This document provides an overview of prosthetics and orthotics. It defines prosthetics as devices that replace missing body parts, while orthotics are devices that support or correct limb or torso function. Various materials are used for prosthetics and orthotics including metals, plastics, wood, leather, rubber and fabric. The document outlines the specifications and types of prosthetics and orthotics used for different parts of the body, such as the upper and lower limbs as well as the spine. It provides details on the components, suspension systems and various models of prosthetic knees, feet and orthotic devices.
2. INTRODUCTION
PROSTHESIS: IT’S A DEVICE DESIGNED TO
REPLACE A MISSING PART OF THE BODY OR
TO MAKE A PART OF THE BODY WORK
BETTER.
ORTHOSES: IT’S A DEVICE THAT SUPPORTS OR
CORRECTS THE FUNCTION OF A LIMB OR THE
TORSO
3. • SPECIFICATIONS FOR IDEAL
PROSTHESIS/ORTHOTICS:
1. FUNCTION:
a) MEET USERS NEED
b) SIMPLE
c) EASILY LEARNED
d) DEPENDABLE
2.COMFORT:
a) FITS WELL
b) EASY TO PUT ON AND TAKE OFF
c) LIGHT WEIGHT
d) ADJUSTABLE.
7. 1)METALS:
A)STEEL:USED IN – PROSTHETIC &
ORTHOTIC JOINTS,METAL
BANDS,CUFFS,SPRINGS,BEARINGS.
B)ALUMINIUM: UPPER
EXTERIMITIES,PEDIATRIC,WHERE WT IS A
MAJOR CONCERN
C)TITANIUM:HIGH COST
8. 2)PLASTICS:
CAN BE MADE INTO COMPLEX
ANATOMIC SHAPES
A)THERMOPLASTICS: LOW TEMPERATURE
THERMOPLASTICS:UPPER LIMB ORTHOTICS &
TEMPORARY USE(# BRACE).HIGH TEMPERATURE
PLASTICS
B)THERMOSETTING:
11. IMPORTANT CHARACTERISTICS OF P & O
MATERIALS :
1)STRENGHT
2)DURABILITY
3)DENSITY
4)CORROSION RESISTANCE
5)EASE OF FABRICATION
6)COST & AVAILABILITY
12. PROSTHETICS
• 1. UPPER LIMB:
THE SHOULDER PROVIDES THE
CENTRE OF RADIUS OF THE FUNCTIONAL
SPHERE OF UPPER LIMB,THE ELBOW ACTS A
CALIPER TO POSITION THE HAND.
• MULTIPLE JOINT-SEGMENT ACTIVITIES ARE
USUALLY DONE SIMULTANEOSLY,WHERE AS
UPPER LIMB PROSTHESES PERFORM THESE
TASKS SEQUENTIALLY,THUS LIMB SALVAGING
IS MORE CRITICAL FOR UPPERLIMB.
13. • AFTER AMPUTATION PROSTHETIC FITTING
SHOULD BE DONE AS SOON AS POSSIBLE,EVEN
BEFORE COMPLETE WOUND HEALING HAS
OCCURRED.
• MYOELECTRIC PROSTHESES PROVIDE GOOD
COSMESIS & ARE USED FOR SEDENTARY WORK.
• BODYPOWERED PROSTHESIS ARE USED FOR
HEAVY LABOUR.
14. WHEN RESIDUAL FOREARM IS SO SHORT:
SUPRACONDYLAR SUSPENSION (MUNSTER
SOCKET) AND STEP UP HINGES CAN BE USED
TO AUGMENT FUNCTION.
THE BEST FUNCTION WITH LEAST WEIGHT AT
LOWEST COST IS PROVIDED BY HYBRID
PROSTHETIC SYSTEMS –MYOELECTRIC+BODY
POWERED+BODY DRIVEN.
15.
16. WHEN THE LEVER ARM CAPACITY OF THE
PROXIMAL TRANSHUMERAL OR SHOULDER
DISARTICULATION AMPUTATIONS,LTD
FUNCTION IS ACHIEVED – MANUAL
UNIVERSAL SHOULDER JOINT POSITIONED BY
THE OPPOSITE HAND,COMBINED WITH LIGHT
WEIGHT HYBRID PROSTHETIC COMPONENTS.
17. LOWER LIMB PROSTHETICS:
1.PROSTHETIC KNEES:
USED IN TRANSFEMORAL &
KNEE DISARTICULATION PROSTHESES AND
CHOSEN BASED ON PATIENT NEEDS,THEY
PROVIDE CONTROLLED KNEE MOTION.
ALIGNMENT
STABILITY(POSITION OF PR. KNEE IN
RELATION TO PATIENTS LINE OF WEIGHT
BEARING:
POSTERIOR:STANCE CONTROL ;MAKES
FLEXION DIFFICULT.
18. ANTERIOR:FLEXION IS EASY,CONTROL
DIFFICULT
SO, ONLY THE POLYCENTRIC KNEE TAKES
ADVANTAGE- HAS A VARIABLE CENTRE OF
ROTATION.
SIX TYPES:B
1.POLYCENTRIC(4- BAR LINKAGE)
2.STANCE PHASE CONTROL
3.FLUID CONTROL
4.CONSTANT FRICTION
5.MANUAL LOCKING KNEE
19. 1.POLYCENTRIC KNEE:
HAS A MOVING INSTANT
CENTRE OF ROTATION,ITS RECOMMENDED
FOR :
a)PATIENTS WITH TRANSFEMORAL
AMPUTATIONS
b)PATIENTS WITH KNEE DISARTICULATIONS
c)B/L AMPUTEES
21. 3.FLUID CONTROL KNEE:
1. ALLOWS ADJUSTEMENT OF
CADENCE RESPONSE BY CHANGING RESISTANCE TO
KNEE FLEXION – PISTON MECHANISM.IT PREVENTS
EXCESSIVE FLEXION & IS EXTENDED EARLIER IN THE
GAIT CYCLE – FLUID GATE
USED-ACTIVE PATIENTS ;GREATER UTILITY &
VARIABILITY @ EXPENSE OF MORE WEIGHT.
22.
23. 4.CONSTANT FRICTION KNEE:
DAMPEN KNEE SWING
VIA SCREW/RUBBER PAD THAT APPLIES
FRICTION TO THE KNEE BOLT.
USED ON UNEVEN TERRAIN
MOST COMMON KNEE USED IN CHILDHOOD
PROSTHETICS
DISADVANTAGE: ALLOWS ONLY SINGLE –SPEED
WALKING & RELIES ON ALIGNMENT FOR STANCE
PHASE
24.
25. 5.VARIABLE FRICTION KNEE(CADENCE
CONTROL):
ALLOWS RESISTANCE TO
KNEE FLEXION TO INCREASE – KNEE
EXTENDS BY EMPLOYING A NUMBER OF
STAGGERED FRICTION PADS.
ALLOWS WALKING @ DIFFERENT SPEEDS
NOT DURABLE,NOT AVAILABLE IN
ENDOSKELETON
26.
27. 6.MANUAL LOCKING KNEE:
CONSISTS OF CFK
HINGE WITH A POSITIVE LOCK IN EXTENSION
THAT CAN BE UNLOCKED TO ALLOW
FUNCTION SIMILAR TO CFK
LTD INDICATIONS:WEAK UNSTABLE
PATIENTS,BEGINNERS,BLIND AMPUTEES
38. 3)SAFE FOOT(STATIONARY ATTACHMENT
FLEXIBLE ENDOSKELETAL):
PERMITS TRIPLANAR MOVT.& EASY ROLL-OVER
LIGHT WEIGHT-OLDER PEOPLE
4)MULTIAXIAL FOOT:
PROVIDE MORE ANKLE MOTION
ENDOSKELETAL & EXOSKELETAL PROSTHESES
ADVANTAGES:
A)ALLOWS MOTION IN ALL PLANES
39. B)REDUCES TORQUE ON RESIDUAL LIMB
C)ADJUSTABILITY
DISADVANTAGES:
A)INCREASED WT
B)INCREASED MAINTAINENCE
C)DECREASED COSMESIS
LESS STABILTY ON SMOOTH SURFACES
40. 5)FLEXIBLE KEEL DYNAMIC – RESPONSE FEET:
INDICATED FOR PEOPLE – GAIT PATTERNS
GENERATE ENOUGH ENERGY
ELASTIC KEEL STRUCTURES- ABSORB ENERGY
DURING MIDSTANCE & TERMINAL
STANCE,RELEASE IT DURING PRESWING &
INITIAL SWING
DURABILITY OF MATERIAL IS NOT TESTED
41.
42. ORTHOSES:
STATIC/DYNAMIC/COMBINED
NAMED ACCORDING TO THE JOINTS THEY
CONTROL & METHODS
THE FOLLOWING ARE USED:
A)SHOES-DIABETIC SHOES:XTRA DEPTH,SACH
HEELS:PARALYTIC FOOT,ROCKER
SOLE:METATARSALGIA,HALLUX RIGIDUS &
FOREFOOT PROBLEMS
43. B)FOOT ORTHOSES:
THEY ARE USED TO:
1)ALIGN & SUPPORT
2)PREVENT,CORRECT/ACCOMODATED
DEFORMITIES
3)IMPROVE FOOT FUNCTION
3 TYPES:RIGID,SOFT,SEMIRIGID
RIGID:FLEXIBLE DEFORMITIES
SOFT:FIXED DEFORMITIES
44.
45. C)A.F.O:
MOST COMMONLY USED TO CTRL ANKLE JOINT
GOALS:ABSORPTION OF GROUND REACTION
FORCES,PROTECTION OF FUSION
SITES,PROTECTION OF MIDFOOT
D)K.A.F.O:
EXTENDS :UPPER THIGH – FOOT
CONTROL UNSTABLE /PARALYSED KNEE JOINT
PROVIDES MEDIOLATERAL STABILITY
46.
47. E)H.K.A.F.O:
PROVIDES HIP & PELVIC STABILITY
RARELY USED
USED IN CHILDREN WITH UPPER LUMBAR
MYELOMENINGOCELE
F)ELBOW ORTHOSES:
HINGE ELBOW ORTHOSES-LIGAMENT
INSTABILITIES
DYNAMIC SPRING LOADED ORTHOSES-
FLEXION/EXTENSION CONTRACTURE
48.
49. G)W.H.O:
USED FOR POSTOP CARE AFTER
INJURY/RECONSTRUCTIVE SURGERY
STATIC/DYNAMIC
OPPONENS SPLINT-PREPOSITIONING THUMB
LOWER CERVICAL QUADRIPLEGICS
LT.FACTORS:WT & CUMBERSOMNESS
50. H)FRACTURE BRACES:
TREATMENT OF ISOLATED # TIBIA & FIBULA
PRE-FABRICATED:ANKLE#,ANKLE
SPRAIN,HAND INJURIES
I)PEDIATRIC ORTHOSES:
THE PAVLIK HARNESS – TREATMENT OF
DEVELOPMENTAL DISLOCATION OF HIP
USED IN PERTHES DISEASE