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

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

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

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

7. HIP DISARTICULATION / HEMIPELVECTOMY

9. MAJOR COMPONENTS
SUSPENSION
LINER
KNEE JOINTS
SOCKET
PYLON
FOOT

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

12. LINERS
SILICONE
PELITE
C-FLEX
HARD SOCKET

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

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

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

19. 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.

20. 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

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

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

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

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

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

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

28. 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

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

30. 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

31. 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)

32. 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

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

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

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

36. FOOT SLAP
(CAUSES)
PROSTHETIC
PF BUMPER TOO SOFT

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

38. 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

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

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

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