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Patient/User has to visit a prosthetist to be fitted with a suitable prosthetic. There are some components in a prosthesis that is custom-made, for instance socket. There are also other parts in the making of a prosthesis that are manufactured in factory and assembled by prosthetist/ technician in order to fulfill patient needs.
Below Knee Prosthetic Leg
Above Knee Prosthetic Leg
Residual limb/stump has to be able to produce powerful and controlled movements that can be transferred to a prosthesis.
Wound care after surgery - To decrease the risk of infection, keep your wound clean and dry or as per the cleaning advice provided by your doctor or nurse. Clean the area surrounding the wound gently with mild soap and water. Do not rub the incision as it may expose to infection before it is totally healed. Check your stump every day and look for any redness or dirt. Wear stump protector whenever you are out of bed. Take good care of your residual limb to prepare for prosthesis fitting.
Elastic bandage / stump shrinker - to prevent/control oedema (swelling of residual limb) and to help create a limb shape that is suitable for prosthesis fitting. Rewrap it every 2 to 4 hours.
Physiotherapy/ Exercise - Practice exercises to maintain the muscle strength and joint range of motion to be able to move the prosthesis. Patient’s standing balance is also trained so they can adopt well after prosthesis fitting.
Potential condition/problem of residual limb after wearing prosthetic leg
Abrasions – rubbing between prosthesis and skin. It may cause or form blisters / raw skin surfaces.
Skin Infection – pus-filled infection with a core of dead tissue. It usually occurs around hair root. Medical care may be required before prosthesis is fitted.
Bone spurs – Bone outgrowths.
Bursa – Sac filled with thick fluid that lies under the skin and over bony prominence.
Process Of Making A Prosthetic Limb
When your residual limb is ready for prosthesis casting, that is when your wound is completely healed and no more swelling on residual limb, a plaster cast of residual limb using bandage will be done by the prosthetist to obtain an exact negative cast of your residual limb.
Filling - The cast is the filled with Plaster of Paris and serve as mold/positive cast. Modification - Any changes or correction to accommodate the anatomical shape of user alignment will be modified on the mold.
Fabrication - The plastic (different type based on different requirement) is heated in the oven until pliable and draped over the mold under vacuum suction to ensure it follow the shape of the mold nicely. The mold is then taken out and the plastic shell is trimmed. Socket is produced and attached to the other components such as adapter, pylon tube and prosthesis foot.
The prosthesis made is then fitted on patient’s residual limb. The height of the prosthesis can be adjusted through pylon tube and the alignment is also adjusted according to user’s walking pattern. Patient is asked to walk with two side bar support. After several days of training with best fit adjustment on the prosthesis, the final stage would be cosmetic restoration on the prosthesis by duplicating the shape of patient’s sound limb. The prosthesis is now ready for use.
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