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total surface bearing socket uniform pressure, can be achieved because of thickness and properties of roll on liner
residual limb contour related to ability to bear weight conical, cylindrical, bulbos
above knee socket design plut fit, quadrilateral, ischial containment, narrow M-L, Contoured Adducted Controlled Alignment Method (CAT-CAM), Mario Ortiz Socket or M.A.S.-great socket
Quadrilateral Four Walled, tuberosity on seat
levels of amputation Lisfrank, Chopart, Symes, Below Knee, (Trans tibial), Knee Disarticulation, Above Knee-Trans femoral-less leverage harder to control, Hip Disarticulation, Hemipelvectomy-cant walk restore sitting balance
B-K Socket design ability to support weight, plug fit
socket styles BK plug fit, patella tendon bearing-medial flare of tibia 60-70% if weight, total contact, total surface bearing
patella tendon bearing socket PTB soft tissue versus bony areas
M.A.S. Ramus controlled socket, similar benefit to Ischial containment, more intimate, more control, more cosmetic, more ROM, more difficult, butt cheek out and looks normal in pants
quadrilateral socket mid-stance socket more lateral without ischial tuberosity containment
below knee socket skin checked for pressure areas-patella tendon bar marking apporpriate area, total contact, distal contact, accurate control of prosthesis, patient comfort
above knee socket quadrilateral socket, tuberosity on seat at mid-stance, distal contact, no space otherwise edema and pain
ischial containment tuberosity in socket
result of volumetric inconsistencies ishial containment rotational whips, prosthesis too long or too short-bulging skin, general fitting problems, too tight or too lose rotational whips, foot whips one way or the other
ishcial ramal containment fitting and application principles Height-checked by palpating crests look to see if level, remember to check for pelvic obliquities-one hip lower.patient comfort is the determing factor, experiment with lifts, obese patient palpate ASIS or look for PSIS
possible remedies for discomfort swelling adjust socks to compensate for volume changes, apply ace wrap or shrinker to reduce swelling, elevate and wrap to decrease swelling
application be sure the interface materials are on without wrinkles, make sure liner is put on before limb put in the socket, check rotational orientation of socket, check proper amount of tissue in the socket, check prosthesis is secure
prosthetic prescription factors patient related, activity level prior to amputation, weight, strength, proprioception, ROM, general health, age, vocation, hobbies, financial resources
Created by: mloft