SPECIAL TOPIC PRESENTATION

BY WINA

Content

Bilateral amputee

Pediatric amputee

Sports

Advance technique

Bilateral amputee

Bilateral amputee1. The most common risk factor of bilateral amputation: a) PVD b) Diabetesc) Hypertensiond) All of the above

2. What is the name of this and its function?

Function:

Important body segment and whole body parameters :

• Dimensions (e.g., length, density, and mass) •Segmental center of mass location •Whole-body center of mass location •Moment of inertia (angular inertia)

How to design a limb for bilateral amputees?

Bilateral amputee

SportsRunning

BasketballGolfing

BicyclingSwimming

Mountain climbingBowling

Flying

SportsRunning

• Can use dynamic response foot to provide push off, energy storage and release vertical shock absorption

Pediatric amputeeMany prosthetic principles used in treating adults can

apply to the treatment of children but most techniques used with adult amputees must be downsized, sequenced in degree of complexity, modified or completely altered to match the ever-changing needs of children.

Pediatric amputee

CausesProsthetic management

• Congenital Deficiencies : Fibula hemi-Melia is the most common in TTP.

• Emergency amputation : Due to emergency problem such as accident, gunshot, electrical burn

• Elective amputation : Disease or trauma include the Skin graft, Partial foot amputation, burns, revisions, disarticulations, occasionally.

• Bone overgrowth• Appropriate material• Fitting • Education and follow up

Pediatric amputee

Appropriate materials

FittingEducation and follow up

Bone overgrowth can cause painful and the prosthetist should to pay attention about this , Make the hard socket bigger than stump and use more socks or thickness of soft liner and another way , can put the distal padding on distal end of socket for prevent pressure and relief pain.

Materials and components should be•Durable•Simplify lengthening•Switch out easily•Very safety for children and parents

• For young children : difficult to tell how they feel about the device due to difficult to adjust alignment

• For old children is easier than young children because they can tell how they feel like or dislike about the device.

• CPO should to let the parents to observe about the device outside the hospital and tell the CPO if have problem

• CPO let the children to begin the gait training on an unfinished prototype prosthesis

CPO should to educate patient and parents about•How to apply, remove and care the prosthesis•Examining the condition of the residual limb•And if the patient have to adjust length, reduce sock or have any problem about the device, Parents should contact to the CPOFollow up :•Device generally will require growth adjustments by a prosthetist three or four times per year.•Every 12 to 18 month during peak growing years, and perhaps every 1 to 3 years during adolescence

Prosthetic managementThe difference between the pediatric amputee that caused by congenital and caused by amputation is about mental status.In congenital limb deficiencies, patient never have the limb but in the amputation amputee, the patient limb is lost by amputation.You have to concern about this !!

Bone overgrowthBone overgrowth can cause painful and the prosthetist should to pay attention

about this , Make the hard socket bigger than stump and use more socks or thickness of soft liner and another way , can put the distal padding on distal end of socket for prevent pressure and relief pain.

Appropriate materials

Materials and components should be•Durable•Simplify lengthening•Switch out easily•Very safety for children and parents

Advance techniqueCAD/CAM technologyIcecast® Modular socket

system (MSS)• Spectra 3D and scanner : use white light that safe for patient and can capture every bump and contours.

• Vorum Canfit BK Transtibial Design Software : Anatomical correctly

• 3-Axis Carving Machine : Durable, low maintenance and accurate

• Total Surface Bearing (TSB) socket design• Reducing rectification time

12 Q’s 3 q’s from each.