NPTE Prosthetic

What happens to the COM for LE amputees?

Moves superior and toward intact limb side

BKA Excessive Knee flexion can be caused by:

Prosthetic:

-shoe heel to high

-insufficient PF

-socket in excessive flexion

-socket to anterior

-heel cushion too stiff

Anatomical:

-flexion contracture (lacks hip extension)

-weak quads

BKA Insufficient knee flexion

Prosthetic cause:

-shoe heel to low

-excessive PF

-heel cushion too soft

-socket too far posterior

-socket insufficiently flexed

Anatomical:

-extensor spasticity

-weak quads

-anterior- distal pain

-arthritis

AKA Lateral bend

Prosthetic:

-Short prosthesis

-inadequate lateral wall

Anatomic:

-Weak ABD

-Short amputation limb

-ABD contracture

AKA ABD gait

Prosthetic

-long prosthesis

-ABD joint

Anatomical:

-ABD contracture

-Knee instability

AKA forward flexion

Prosthetic:

-unstable knee joint

-short walker

Anatomical

-Weak quads

-low anterior wall

AKA high heel raise

-Inadequate friction

-Slack extension aid

AKA terminal impact

-Inadequate friction

-taut extension aid

Forceful hip flexion

LIME Whip

Lateral Whip = Internally rotated tibia

Medical Whip = Externally rotated tibia

If PF of foot to restricted by stiff heel cushion or hard PF bumper =

Excessive knee flexion

If too soft heel cushion or soft PF bumper =

allows excessive compression of heel cushion

-causes hyperextension of knee (PF contracture like presentation)

Pressure Tolerant areas

i'M a DPT

Medial tibial plateau

Distal end

Patellar tendon

Tibial and fibular shafts

Pressure sensitive areas

FAT, FAT

Fibular head and neck

Fibular nerve

Anterior tibia

Anterior tibial crest