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    AMPUTACIONES DEL MIEMBROINFERIOR Y DISPOSITIVOS

    ORTOPDICOS

    HOSPITAL NACIONAL EDGARDO REBAGLIATI MARTINSDEPARTAMENTO DE MEDICINA FSICA Y REHABILITACIN

    PRESENTADO POR:MR E.T.C

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    Aim of prosthesis fitting

    to substitute for a lost part and torestore lost function.

    In the lower extremityprosthesis must permitcomfortable ambulationminimal expenditure of energy.

    Reduction of energy requirementdepends on minimizing the shift ofthe center of gravity of the bodyduring gait

    by a well-fitted socket and properalignment.

    But for upper limb:It is difficult to get the function as it

    is not possible to replace theormal !and"

    center of r!"#t$ of t%e&o'$ '(r#n !#t )%ee*'oe+ not 'e"#!te fro,+tr!#%t *#ne-%enceetre,e eff#c#ent

    Nor,!* %(,!n *oco,ot#on/01'e"#!t#on of CG &ot%%or#2ont!**$ !n' "ert#c!**$%ence !*+o eff#c#ent

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    Power source of prosthesis

    Body poweredamputation stump & other limbs.

    Externally poweredelectric or battery

    #ore distal the amputationmore the functional

    ability $ more natural limbcontrol the prosthesis%.

    used in the upper limb

    prosthesis more.

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    Level of amputatio a!p"o#t$e#i#Toe !i#a"ti%ulatio& toe 'lli( "u))e"*

    foam* +ool a# #pa%e" to p"evet$,pe"e-te#io of )oot at toe )"ea./

    T"a#metata"#al amputatio& )oot +it$lo( #teel #$a.* metata"#al pa! a!#ti0 i#ole/

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    Li#f"a%1# amputatio& )oot 'lle! +it$#ti0 i#ole

    C$opa"t1# amputatio&

    2/ #,me1# mo!el p"o#t$e#i#

    3/ $i($ %olla" #$oe +it$ toe 'lle"

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    S,me1# amputatio& #,me1# p"o#t$e#i#

    S,me1# p"o#t$e#i# #$oul! $ave e!

    )ea"i( pa! fo" #$o%. a)#o"ptio/ T,pe#2/full e! )ea"i( i/e/ Covetioal

    p"o#t$e#i#&

    4a# leat$e" #o%.et a! +oo!e footpie%e

    Mo#t pt# a"e ua)le tom )ea" lo( time

    #ta!i( a! !i#ta%e +al.i(3/CANADIAN SYME1S PROST4ESIS& mo"e

    !i#tal e! )ea"i( a! le## p"o-imal PTB

    +ei($t )ea"i(

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    SYME1S PROST4ESIS

    5/ %lo#e! e-pa!a)le #,me1#p"o#t$e#i#& mo"e PTB )ea"i( a!le## e! )ea"i(

    P"e#%"i)e! fo" mo!i'e! #,me1#amputatio +$e"e t$e lo+e" e! i#le## )ul)ou# a! t$e"e i# o ee! fo"

    a, +i!o+ A!vata(e#& )ette" %o#me#i# a!

    )ette" #u#pe#io

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    -&ocket-&uspension system

    -'xtension (oints$knee assembly%

    -&hank)pylon

    -*erminal device $usually includes

    foot and +nkle %

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    Suction& Mechl close fitting

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    ,. 'nd bearing

    3'nd of the stump bears the weight

    . *otal ontact socket

    3 load is distributed to entire stump

    3 supports all the distal tissues within the closed system

    3 +s there is total contact proprioception will be good.

    3 give good sensory feed back.

    3 good control of stump

    3 acts as a circulatory pump3 . /uring stance phase 0 positive pressure encourages venous

    return1

    3 during swing phase 0negative pressure encourages distal

    blood flow/

    &ocket 2* bearing 3 types

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    *otal ontact socket3 4sed for most older patients

    3 5ffers partial suction"3 &uspended by pelvic belt and hip (oint that is

    attached to socket

    3 + selsian bandage suspension preferred over pelvic

    belt as the latter often interferes with sitting

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    suspension system -forattaching socket to

    body. can be done by

    a%belt 0straps or cuff

    b%others3 by suction

    prosthesis

    3 by #echanical closefitting or silicon sock

    helps to maintainairtight seal

    &ilesian bandage

    !ip(oint0pelvicbandwaist belt

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    suspension systemSoft belts 4sed as primary or auxiliary suspention

    *raditional form is silesian belt3 &imple

    3 disadvantage

    hygiene if it is non removable

    /iscomfort due to constrictive effect

    *otal elastic suspension $*'&%

    3 ew 0made ofelasticneoprene lined with smooth ylon3 Belt fits around proximal 6" of prosthesis

    !ip (oint with pelvic band or belt3 7rovides rotational stability3

    significant mediolateral pelvic stability3 'ssential when abductors are week

    and amputees are obese

    Silesian bandage

    !ip "oint#pel$icband waistbelt

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    held on by suction and close

    anatomical fit most suitable for aboveknee.

    eliminates the hip (oint andpelvis belt or shoulderharness1

    permits free rotator motionabout the hip and eliminates piston action

    of the stump in the socket 0permitting greater toeclearance and smoother gait.

    o stump sock needed.

    closely fitted

    create negative pressureduring the swing phase and positive pressure that

    expels air through a flapvalve during the stancephase.

    *he tight fit is applied atthe upper two and half orthree inchesand along the anterior wallof the socket0 the reminderstump hangs free.

    + groove in the anteromedialwall accommodates theadductor tendons.

    &uction socket prosthesis

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    &uction socket prosthesis

    Indicated foramputees forsmooth residual limbcontours

    8olume fluctuantssuch as weight gainand fluid retention3 contraindications

    /isadvantages

    /ifficulty inobtaining press fit

    5cassional lossofsuction in sittingposition

    o medium forabsorbingperspiration

    9euirement ofvolume and weightstability

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    ,. +xis system

    . ;riction mechanism

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    +xis system&ingle axis =.

    3 +xis of prosthetic knee is same as that of weightybearing axis

    3 ;lexion easier0 But stance phase control difficult7osterior off set axis=

    3 +xis of prosthetic knee is posterior

    3 ;lexion difficult0 stance phase control easier

    7olycentric=.3 variable center of rotation 3advantage in both

    phases

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    ;riction mechanism

    onstant friction3 !inge to dampen knee swing

    3 +llows single speed walking

    3 #ost used in children

    3 ot used for older or weaker

    8ariable friction-cadence control3 &taggerd friction pads

    3 #ore friction at extreme ranges0

    3 >ess friction at mid swing

    3 +llows walkig at more speed 0but not durale#edium friction

    5il $hydraulic% friction

    +ir $pneumatic%friction

    +llows best gait pattern 3best for active patients-expensive

    Mediumfriction

    %hydraulicfriction

    Constant friction

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    Intelligent prosthesis $I7%"

    7rogrammed to each individualuser during walking to achieve

    the smoothest0 most energy-saving pattern.

    9eacts to speed changes

    Intelligence does not extend tounderstanding environmentalconsiderations

    'x. stairs0 ramps or uneventerrain.

    utilizes electronicsensorsdetect rate and rangeof shank

    7rovides instantfriction ad(ustmentsto changes in gaitpattern

    '()E*+

    ;riction mechanism

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    &tabilizers

    #anual locking knee

    left locked in extension0

    unlocked whole sitting to permit flexion

    4sed in weak 0unstable patients primarily

    Stabili,ersManual loc-ing

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    ,. 'ndoskeleton

    #odular prosthesis"

    0'xo skeleton:

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    'ndoskeleton:centrally located tubularstructure

    made of prefabricated.

    #ade of carbon fibers the load bearing structure *he socket used over it +d(ustments can be easily

    made

    *hese are called #odularprosthesis"

    'xo skeleton:-conventional artificiallimbs outer visible skin"

    like-Inner hollow structures.-made of aluminum 0plastic-ad(ustments are difficult

    -accurate measurementshould be there in thebeginning it self.

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    7roviding contact between tothe ground the foot providesshock absorption and stabilityduring stance

    influences gait biomechanicsby its shape and stiffness.*his is because thetra(ectory of the centre ofpressure $57% and the angleof the ground reaction forcesis determined by the shapeand stiffness of the foot and

    needs to match the sub(ectsbuild in order to produce a

    normal gait pattern.

    *he main problem

    found in currentfeet is durability0endurance rangingfrom ,?3

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    articulated

    .on articulated

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    Non articulated

    E-&26#a%$ Foot 7#oli! A.le %u#$io

    4eal6

    36Ma!"a# foot 8mo!i'e! #a%$9Po#t TA li.e loo.

    8#po(e )et+ee $eel:("ou!

    56;aipu" foot

    IS

    MULTI A>IS

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    &+! ;oot

    $solid +nkle cushion !eal%&ome movementt in all directions4seful when not used for heavy duty2omen)childrenot suitable for indian amputies

    barefoot)suating cannot

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    Aaipur foot

    #crvulcanised rubber >ooks natural Bare foot

    walking)suatingpossible)crossleg)roughuse

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    &ingle axis ankle and wood foot

    !eavy duty activities0 rapid plantar flexion at healstrike

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    ommonly used varieties of prosthesis

    A/ prosthesis

    preferred design uadrilateral socket3pelvic belt

    3 &uction prosthesis

    B/ prosthesis

    7atellar tendon bearing

    #echanical ;itor with bar suspension system

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    ommonly used varieties of prosthesis

    A/ prosthesisuadrilateral socket

    3medwall high0latwall flat,Cdeg adduction med inclination

    pelvic belt

    &uction prosthesis

    B/ prosthesis7atellar tendan

    bearing?CDpt ECD condyles0post wall#ed flare oftibiaalso wt bearing

    #echanical ;it orwith bar suspensionsystem

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    &lide the 952 into position0ensuring that the heel is fully

    seated within the 952

    *he heel needs to be back all theway and in contact with the

    bottom of the footplate.

    heck by looking along the sidesand the back where it isseparated above the heel.

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    +pply the front section of thedevice0

    making sure itFs sides overlapthe back section

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    +pply the instep strap onthe front of the ankle

    ;asten all remaining straps

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    &kin should be checkedfor redness that does notgo away afterapproximately,G minutes.

    &light redness is commonover the instep and underthe ball of the foot.

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    T%e ,!#n o&4ect#"e+ of t%e oo'

    con+tr(ct#on of t%e *o)er *#,&5ro+t%e+#+ #+ to 5ro"#'e !n' en+(re fort%e (+er +(ff#c#ent cert!#nt$6 +t!*#t$6&!*!nce6 !n' co,fort '(r#n t%e +t!nce

    !n' '(r#n t%e )!*7 to ,#n#,#2e t%eener$ co+t !n' !#t !+$,,etr$.

    T i l t ti)i l

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    T,pi%al t"a#ti)ialp"o#t$e#i# con+#+t+ of ! 5ro+t%et#c foot6 t(&e

    !'!5tor6 !n' tr!n+t#!* +oc7et

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    T,pi%al t"a#femo"al p"o#t$e#i#

    con+#+t+ of ! 5ro+t%et#c foot6 t(&e!'!5tor6 5ro+t%et#c 7nee 4o#nt6 !n'tr!n+fe,or!* +oc7et.

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    Lo+e" lim) p"o#t$e#e# %a )e?

    eo+7e*et!* 85ro+t%e+#+ )#t% t%e5er#5%er!* )e#%t-&e!r#n c!5!c#t$6 t%e(+e of )%#c% f!c#*#t!te+ t%e tr!n+fer of !

    5!t#ent9+ )e#%t to t%e ro(n' !*on t%e'e"#ce9+ c#rc(,ference

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    Mo+t fre;(ent*$ (+e' en'o+7e*et!* 3,o'(*!r 85ro+t%e+#+ )#t% t%e centr!*

    )e#%t-&e!r#n c!5!c#t$6 t%e (+e of)%#c% f!c#*#t!te+ t%e tr!n+fer of !5!t#ent9+ )e#%t to t%e ro(n' ! t(&(*!r+tr(ct(re #n t%e 5ro+t%e+#+ centre.

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    He!*t% con'#t#on !++e++,ent !n'!++#n,ent to ! f(nct#on!* re#,e #+c!rr#e' o(t con+#'er#n t%e fo**o)#n

    !+5ect+:

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    >. ,o*#t$ of ! 5er+on #n+(re' )#t% !nort%o5!e'#c 5ro+t%et#c 'e"#ce6

    ?. *oc!* f#n'#n on ! re+#'(!* *#,& !n' !

    re+#'(!* *#,&9+ &e!r#n c!5!c#t$6@. 5+$c%o*o#c!* 5recon'#t#on+ for t%e (+eof 5ro+t%e+#+.

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    CONSTRUCCI@N DE LA PR@TESIS

    In ,!4or#t$ of #n'#"#'(!*+ )#t% &ot% *#,&+6t%e )e#%t #+ '#+tr#&(te' #n t%e ?:?r!t#o )%#c% f!c#*#t!te+ #'e!* +$,,etr#c

    *o!'#n of *o)er *#,& 4o#nt+.

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    #t% !,5(t!t#on+6 t%e *o!' #+ oftentr!n+ferre' t%ro(% t%e t(&ero+#t$ of t%e

    #+c%#(, )%#c% #+ (n+(#t!&*e '(e toc%!ne' 5o+#t#on of t%e centre of r!"#t$#n t%e front!* 5*!ne t%e centre of r!"#t$

    #+ ,o"e' *!ter!**$ to t%e %e!*t%$ *#,&+#'e.

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    B$ 5ro5er con+tr(ct#on !n' ! +(#t!&*e+e*ect#on of co,5onent+ #t c!n &e!rr!ne' t%!t t%e TF 5ro+t%e+#+

    tr!n+fer+ !t *e!+t > of t%e #n'#"#'(!*9+&o'$ )e#%t.

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    St!*#2#n !ct#"#t$ of t%e *#,&5ro+t%e+#+'e5en'+ on t%e !,5(t!t#on %e#%t6 #.e.on re+#'(!* ,(+c*e+ t%!t re,!#ne' on

    t%e re+#'(!* *#,&.

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    Fa%to"# fo" t$e %"eatio ofp"ope"l, fu%tioi( p"o#t$e#i#

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    T%e 5r#nc#5!* f!ctor+ for t%e +e*ect#on of5ro+t%et#c co,5onent+ !re:5!t#ent9+ )e#%t

    5%$+#c!* !ct#"#t$.

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    0.- Re+#'(!* *#,&9+ con'#t#on+6!,5(t!t#on %e#%t6 re+#'(!* *#,&9+ +%!5e8con#c 3 +,!**er c#rc(,ference on t%e

    '#+t!* 5!rt t%!n on t%e 5ro#,!* 5!rt65e!r-+%!5e'6 c$*#n'r#c!* 3 t%e +!,ec#rc(,ference on t%e '#+t!* !n' 5ro#,!*

    en'6 !,5(t!t#on +c!r6 !+ )e** !+ ot%er5ro&*e,+ or '#+e!+e+.

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    Step#&

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    )%en t%e 5ro+t%e+#+ #+ con+tr(cte'6 #t+%o(*' r(n t%ro(% t%e centre+ of 4o#nt+of one *#,&.

    Lo!' *#ne:

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    In t%e f#r+t 5%!+e6 #t #+ cr(c#!* to'eter,#ne t%e con+tr(ct#on *#ne 8F#. >6)%#c% #+ !n !rtr!r$ "ert#c!* *#ne to)!r'+

    )%#c% #n'#"#'(!* 5ro+t%e+#+ co,5onent+!re 5o+#t#one' !ccor'#n to cert!#n r(*e+8T!&*e 0.

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    Ta)le 3 Po#itioi( of

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    Ta)le 3 Po#itioi( of%ompoet# a%%o"!i( to

    %e"tai "ule#

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    TT TF

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    TF

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    0.- STATIC CORRECTIONTT TF

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    In t%e +t!t#c !'4(+t,ent6 #t #+ #,5ort!nt to!'4(+t t%e correct 5ro+t%e+#+ *ent% +ot%!t &ot% *#,&+ !re e"en*$ *o!'e' !n'

    t%e 5e*"#+ #+ *e"e*e'. Ne!t#"e effect on t%e +t!nce )#t% !

    5ro+t%e+#+ #+ #nf*(ence' &$ t%e +%#ft oft%e *o!' *#ne c!(+e' &$ t%e 5*!nt!rf*e#on of t%e foot or ,o"#n t%e footfor)!r'.

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    =.- DYNAMIC CORRECTION

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    %en ! 5!t#ent9+ !#t #+ !++e++e' #n t%e+!#tt!* !n' front!* 5*!ne+6 'e"#!t#on+fro, t%e nor,!* +te5 c$c*e !re

    e!,#ne'. T%e 'e"#!t#on+ c!n &e c!(+e' &$

    #,5ro5er con+tr(ct#on of t%e 5ro+t%e+#+or &$ 5%$+#c!* 'ef#c#enc#e+6 !+ )e** !+ !5!t#ent9+ ,ent!* con'#t#on.

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    D(r#n t%e !#t )#t% ! 5ro+t%e+#+6 t%ef#r+t cont!ct of t%e foot !n' t%e ro(n' #+#,5ort!nt6 !+ )e** !+ tr!n+fer of *o!' on

    t%e foot.

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    T%e foot cont!ct #+ c!rr#e' o(t t%ro(%t%e %ee* +o t%!t t%e )!*7#n #+ !+ n!t(r!*!+ 5o++#&*e6 !n' +(&+e;(ent*$ t%e ent#re

    +o*e +(rf!ce cont!ct+t%e ro(n' !n't%e *o!' #+ tr!n+ferre' to t%e foot.

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    It #+ fo**o)e' &$ t%e foot ro**#n !)!$fro, t%e ro(n' !n' t%e 5(+%-offt%ro(% t%e toe6 )%en t%e ener$ #+

    re;(#re' for t%e +)#n 5%!+e.

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    In t%#+ 5%!+e6 t%e #,5ort!nt ro*e #+5*!$e' &$ t%e 5ro5er +e*ect#on of ! foot8foot ro** !)!$ fro, t%e ro(n'6

    !'!5t!t#on to t%e +(rf!ce6 co,5en+!t#on,o"e,ent+6 ener$ !cc(,(*!t#on !n'e5en'#t(re !n' ! 5ro5er 5o+#t#on of t%e7nee 4o#nt.

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    P!rt#c(*!r*$ t%e+e co,5onent+ 8foot !n'7nee 4o#nt !n' t%e#r 5ro5er !++e,&*$!ffect t%e f#n!* f(nct#on of t%e 5ro+t%e+#+

    !n' t%(+ #nf*(ence t%e (+er9+ !ct#"#t$.

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    In t%e +)#n 5%!+e6 t%e 7nee f(nct#on #+#,5ort!nt6 !+ #t #+ nece++!r$ to en+(ret%e ,o"e,ent fro, f*e#on to eten+#on

    8eten+#on ,o,ent of t%e 7nee )%#c%f!c#*#t!te+ t%e foot tr!n+#t#on fro, 5*!nt!rf*e#on to 'or+!* f*e#on6 #.e. t%e toee*e"!t#on6 #n or'er to !"o#'

    +t(,&*#n8tro5#e2o+ !n' +(&+e;(ent f!**of t%e (+er

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    Biomechanics of the socket

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    T%e re+#'(!* *#,& #+ 5*!ce' #n t%e +oc7ett%!t 5ro"#'e+ r##' !n' +t!&*e !tt!c%,entto t%e *#,&6 )%#c% #+ #,5ort!nt for t%e

    contro* t%ereof. T%e 5ro+t%e+#+ +oc7et8F#. c!n &e '#"#'e' #nto = 5!rt+ t%!t%!"e '#fferent f(nct#on+.

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    T%e to5 5!rt #+ t%e +o-c!**e' +e!t#n f!ce. T%e centr!* 5!rt #+ !ct(!**$ t%e contro**#n

    +oc7et !re! )#t% t%e f(nct#on to en+(re

    correct ,o"e,ent !n' re+tr!#n #t #n t%e P-A'#rect#on6 )%#c% #+ #,5ort!nt '(r#n t%e !#t. T%e *!+t 5!rt #+ t%e '#+t!* +oc7et en' )%#c%6

    #n !n #'e!* c!+e6 +%o(*' tr!n+fer on*$

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    A +oc7et ,(+t &e !&*e to tr!n+fer t%e *o!'6 en+(re +t!*#t$6 !n' 5ro"#'e eff#c#ent contro* '(r#n t%e

    ,o*#t$.

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    In ! +t!n'#n 5o+#t#on6 t%e ,. *(te(+,e'#(+ #+ +tretc%e' #t en+(re+ t%!t t%e5e*"#+ #+ ,!#nt!#ne' #n ! &!*!nce' 5o+#t#on.

    In ! %e!*t%$ #n'#"#'(!*6 t%#+ 5roce++ #+en+(re' &$ !tt!c%#n t%e fe,(r to t%ero(n' &$ ! *o)er *#,&

    In c!+e of t%e *o)er *#,& !,5(t!t#on6 t%#+

    f(nct#on #+ t!7en o"er &$ t%e 5ro+t%et#c+oc7et.

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    T%erefore6 5ro5er +oc7et +%!5e #+#,5ort!nt6 !+ )e** !+ #t+ ML 8,e'#!*-*!ter!*!n' AP 8!ntero5o+ter#or

    '#,en+#on+6 +o t%!t t%e fe,(r c!n &e!tt!c%e'.

    In ! tr!n+"er+e o"!* +oc7et of

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    ! t ! + e +e o ! +oc et otr!n+fe,or!* 5ro+t%e+e+6 t%e 5re++(reon t%e '#+t!* fe,(r en' #ncre!+e+ !n't%e &o'$ #+ ece++#"e*$ &en'#n !+#'e tore'(ce t%e 5re++(re 8F#. J *eft6 ,#''*e.

    It #+ ! non 5%$+#o*o#c!* *o!' tr!n+fer !+

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    It #+ ! non-5%$+#o*o#c!* *o!' tr!n+fer6 !+t%e *o!' #+ tr!n+ferre' t%ro(% t%et(&ero+#t$ of t%e #+c%#(,6 )%#c% re'(ce+t%e !r, of t%e eerte' force !n' t%eo"ert(rn#n ,o,ent+ !re #ncre!+e' 8F#. Jr#%t .

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    On t%e contr!r$6 t%e *on#t('#n!* o"!* +oc7et f!c#*#t!te+

    t%e 5%$+#o*o#c!* tr!n+fer6 !+ t%e rot!t#on

    centre #+ #n t%e %#5 4o#nt !n' t%e 5e*"#+'oe+ not t(rn o"er 8t%e 5e*"#+ #+ #n !&!*!nce' 5o+#t#on !n' no (nn!t(r!*+t!*#+!t#on &o'$ ,o"e,ent+ !rere;(#re' ?.

    I!eal O"t$o#i#

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    I!eal O"t$o#i# P"o#t$e#i#F(nct#on!*F#t+ )e**

    L#%t #n )e#%t

    E!+$ to (+eCo+,et#c!**$ !cce5t!&*e

    E!+#*$ ,!#nt!#ne're5!#re'

    I'e!**$ *oc!**$ ,!n(f!ct(re'

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    *Wedge: a heelall the way under the shoe

    PROSTETIC OPTIONS BALANCE GAIT

    PROSTETIC OPTIONS BALANCE GAIT

    http://dictionary.cambridge.org/dictionary/english/heelhttp://dictionary.cambridge.org/dictionary/english/shoehttp://dictionary.cambridge.org/dictionary/english/shoehttp://dictionary.cambridge.org/dictionary/english/heel
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    PROSTETIC OPTIONS BALANCE GAIT

    PROSTETIC OPTIONS BALANCE GAIT

    * resilient: ableto quicklyreturnto a previousgood condition.* fastening: a deviceon a window, door, box, etc. for keepingit closed

    T%e +# '#fferentt$5e+ of roc7er+o*e.

    A,M#*'. B,Hee*-to-toe. ,Toe on*$. !,Se"ere !n*e.

    ",Ne!t#"e %ee*. #,Do(&*e.

    http://dictionary.cambridge.org/dictionary/english/ablehttp://dictionary.cambridge.org/dictionary/english/quicklyhttp://dictionary.cambridge.org/dictionary/english/returnhttp://dictionary.cambridge.org/dictionary/english/previoushttp://dictionary.cambridge.org/dictionary/english/conditionhttp://dictionary.cambridge.org/dictionary/english/devicehttp://dictionary.cambridge.org/dictionary/english/windowhttp://dictionary.cambridge.org/dictionary/english/doorhttp://dictionary.cambridge.org/dictionary/english/boxhttp://dictionary.cambridge.org/dictionary/english/keepinghttp://dictionary.cambridge.org/dictionary/english/closedhttp://dictionary.cambridge.org/dictionary/english/closedhttp://dictionary.cambridge.org/dictionary/english/keepinghttp://dictionary.cambridge.org/dictionary/english/boxhttp://dictionary.cambridge.org/dictionary/english/doorhttp://dictionary.cambridge.org/dictionary/english/windowhttp://dictionary.cambridge.org/dictionary/english/devicehttp://dictionary.cambridge.org/dictionary/english/conditionhttp://dictionary.cambridge.org/dictionary/english/previoushttp://dictionary.cambridge.org/dictionary/english/returnhttp://dictionary.cambridge.org/dictionary/english/quicklyhttp://dictionary.cambridge.org/dictionary/english/able
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    PROSTETIC OPTIONS BALANCE GAIT

    Kee* ;(#**!

    Usual Shoe

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    Usua S oemodications $eel %aise &otal %aise

    Arch 'upport

    &ho(as $eel %everse )" $eel

    'ole Wedge

    & Bar

    &oe wedge

    Wedge: a pieceof so(ething, especiallyfood, in

    the shapeof a triangle:

    http://dictionary.cambridge.org/dictionary/english/piecehttp://dictionary.cambridge.org/dictionary/english/especiallyhttp://dictionary.cambridge.org/dictionary/english/foodhttp://dictionary.cambridge.org/dictionary/english/shapehttp://dictionary.cambridge.org/dictionary/english/trianglehttp://dictionary.cambridge.org/dictionary/english/trianglehttp://dictionary.cambridge.org/dictionary/english/shapehttp://dictionary.cambridge.org/dictionary/english/foodhttp://dictionary.cambridge.org/dictionary/english/especiallyhttp://dictionary.cambridge.org/dictionary/english/piece
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    Floor Reaction Orthosis

    Foot

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    FootJaipur foot Sach foot

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    Type of o!er im"

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    ypStumps

    En' Be!r#n +t(,5

    S#'e &e!r#n or Tot!*

    Cont!ct

    B $ %rosthesis

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    B#$# %rosthesis

    Co,5onent+S(+5en+#on

    Soc7etS%!n7S%#n 5#ece

    An7*e !n' footA++e,&*$

    Suspension

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    Suspension

    F*e#&*e A. S(5r!con'$*!r C(ffB. S*ee"eC. S(ct#on

    Br#, Conto(rA. S(5r!con'$*!rB. S(5r! P!te**er

    T%#% cor+et con+#+t+ of

    - 0 Met!* B!r+ )#t% 7nee 4o#nt+- Cor+et- Le!t%erP*!+t#c

    Socket

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    Socket

    H!r' +oc7et for #'e!* B.K. St(,5 H!r' Soc7et )#t% #nner *#n#n

    Weight Bearing

    Anter#or*$ - Lo)er =r' of 5!te**!-L#!,ent(, 5!te**ee6 t#!* t(&ero+#t$

    Po+ter#or*$ - Po5. Fo+!

    L!ter!**$ - L!t. con'$*e of t#! !n' %e!' of f#&(*! Me'#!**$ - Me'.con'$*e of t#!

    Shank&Shin %iece

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    Shank&Shin %iece

    "xoskeleton- P*!+t#c re+#n !n')oo'

    "ndoskeleton-Met!*PC t(&e

    Ankle #oot Asse(bly

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    +on Articulated Articulated

    S#n*e A#+ M(*t#5*e A#+

    SACH SAFE STEN

    CARBON COPY II

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    A"o'e $nee

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    %rosthesiso(ponents

    S(+5en+#onSoc7etKnee o#ntS%!n7S%#n 5#ece

    An7*e foot !++e,&*$

    Suspension

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    Suspension

    S(ct#on S#*e+#!n &e*t

    Pe*"#c &e*t )#t% %#5 4o#nt S%o(*'er +(+5en'or

    Socket

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    Socket

    uadrilateral- Co,,on*$(+e'

    &otal contact

    $nee Joint Assem"ly

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    $nee Joint Assem"ly

    onventional single axis knee- co,,on*$ (+e'

    -olycentric knee oint

    onstant friction knee

    onstant friction with friction lock

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    Syme %rosthesis

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    Syme %rosthesis

    onventional "nd weight bearing : -Le!t%er5*!+t#c +oc7et !tt!c%e' to SACH foot -.&.B. 'y(e prosthesis : - %en %ee* 5!'

    #+ not +(ff#c#ent for )e#%t &e!r#n t%!n P.T.B.

    t$5e S$,e 5ro+t%e+#+ #+ #"en.

    Specications of(ntelli)ent $nee %rosthesis

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    22

    *m) +,-++-+.-+/-+0*m)+1

    2id3,

    DEC83H

    4e'ices on the marketCompetin) companies5%roduct

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    222

    $e I%ela!i% %ompa, Ossur Rheo $nee

    T$e =e"ma %ompa, Otto Bock C-le)

    T$e ;apa %ompa, Na"tesc :y"rid $nee

    *m)+6

    *m)

    +7

    *m)+8

    *m).3

    *m).,

    *m).+DEC83H

    4e'ices on the marketCompetin) companies5%roducts Cont9d

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    223223

    ee ei($t 5

    ei($t Limit 23.( fo" up to 5* fo"