Bryan Humble CPO/LPO Precision Prosthetics PROSTHETIC COURSE Bryan Humble CPO/LPO Precision Prosthetics

AMPUTATION LEVELS TRANS TIBIAL (BELOW KNEE) TRANS FEMORAL (ABOVE KNEE) HIP DISARTICULATION / HEMIPELVECTOMY

TRANS TIBIAL (BELOW KNEE) PHALANGEAL TRANSMETATARSAL LIS FRANC CHOPART SYMES TRANSTIBIAL SHORT MEDIUM LONG

TRANS FEMORAL (ABOVE KNEE) KNEE DISARTICULATION TRANS FEMORAL SHORT MEDIUM LONG

HIP DISARTICULATION / HEMIPELVECTOMY

MAJOR COMPONENTS SUSPENSION LINER KNEE JOINTS SOCKET PYLON FOOT

SUSPENSION SUCTION SILICONE WITH LOCK SLEEVE PTB CUFF JOINT AND CORSET BELT

LINERS SILICONE PELITE C-FLEX HARD SOCKET

KNEE JOINTS LOCKING SINGLE AXIS SAFETY 4-BAR HYDRAULIC COMPUTER CONTROLLED

FEET SACH SINGLE AXIS MULTI-AXIS ENERGY STORING (SEATTLE) DYNAMIC RESPONSE (FLEX FOOT)

COMPONENT SELECTION MUST MATCH PATIENT AND ACTIVITY LEVEL. *(K-LEVEL)

INSURANCE REIMBURSEMENT MEDICARE REIMBURSEMENT MEDICAID REIMBURSEMENT PRIVATE INSURANCE FUNDING SOURCES FOR AMPUTEE TEXAS REHAB SSD UASA (BARR FOUNDATION) MEDICARE USUALLY ALLOWS ONE PROSTHESIS PER YEAR IF DOCUMENTED AS MEDICALLY NECCESARY.

SOCK BALANCING SOCK BALANCE IS ONE OF THE MOST IMPORTANT FACTORS IN SUCCESSFUL PROSTHESIS USE. 1, 2, 3 & 5 PLY SOCKS SUPPLIED MAINTAIN “SNUG” FIT AT ALL TIMES. SHORT SOCKS

HYGENE STUMPS SOCKS CHANGED EVERY DAY SILICONE LINER CLEANED & DISINFECTED EVERY DAY.

SHRINKER USE MUST BE WORN ANYTIME NOT IN PROSTHESIS. (USUALLY IN THE 1ST YEAR OF POST-OP) SHRINKERS MAINTAIN VOLUME CONSISTANCY.

GAIT DEVIATIONS & CAUSES (TRANSTIBIAL) HEEL STRIKE TO MIDSTANCE AT MIDSTANCE MIDSTANCE TO TOE OFF

HEEL STRIKE TO MIDSTANCE EXCESSIVE KNEE FLEXION (CAUSES) PROSTHETIC EXCESSIVE D.F. OR S.F. STIFF HEEL ANTERIOR SKT. OTHER FLEXION CONTRACTURE

HEEL STRIKE TO MIDSTANCE ABSENT KNEE FLEXION (CAUSES) PROSTHETIC EXCESSIVE P.F. SOFT HEEL ANTERO-DISTAL PAIN OTHER WEAK QUADS HABIT

AT MIDSTANCE LATERAL THRUST (CAUSES) PROSTHETIC MEDIAL FOOT ABDUCTED SKT. SKT. M-L LOOSE OTHER LIGAMENTOUS LAXITY @ KNEE

MIDSTANCE TO TOE OFF EARLY FLEXION (DROP OFF) DELAYED FLEXION ANT. DISPLACEMENT SKT. POST. DISPLACEMENT OF KEEL EX. D.F. OF FOOT SOFT D.F. BUMPER DELAYED FLEXION POST DISPLACEMENT SKT. ANT DISPLACEMENT OF KEEL EX. P.F. OF FOOT HARD D.F. BUMPER

GAIT DEVIATIONS & CAUSES (TRANS FEMORAL) LATERAL TRUNK BENDING ABDUCTED GAIT CIRCUMDUCTION VAULTING SWING PHASE WHIPS FOOT ROTATION @ HEEL STRIKE FOOT SLAP UNEVEN HEEL RISE TERMINAL IMPACT 10 UNEVEN STEP LENGTH 11 EXAGERATED LORDOSES

LATERAL TRUNK BENDING PROSTHETIC OTHER (CAUSES) WEAK HIP ABDUCTORS ABDUCTED SKT. LATERAL SKT. WALL PAIN D.L. FEMUR SHORT TFB OTHER WEAK HIP ABDUCTORS ABDUCTED GAIT

ABDUCTED GAIT PROSTHETIC OTHER (CAUSES) PAIN IN PERONEAL AREA LONG TFP VALGUS ALIGNMENT HIP JT. MISALIGNED OTHER CONTRACTED HIP ABDUCTORS PATIENT INSECURITY - COMPENSATES WITH WIDE GAIT (CAUSES)

CIRCUMDUCTION PROSTHETIC OTHER (CAUSES) MECHANICAL INSUFFICIENT KNEE FLEXION (FEAR) LOCKED KNEE TIGHT EXT. ASSIST TIGHT KNEE FRICTION POOR SUSPENSION - CAUSES “PISTONING” SKT. SMALL EX. PF

VAULTING PROSTHETIC OTHER (CAUSES) LONG TFP (LOCK, SUSP. FRICTION EX. PF. INSUFFICIENT OR EXCESSIVE KNEE FRICTION OTHER INSUFFICIENT KNEE FLEXION (FEAR) HABIT

SWING PHASE WHIPS PROSTHETIC OTHER (CAUSES) KNEE JOINT MISALIGNED TIGHT OR IMPROPER SKT. CONTURE OTHER WEAK OR FLABBY MUCULATURE

FOOT ROTATION AT HEEL STRIKE (CAUSES) PROSTHETIC HARD PF CUSHION OR PF BUMPER

FOOT SLAP (CAUSES) PROSTHETIC PF BUMPER TOO SOFT

UNEVEN HEEL RISE PROSTHETIC OTHER (CAUSES) INS. KNEE FRICTION ABSENT OR LOOSE EXT. AID !EXCESSIVE! OTHER FORCEFUL HIP FLEXION BY PATIENT

UNEVEN HEEL RISE PROSTHETIC OTHER (CAUSES) EX. KNEE FRICTION EX. AID TIGHT MANUAL LOCK !INSUFFICIENT! OTHER FEAR / AMPUTEE WALKS WITH LITTLE OR NO KNEE FLEXION

TERMINAL IMPACT PROSTHETIC OTHER (CAUSES) INS. KNEE FLEXION TIGHT EX. AID EXTENSION BUMPER DEF. OTHER AMPUTEE FEAR OF KNEE BUCKLING

UNEVEN STEP LENGTH PROSTHETIC OTHER (CAUSES) LACK OF FRICTION OR LOOSE EXT. AID INSUFFICIENT SKT. FLEXION OTHER PAIN / INSECURITY HIP FLEXION CONTRACTURE

EXAGGERATED LORDOSIS PROSTHETIC OTHER (CAUSES) INSUFFICIENT SKT. FLEXION INSUFFICIENT SUPPORT - ANTERIOR SKT. BRIM OTHER HIP FLEXION CONTRACTURE WEAK HIP EXTENSORS WEAK ABDOMINALS