Check Out Procedure for Trans-tibial Prosthetics

  • Identify any problems (discomfort / rubbing / noises), ensure prosthetic is as prescribed, cosmesis is satisfactory

  • Review patient standing, walking, sitting

Standing Assessment

  • Ensure applied correctly

  • Leg length equivalent (use dimples or iliac crests for reference)

  • Knee stability (do they have to resist the knee being forced in to flexion or extension)

    • Instability towards flexion: excessive socket flexion or DF of foot, heel cushion to hard

    • Instability toward hyperextension: inadequate socket flexion, too much foot PF, heel cushion too soft

  • Sole of the shoe - maintaining even contact with the floor + not inverted / everted

  • Suprapatellar cuff tabs - firm enough and in correct position?

  • Anterior trim lines - PTB to mid patella, PTS higher, PTK encircles patella

Walking Assessment

  • Knee hyperextension or over-flexion (causes as above)

  • Medio-lateral instability (new leg needs new alignment, old leg likely loose fit)

  • Gaping at brim of socket - should fit will when knee is in extension

  • Is pistoning minimal?

Sitting Assessment

  • Can they flex 90degrees and get foot flat on ground?

  • Has adequate flexion been incorporated in the socket? (5 degrees initial flexion)

  • Is the stump in contact with distal end of socket (plasticine test)

  • Blisters or area of rubbing, weight bearing distributes over proper areas of the stump

  • Hamstring abrasions

  • Sock imprint on teh stump - should be evenly distributed