using velcro straps

advantages of silesian/TES belt

added bulk, not intimate fit

disadvantages of silesian/TES belt

anatomy or skin integrity issue, aux suspension needed, rotational control, gait diagnostic control

indications for silesian/TES belt

patient who can tolerate suction or gel liner suspension

contraindication for silesian/TES belt

1” superior, 1/2” lateral to GT

where is the hip joint of a hip joint/pelvic band/waist belt located?

ASIS to point 2” lateral

where is the pelvic band of a hip joint/pelvic band/waist belt located?

easy to don, increased ML control

advantages of hip joint/pelvic band/waist belt

adds weight and bulk, decreases sitting comfort

disadvantages of hip joint/pelvic band/waist belt

weak hip abductions, poor dexterity/strength, short or weak limbs

indications for hip joint/pelvic band/waist belt

when not needed

contraindications for hip joint/pelvic band/waist belt