Suspension

What 3 things make transfemoral suspension unique?

1. increased soft tissue (more than transtibial)

2. minimal bony anatomy

3. general residual limb shape (cylindrical/conical)

What is done to a hypobaric liner prior to donning in socket?

applying lubricant to silicone bands

What is used in conjunction with a seal-in liner?

elevated vacuum

What is the major advantage of a skin fit suction suspension method?

increased proprioception

What are the disadvantages for a skin fit suction suspension method?

1. can’t accommodate volume changes

2. difficult to don

3. can’t absorb shear forces on limb (not as much padding compared to having a gel liner)

pistoning can lead to what?

1. skin irritation

2. distal end edema

3. gait deviations

4. discomfort

5. loss of control

What is the gold standard for transfemoral suspension?

there is none

In order to utilize a skin fit suction suspension method, what adjustment must be made to the socket?

snug fit on proximal brim

Explain Sock and Valve suction method

provides particle suction suspension where user wears a prosthetic sock

must utilize an additional suspension method

What is the difference between Sock & Valve Suction and Skin Fit Suction?

Sock & Valve has user wear a prosthetic sock and uses valve to create partial suction

• need to have another suspension method

Skin Fit has skin between the socket to create maximum suction from valve

• no need for another suspension method

Explain the Hypobaric Suspension method

fabric liner with silicone bands

suspension in areas with bands

What is the difference between a Hypobaric Suction Liner and a Full Suction Liner?

FSS has suction suspension everywhere compared to Hypobaric Suction Liner has suspension only where there are the rings

What type of patients would benefit from suction suspension?

1. patients with long residual limbs (more surface area=better suction)

2. patients with good balance (standing into socket will help donning)

3. patients with good skin integrity (suction may be aggressive on skin)

4. patients with good hand dexterity

5. patients with mature limb

Why would a patient with a mature limb benefit from a skin fit suction suspension method over a new amputee?

new amputees are prone to volume fluctuations, and the suspension would be greatly affected if the size of the limb changes

(prosthesis would fall right off)

A pin lock and a lanyard would be best for what types of amputee

pin-lock: transtib

lanyard: transfem

What are the advantages of a roll on sleeve/gel liner?

1. can accomodate volume changes (you can add padding/socks and it won’t affect suspension)

2. can be donned while seated

   1. can provide skin protection (thick sleeve)

What kind of patient would benefit from a roll on sleeve/gel liner

1. new amputee (volume fluctuations)

2. patient with bad skin integrity (thick sleeves will offer protection

3. geriatric patient (they don’t have to stand up)

What patient would not be best for a roll on sleeve/gel liner?

1. patient with long residual limb (can be difficult to don

2. higher functioning patient

3. patient with upper extremity debilitation (unable to roll sleeve on)

How does an elevated vacuum operate?

through either pf/df on the foot components

What category do Silesian Belts fall under in terms of manufacturing?

custom

How does a Silesian Belt offer suspension?

by pulling prosthesis superiorly and medially

Which suspension method is the OTS version of the Silesian Belt?

TES Belt

What are the advantages of a Silesian/TES Belt

1. very easy to don (if they can put a belt on, they can use this)

   1. very adjustable (velcro straps/holes in belt

What are some disadvantages of a Silesian/TES Belt?

1. increase bulk compared to other suspension methods

   1. not as great of a suspension compared to others

What are some indications for a Silesian/TES Belt?

1. patients that can’t tolerate suction

2. patients that need increased auxiliary suspension (secondary suspension)

3. patients that need rotational control

4. gait diagnostic control (since the belt pulls the socket medially, it can help with a deviation like lateral thrust)

Where does the Pelvic band span to?

from ASIS to 2” lateral to spinous process

What is the exact location of the hip joint?

1” superior, 1/2” anterior to GT

Where should the waist belt/pelvic band be positioned?

on the actual waist (not on ASIS)

What are the advantages of a Hip Joint, Pelvic Band, and Waist Belt

1. easy to don

2. maximum ML support

What are the disadvantages of a Hip Joint, Pelvic Band, and Waist Belt?

1. increase weight

2. uncomfortable sitting

   1. bulky

What are the indications for a Hip Joint, Pelvic Band, and Waist Belt?

1. patient that needs more ML control (weak hip abductors)

2. short limb

Which type of suction suspension method is easier to don?

Partial suction bc skin fit suction has snug ft on proximal brim