Prosthetics and Prosthetic Fabrication Notes

Prosthetics

Prosthetic Prescription

• Prosthetic prescription is a multidisciplinary process involving the user, prosthetist, physiotherapist, and doctors.

• The team decides on the type of device, socket design, components, and suspension.

• These decisions are crucial for the subsequent rehabilitation process.

Fabrication of the Prosthesis

• The fabrication process includes several stages that influence the rehabilitation and physiotherapy program.

• Fabrication steps:

  • Casting

  • Positive mold

  • Rectification

  • Production & Assembling

  • Alignments

  • Cosmetic

Casting

• Casting is a procedure to make a new prosthetic leg or artificial limb.

• It is relevant in cases of elective amputation and limb loss, for example to create a leg prosthesis.

• See: https://youtu.be/vOhtOUF-ROC for casting demonstration.

• https://youtu.be/pEXamq6eZ7s for lamination process.

Rectification of the Cast

• Rectification involves adjustments to the cast, particularly on the anterior and medial sides.

Socket Production

• Socket production often employs prosthetic lamination techniques.

Socket Alignment

• Socket alignment involves adjustments for lateral tilt (Valgus/Varus) and posterior/anterior tilt (Extension/Flexion).

• Alignment addresses adduction and abduction.

• Lateral tilt includes valgus (external valgus moment) and varus. Medial Tilt.

• Sagittal view shows anterior and posterior tilt. Anterior Tilt (Flexion).

Translation Alignment Changes

• Translation alignment changes involve anterior, posterior, medial, and lateral adjustments.

TT Initial Alignment: Lateral View

• Medium Stump:

  • Cup is horizontal.

  • Tube is vertical.

  • Anteriorisation: 22-25 mm for medium and long stumps, 30-35 mm for short stumps.

  • Flexion = 5^\circ