? Types of prosthesis
? Materials used
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? Prescription Criteria
? Recent Advancement
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2Prosthetics
? The branch of medicine dealing with the Study, Production and
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use of artificial body parts.Prosthesis
? It is an artificial device extension that replaces a absence/lost
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body part.
Prosthetist
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? The professional skilled in making or fitting prosthetic devices3
Types based on Function:
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? Functional Prosthesis (Body-powered or Externally powered
system )
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? Cosmetic Prosthesis? Activity Specific Prosthesis
Types Based on Design:
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? Exoskeletal Design
? Endoskeletal Design
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4? 1) Wood - commonly willow which is light weight, resilient
& easily shaped.
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? 2) Aluminum & its alloys which is light weight, rust free &durable.
? 3) Plastic and PVC materials.
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? 4) Carbon fiber light weight, strong , rust free and durable.
? 5) Leather derivatives.
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? 6) costly metals Titanium, Ni, Co etc.5
? Body-powered prostheses: use forces generated by body
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movements transmitted through cables to operate joints and
terminal devices.
? Externally powered prostheses: use muscle contractions or manual
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switches to activate the prosthesis.
1) Myoelectrically controlled prosthesis - using surface electrodes
to detect electrical activity from select residual limb muscles to
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control electric motors.2) Switch-controlled prostheses - A switch can be activated by the
movement of a remnant digit or part of a bony prominence against
the switch or by a pull on a suspension
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? The two-site/two-function (dual-site) system
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? One-site/two-function (single-site) system9
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? Multi-articulating myoelectric hands
? Individual motors in each finger
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? Microprocessors continuously monitorthe position of each finger
? Automatically senses when a gripped
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item
? Different grip patterns
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131) Exoskeletal Design
2) Endoskeletal Design
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? Socket ? Interface between stump and
prosthesis- most important.
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? Suspension ? which holds prosthesis.? Prosthetic shank ? mounting block & ankle
block in exoskeletal & pylon in endoskeletal
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prosthesis.
? Prosthetic joint ? knee, ankle
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? Foot / ankle foot assembly.15
? Fork strap with waist belt
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? Cuff
? Sleeve
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? Supracondylar? Supracondylar supra-patelar
? Gel or elastomeric
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? Suction
? Vacuum assisted
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? Pin-locking16
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1) Quadrilateral Socket
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2) Ischial containment socket
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Socket design--? Plug fit(obsolete)
? Patellar Tendon Bearing(PTB)
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? Total Surface Bering(TSB)
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? Manual locking
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? Single axis with constant friction? Weight-activated stance control (safety knee)
? Polycentric
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? Hydraulic or pneumatic swing phase control
? Hydraulic swing and stance control
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? Microprocessor control (stance or stance and swing phasecontrol)
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1) SACH foot
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2) Single axis foot3) Multi-axial foot
4) Dynamic response foot
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? Long residual limb & end weight bearing
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? Poor cosmesis & limited foot options? Three conventional types
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? AFO style prosthesis is usually
needed
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? It extends upto the the pateller
tendon to distribute forces
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23? Medical factors
? Amputation type
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? General health
? Stump
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Stump : Scar, skin, neuroma, spur, hypersensitivity, redundanttissues, range of motion, strength and phantom pain
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? Patient's requirement
? Activity Level
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? Socio-Economic Condition
? Personal preference
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? Availability25
Patient's Vocation
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? Executive / Businessman
Better limbs (sophisticated)
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? Manual workerHeavy duty (conventional)
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? Infant ? Soft prosthesis
? Child ? Light weight limb
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? Adolescent - Functional limb advanced version limb
? Adult - Functional limb advanced version limb
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? Elderly ? Light weight limb? Female ? Better cosmetic limb
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? Old amputee has good experience of previous prosthesis
? Knows the pros and cons
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? Take advantage of his experience with previous prosthesis
? No need to change.
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29? May be unrealistic
? Listen
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? May be possible / impossible
? Do the needful most suitable
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30? For a 24 year old female teacher sustained an open
comminuted fracture & had a mid-thigh amputation after
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osteomyelitisAdv.
? AK Prosthesis with
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? Total contact thermoplastic Ischial containment socket
? TES belt suspension
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? Hydraulic knee joint? Lightweight dynamic-response foot
? Cosmetic foam cover
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? For a 72 year old retired man with type II diabetes & peripheral
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vascular disease with BK amputation for infected non-healingulcer & gangrene
Adv.
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? BK Prosthesis with
? total contact PTB thermoplastic socket
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? foam liner (soft insert)? lightweight align able shank
? SACH foot
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Thank you
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