Immediate Post-Op Prosthesis

Physicians and therapists generally refer their patients for prosthetic evaluation after their amputation. The prosthetist and therapist will work with the physician to formulate a proper prosthetic prescription for each patient.

Before the new amputee is considered for a prosthesis, he or she should be actively involved in a limb care program with his or her physical therapist/occupational therapist. This program should include:

• Edema control- ace wrapping or wearing a stump shrinker to reduce swelling.
• Range of motion/flexibility exercise- to prevent joint contractures and maintain strength in the affected limb as well as the entire body.
• Limb hygiene- to promote healing and decrease limb sensitivity

GENERAL INFORMATION
Temporary prostheses, as the name implies, are intended for short-term use, usually for two to four months. They are custom-fabricated on the patient and are designed to:

• Assist in overcoming psychological barriers in becoming a recent amputee
• Control swelling and edema
• Promote earl ambulation (walking)
• Expedite preparation of the stump for successful definitive prosthetic fitting.

Regardless of if the patient is an AK (transfemoral/above knee) of BK (transtibial/below knee) amputee, the principles of using this temporary are the same. Muscles make up the major portion of the stump and, through a natural process, they will shrink due to their non-use. This will occur rapidly at first, but can continue for an extended period. The status of the limb will be evaluated frequently and multiple cast changes will be required as shrinking occurs.

When it is determined that as much shrinking has occurred as can be expected, the patient will be evaluated and measured for a definitive (permanent)type prosthesis. The permanent prosthesis will encompass components that have been selected long-term use and will present a cosmetic appearance.

WEARING THE TEMPORARY PROSTHESIS
The temporary prosthesis (cast) is made up of a solid material that will not change in size. However, the stump will. Therefore, the patient will receive stump socks to take up the loose feeling in the socket. Socks come in a variety of thicknesses. The patient must remember to wear as many ply of socks as needed to maintain a snug fit within the socket while using the least number of socks in combination.

PYLON AND FEET:
The pylon for BK temporary prostheses is simply an extension from the prosthetic cast to the prosthetic foot that allows for alignment changes to be made. The pylon for AK is an extension between prosthetic cast and prosthetic foot incorporation a prosthetic knee that can be utilized either locked or unlocked. The pylons detach from the prosthetic cast by means of a thumbscrew. This is important because physicians may require extended wear of the prosthetic casts in some cases.All prostheses are attached to the prosthetic foot. There are many types of feet available for use and the prosthetist can determine which type is best for the patient.

ADDITIONAL INFORMATION
Shrinkers:
When the prosthetist provides the patient with a shrinker, it must be worn properly:

1. Always pull it up tightly so that there is no loose material at the bottom
2. Always wear it when the cast is not on, such as when sleeping , it may be removed to bathe. *remember--sitting in a hot tub for even a short time may cause the stump to swell.
3. The shrinker is never worn inside the prosthesis. Use only the stump socks provided.

Safety:
Inspect the temporary prosthesis before each use. Ensure all screws are tight. If anything should look or sound broken, call the prosthetist to inspect it.

Skin Care:
The patient should wash the stump and socks daily. If any irritation, discoloration, or drainage is noted, check the proper number od socks is worn with the prosthesis. If irritation persists, call the prosthetist to have adjustments made.

The temporary device is intended for short-term use. Activity levels of patients vary. Safety must be adhered to.

If you have further questions, follow the physician's advice.