By Robin McRae, CP, LP, Comprehensive Prosthetics and Orthotics
According to the National Limb Loss Information Center, in the United States there are approximately 1.7 million people living with limb loss. It is estimated that one out of every 200 people in the U.S. has had an amputation. The most common reasons for amputation are vascular complications (mainly diabetes), cancer and trauma. Regardless of the reason for an amputation, every individual’s personal experience of limb loss is unique; many amputees have successfully overcome the loss or absence of a limb and regained function and a positive outlook.
When faced with amputation there are many questions and concerns that go through one’s mind. The more information a person has prior to surgery the better the outcome can be. There will be many questions along the way as one prepares for amputation and the best course to take is to communicate with those who will be a part of the rehabilitation team. A physician, physical therapist, occupational therapist and prosthetist are those who will help an individual become a successful wearer of a prosthetic device but it is ultimately up to the individual to take charge of his/her care and their life as an amputee.
Once surgery has been completed there are several methods of post-operative care a surgeon may use, depending mostly on current health status, condition of the residual limb and the potential one has to become a prosthetic candidate. After the initial surgical dressing is removed, a person may receive a device that is intended to control edema, protect the limb, provide a way of early gait-training during therapy; or a combination of all three.
Rehabilitation begins soon after surgery. Physical therapy begins in the hospital and usually continues once discharged home. Once a person has been fit with their first prosthesis, usually 6-8 weeks after surgery, depending on the individual; therapy is then continued in an out-patient therapy setting.
When the physician has given clearance to begin the process of obtaining a prosthesis, the prosthetist will take a cast or scan of the residual limb. This will provide him/her with a model to make the prosthesis. Prior to this appointment he/she will have assessed the individual needs and goals of the amputee. This includes but is not limited to the current or expected activity level of the amputee, weight, occupation or leisure activities, current health status, and the condition of the residual limb. This information is extremely important when determining the components and which type of prosthetic device is most suitable.
A clear plastic diagnostic socket is made from the model; this is used for the initial fitting. The diagnostic socket allows the prosthetist to make changes to the fit of the prosthesis or to change the alignment as the amputee begins to walk in therapy. Typically the diagnostic socket is utilized for one to two weeks during physical therapy or until an appropriate fit has been established.
Once the fit of the prosthesis has been determined and no immediate changes are needed, a definitive (permanent) prosthesis will be made. A definitive prosthesis is a much stronger and more durable version of the diagnostic socket that was used in the fitting process. This socket is constructed of carbon fiber, nylon, resin and other materials that give it its strength. The look of the prosthesis can be as original as the individual or it can be made to resemble the other leg by adding a soft foam shaped cover.
To become a successful wearer of a prosthesis it is best to follow the recommendations of the physician, prosthetist and physical therapist and it is imperative to follow through with all appointments and call when there are any questions or concerns. Facing limb loss can be a very challenging and stressful time in a person’s life and being as prepared as possible by talking to the professionals who will assist after amputation or even other amputees is a positive way to begin the process.
Robin McRae is a Certified/Licensed Prosthetist at Comprehensive Prosthetics & Orthotics, Inc. (CPO). CPO provides patients in Central Illinois with prosthetic and orthotic devices and care, and also houses an on-site fabrication department where custom orthoses and prostheses are designed and created for each patient. CPO can be reached by calling toll free 888-676-2276. Visit the website at www.cpousa.com.
Photos courtesy of Comprehensive Prosthetics and Orthotics