Disarticulation of the talocrual joint
Calcaneus and talus removed
Although calcaneus is removed, a well held residual limb can be amb on with a
prosthesis for long distances and/or without a prosthesis for short distances
Bilateral malleoli are removed good
Repositions fat pad/soft tissue under distal tibia/fibula
Creates a flat surface for WB
Surgical Issues that May Arise
Posterior migration of the heel pad
Skin Slough
Distal flare that leads to an ill-fitting prosthesis or poor cosmesis
Those with vascular disease will have a prolonged period of healing and may have to
undergo a
more proximal amputation
Give this one a try later!
syme
,Disarticulation of tarsal/metatarsal joint
Attempt to maintain transverse arch of midfoot—leave the keystone base of the 2nd
metatarsal in place
May reposition the attachments of the Peroneals to allow for some restoration in level
of equity among
the muscle groups on either side of the foot
Give this one a try later!
lisfranc
Indicated when Vascular disease, Neuropathic ulcer, or Osteomyelitis has
compromised >1 rays of the forefoot
50% or more of the metatarsal is removed, with the residual metatarsal beveled at a
30-45*
Eliminates any sharp edges / Reduces possibility of tissue damage during late stance
phase
Surgery of choice for 4th and 5th ray removal—as long as the 1-3 remain intact
Little or no disruption of forward progress in gait on a healed limb
Not surgery of choice if 1st and 2nd ray removed
● High risk of ulceration
● Disruption of WB forces when walking
● A complete Transmetatarsal amputation may be a better choice and have a better
functional outcome when managed with custom footwear and a rocker bottom
Give this one a try later!
ray resection
,Socket and 5 of flex & 5 of add, level top of the foot (sagittal and frontal planes)
Flexion of the socket helps to elongate the Quads in preparation for weight
acceptance and to aid in shock absorption.
Adduction of the socket creates a varus moment during stance, so that the pt. may
properly load
the limb.
Standard bench alignment is not used if a deformity or contracture is present
With medial border of the foot parallel to the lining progression
Plumb line should fall from the anatomical knee and pass through the foot at a point
1/3 of the foot length from the back of the heel (viewing from the sagittal plane).
Give this one a try later!
bench alignment (transtibial)
has the ability or potential for prosthetic ambulation that exceeds basic ambulation
skills, exhibiting high impact, stress, or energy levels. typical of the prosthetic
demands of the child, active adult, or athlete
any ankle/ foot system appropriate
For the serious athlete, weekend runner, children task
Sprinting and running Multiaxisfeet for golfers, hikers Swim footRock climbing foot
Give this one a try later!
level 4
unable to drive and talk at the same time, one speed (start with a puff, ends with
another)
, CON:
If the straw gets away from them they could be stuck in motion—safety stop to
prevent this
Cosmetic: looks medical
Give this one a try later!
sip and puff
intermittent claudication (painful cramp or feeling of muscle fatigue that happens
distal to the stenotic vessel during exercise that relieves when exercise stops) and the
loss of one or more of the LE pulses
Give this one a try later!
classic indicators of vascular insufficiency
prosthetic cause: Excessive IR Too tight socket
Excessive valgus
amputee cause: Improper donning of prosthesis
Poor muscle control
Give this one a try later!
lateral whip (transfemoral)
Does not require myoelectrical component—no sensors a top of the motor
components
Calcaneus and talus removed
Although calcaneus is removed, a well held residual limb can be amb on with a
prosthesis for long distances and/or without a prosthesis for short distances
Bilateral malleoli are removed good
Repositions fat pad/soft tissue under distal tibia/fibula
Creates a flat surface for WB
Surgical Issues that May Arise
Posterior migration of the heel pad
Skin Slough
Distal flare that leads to an ill-fitting prosthesis or poor cosmesis
Those with vascular disease will have a prolonged period of healing and may have to
undergo a
more proximal amputation
Give this one a try later!
syme
,Disarticulation of tarsal/metatarsal joint
Attempt to maintain transverse arch of midfoot—leave the keystone base of the 2nd
metatarsal in place
May reposition the attachments of the Peroneals to allow for some restoration in level
of equity among
the muscle groups on either side of the foot
Give this one a try later!
lisfranc
Indicated when Vascular disease, Neuropathic ulcer, or Osteomyelitis has
compromised >1 rays of the forefoot
50% or more of the metatarsal is removed, with the residual metatarsal beveled at a
30-45*
Eliminates any sharp edges / Reduces possibility of tissue damage during late stance
phase
Surgery of choice for 4th and 5th ray removal—as long as the 1-3 remain intact
Little or no disruption of forward progress in gait on a healed limb
Not surgery of choice if 1st and 2nd ray removed
● High risk of ulceration
● Disruption of WB forces when walking
● A complete Transmetatarsal amputation may be a better choice and have a better
functional outcome when managed with custom footwear and a rocker bottom
Give this one a try later!
ray resection
,Socket and 5 of flex & 5 of add, level top of the foot (sagittal and frontal planes)
Flexion of the socket helps to elongate the Quads in preparation for weight
acceptance and to aid in shock absorption.
Adduction of the socket creates a varus moment during stance, so that the pt. may
properly load
the limb.
Standard bench alignment is not used if a deformity or contracture is present
With medial border of the foot parallel to the lining progression
Plumb line should fall from the anatomical knee and pass through the foot at a point
1/3 of the foot length from the back of the heel (viewing from the sagittal plane).
Give this one a try later!
bench alignment (transtibial)
has the ability or potential for prosthetic ambulation that exceeds basic ambulation
skills, exhibiting high impact, stress, or energy levels. typical of the prosthetic
demands of the child, active adult, or athlete
any ankle/ foot system appropriate
For the serious athlete, weekend runner, children task
Sprinting and running Multiaxisfeet for golfers, hikers Swim footRock climbing foot
Give this one a try later!
level 4
unable to drive and talk at the same time, one speed (start with a puff, ends with
another)
, CON:
If the straw gets away from them they could be stuck in motion—safety stop to
prevent this
Cosmetic: looks medical
Give this one a try later!
sip and puff
intermittent claudication (painful cramp or feeling of muscle fatigue that happens
distal to the stenotic vessel during exercise that relieves when exercise stops) and the
loss of one or more of the LE pulses
Give this one a try later!
classic indicators of vascular insufficiency
prosthetic cause: Excessive IR Too tight socket
Excessive valgus
amputee cause: Improper donning of prosthesis
Poor muscle control
Give this one a try later!
lateral whip (transfemoral)
Does not require myoelectrical component—no sensors a top of the motor
components
