Download MBBS Physical Medicine and Rehabilitation Presentations 15 Prosthesis Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) 1st Year, 2nd Year, 3rd Year and Final year Physical Medicine and Rehabilitation 15 Prosthesis PPT-Powerpoint Presentations and lecture notes


AMPUTATION: PROSTHESIS

Prosthesis
? An artificial substitute
? replace the lost part of the body
? appearance and function

? Objectives of LL prosthesis

? Transfer body weight

? Simulate normal locomotion

? Objectives of UL prosthesis

? Simulate normal hand function


ORTHOSIS

An external device applied on the body to:-
?Limit motion
?Correct deformity
?Reduce axial loading
?Improve function in certain segment of the body.

Functional levels




Lower Limb Amputation level

Lisfranc / chopart amputation

The options are

1. high-top shoe with fil er



2. AFO with fil er


Syme's amputation

socket extends proximally

til the patellar tendon

to make it easier to insert



the bulbous stump inside

a window is provided

(medial / posterior)

or

a flexible inner wall

is used

suspension is provided

by a constriction proximal to

SACH / dynamic response foot

the bulbous end

Below Knee/Transtibial Prosthesis

Suspension Cuff

PTB Socket

Prosthetic Shank / Shin

Foot Ankle Assembly




B/K amputation

? foot-ankle assembly

types

# SACH foot

# single axis foot

# multiaxis foot

# dynamic response foot

# jaipur foot

# madras foot

B/K amputation

# exoskeletal

# endoskeletal/modular




B/K amputation

? socket

types

? PTB socket
? total surface bearing



B/K amputation

? suspension

types

# supracondylar cuff

# sleeve

# distal attachment

# suction

# thigh corset

# fork strap & waist belt




Above Knee/Transfemoral Prosthesis

Socket (Quad Socket

or Ischial containment)

Silesian Suspension

Knee Unit

Prosthetic Shank / Shin

Foot Ankle Assembly

Knee Joints

? Constant Friction Single axis knee joints
? Manual Locking knee
? Polycentric knee units
? Weight Activated Stance Control knee
? Hydraulic knee units
? Pneumatic knee units
? Microprocessor controlled knee joints




A/K amputation

quadrilateral

socket

ischial

containment

socket

A/K amputation

? suspension

types

# suction

# silesian belt

# hip joint & pelvic band

# total elastic suspension belt

# shoulder suspension


Knee disarticulation prosthesis

# knee joints

the options are

1. outer hinges

2. polycentric knee joint



hip disarticulation / hemipelvectomy / <5 cm residual femur




translumbar amputation / hemicorpectomy

? for sitting

bucket prosthesis

slits for bladder / bowel

drainage bags

Proximal focal femoral deficiencies

? extension prosthesis

features
? socket ? is like an AFO
? if adequate weight-bearing is not

possible on the foot, the socket is

extended upto the ischium
? below the socket

a shoe raise is given



(if limb length discrepancy is less)

or



a prosthetic foot is given

(if limb length discrepancy is more)


energy consumption

? traumatic unilateral B/K 7% more than non-amputees
? vascular unilateral B/K 25%
? traumatic unilateral A/K

25%

? vascular unilateral A/K

87%

? bilateral amputees

more

UPPER LIMB LEVELS OF AMPUTATION

? Transphalangeal

? Transmetacarpal

? Transcarpal

? Wrist disarticulation

? Transradial

? Elbow disarticulation

? Transhumeral

? Shoulder disarticulation

? Forequarter amputation
MAJOR MOTOR FUNCTIONS OF THE HAND

? GraspSpherical

Cylindrical

Hook

? Release

? Precision

Pinch-tip to tip, pulp to pulp, lateral key

Three jaw chuck



VARIOUS UPPER LIMB PROSTHESES

? Cosmetic: least function
? Body powered: most harnessing & body movt. needed
? Battery powered (myoelectric or switch controlled): heavy, expensive

& extended therapy time

? Hybrid (cable to elbow or TD and battery powered)




BODY POWERED PROSTHESES : COMPONENTS

? Socket
? Suspension
? Control cable system
? Terminal device
? Interposing joints (wrist, elbow, shoulder)

TERMINAL DEVICES



1.Passive: cosmetic hand , flexible mitts

2.Active: hook devices , prosthetic hand



a. Voluntary opening



b. Voluntary closing




CONTROL CABLE MECHANISMS

SOCKET

? Socket
dual-wall design




SUSPENSION

Harness

1.Figure of 8/ Standard trans radial harness

2.Shoulder saddle and chest strap

Self suspending

1.Muenster

2.Supracondylar

Suction

1.Suction socket with air valve

2.Gel sleeve with locking pin

JOINTS: WRIST, ELBOW & SHOULDER UNITS


External y powered prostheses/Myoelectric prostheses

BIONIC HAND

This post was last modified on 08 April 2022