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DISTRIBUTION AND FUNCTION OF MUSCULE GROUPS

FLEXION OF THE HIP AND
EXTENSION OF THE KNEE

ADDUCTION OF THE HIP

QUADRICEPS ABDUCTION OF
THE HIP

FEMUR ABDUCTORS

EXTENSION AND INTERNAL

ROTATION OF THE HIP

EXTENSION OF THE HIP

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 MEASURES TRANSFEMORAL

LIMB R L

MEASURES RECTIFICATION FINAL

A-P

KNEE HEIGHT ISCHIAL HEIGHT

FLEXION ABDUCTION

LOWER LEG (SHIN) ANKLE

FOOT 3
 MEASURES TRANSFEMORAL

CLEAR APPEARANCE OF
ADDUCTOR LONGUS TENDON

TECHNICIAN PATIENT FORCES

CONTRFORCES TO TO ADDUCTION
ABDUCTION

AP MEASURE :
DISTANCE BETWEEN ISCHIUM
AND ADDUCTOR LONGUS TENDON

LIMB MEASURES: LENGTH OF

LIMB, LENGTH OF FEMUR
(to be taken from ramus and/or
ischial tuberosity)

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 TF STUMP ABDUCTION-ADDUCTION
SHORT STUMP MEDIUM AND LONG STUMPS
ABDUCTION/ADDUCTION = 0° ADDUCTION = 5 - 7°

WARNING: FIGURES ARE GIVEN AS GENERAL GUIDENCE WHILE EACH PATIENT IS UNIQUE !

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 TF STUMP FLEXION

SHORT STUMP MEDIUM STUMP LONG STUMP

FLEXION = 7-10° FLEXION = 3- 5° FLEXION = 0- 3°

WARNING: FIGURES ARE GIVEN AS GENERAL GUIDENCE WHILE EACH PATIENT IS UNIQUE !
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 CASTING TF QUADRILATERAL:
TRANSVERSAL VIEW
POSTERIOR

LATERAL TROCHANTER MEDIAL

PROMINENCE OF
SCARPA'S TRIANGLE

POSITION OF THE HANDS

ANTERIOR
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 CASTING TF QUADRILATERAL:
ANTERIOR VIEW

POSITION OF THE HANDS

HORIZONTAL

PLACE FOREFINGER HORIZONTALLY

TO MARK THE ISCHIAL SEAT AND
POSTERIOR SHELF

THUMB PRESSES BEHIND AND SLIGHTLY

HIGHER THAN THE GREATER TROCHANTER

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 CASTING TF QUADRILATERAL:
LATERAL VIEW

POSITION OF THE HANDS

HORIZONTAL

PLACE FOREFINGER HORIZONTALLY

TO MARK LEVEL OF MEDIAL SHELF
(To be reshaped on the mould;
see TF rectification medial view)

THUMB PRESSES AT DEEPEST AREA

OF SCARPA'S TRIANGLE

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 NEGATIVE CAST: TRANSVERSAL VIEW
ML - divide the stump circumference of "0" level by 3.14;
AP - divide ML by 2 (AP - dimension from ischial seat to adductor longus canal);

~105°

~15°
1/2 ML 1/2 ML

~15°

~105°

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 NEGATIVE CAST: TRANSVERSAL VIEW

ML=172mm
~15°

~15°
CIRCUMFERENCE=540mm

Circumference of "0" level: 540mm

ML dimension: 540 / 3.14 = 172mm
AP dimension: 172 / 2 = 86mm 11
 NEGATIVE CAST: TRANSVERSAL VIEW

PROMINENCE OF SCARPA'S TRIANGLE

OPPOSITE ISCHIAL SEAT = 1/3 ML

~25mm

1/3 ML 1/3 ML 1/3 ML

1/6 ML 1/6 ML

ISCHIAL SEAT = 1/6 ML

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 WARNING!!!
THE STUMP OF EACH PATIENT IS UNIQUE.
THEREFORE ALL MEASURES, FIGURES, COMMENTS ETC IN
THIS CHAPTER ARE GIVEN AS A GENERAL GUIDENCE AND
HAVE TO BE ADJUSTED TO EACH PARTICULAR CASE.
ALWAYS CONTROL MEASURES BEFORE AND AFTER
RECTIFICATION!

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 TF RECTIFICATION: MEDIAL VIEW
Medial wall
Medial shelf is inclined from ischial seat towards adductor longus about 10-15°. The
relief for adductor tendon is about 10-15mm; width of medial shelf is approx. 15-
20mm.
Proximal part of medial wall must be vertical and flat about 100 mm, then it
connects smoothly with distal end.
Control the lenghth of stump from perineal area to distal end.
Control the AP dimension from adductor canal to ischial seat.
Make your choice of measures according to the siz e and condition of the stump.
(1 - 2)
1- WIDTH OF MEDIAL SHELF ~15-20 mm
10-15° 2 - MEDIAL SHELF IS INCLINED 10-15°;
HORIZONTAL
RELIEF FOR ADDUCTORS ~10-15mm
3 - PROXIMAL PART OF THE WALL IS FLAT AND VERTICAL ~100mm
~100 mm

(3)
~10-15 mm

4 - SHELF AND WALL REMAIN PARALLEL

(6) IN TRANSVERSAL PLANE
5 - SHELF AND WALL ARE PARALLEL TO THE
LINE OF PROGRESSION
6 - POSTERIOR WALL "POCKET" FOR EXTENSORS ~100mm
(shown also on posterior view)
VERTICAL

~5-10 mm
5°
LINE OF PROGRESSION

(1- 4- 5)
15-20 mm

90°
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 TF RECTIFICATION: POSTERIOR VIEW
Posterior wall
Width of posterior shelf is approx. 25-30 mm.
Edge of posterior shelf must be perpendicular to the edge of medial shelf in
transversal plane.
Posterior wall has a "pocket" about 100 mm high and 5-10mm deep to contain
extensors, then it smoothly connects with distal end (shown also on medial view).
It is important to minimize posterior-lateral aspect – support for gluteus.
Round the medial-posterior corner.
Make your choice of measures according to the size and condition of the stump.

(1 - 2 - 3) 1- WIDTH OF POSTERIOR SHELF ~ 25-30 mm

2 - POSTERIOR SHELF IS HORIZONTAL IN 2 PLANES
HORIZONTAL 3 - POSTERIOR EDGE IS IN 90° WITH MEDIAL EDGE
4 - POSTERIOR WALL "POCKET" FOR EXTENSORS ~100mm
~100 mm

(shown also on medial view)

(4- 5) 5 - POSTERIOR WALL IS IN 105° WITH MEDIAL WALL
VERTICAL

15-18 mm 5-7°
LINE OF PROGRESSION

(1- 3 - 5)

90°
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 TF RECTIFICATION: ANTERIOR VIEW

Anterior wall
Reduce the height of lateral aspect of anterior edge up to the prominence of rectus
femoris. Medial aspect of anterior edge is about 30mm higher than medial shelf.
Max depth of Scarpa's prominence is located about 15-20mm lower from medial
aspect of anterior edge.
Round the medial-anterior corner.
Make your choice of measures according to the size and condition of the stump.
~30 mm

(1 - 2 - 3)

1 - HEIGHT OF ANTERIOR MEDIAL EDGE ~ 30 mm

2 - ANTERIOR WALL IS IN 105° WITH MEDIAL WALL
3 - HEIGHT OF SCARPA'S TRIANGLE ~ 100 mm
4 - DEPTH OF SCARPA'S TRIANGLE ~ 6-10 mm
~100 mm

~25 mm

~ 6-10 mm
5-7°
VERTICAL

LINE OF PROGRESSION

~ 25- 30mm

(2 - 4)

90°
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 TF RECTIFICATION: ANTERIOR VIEW
Determination of Scarpa's Triangle.
Divide the medial-lateral dimension by 3.
Mark point a – 1/3 of the ML dimension, then mark point c - ~25mm from the
medial wall and from here draw a vertical line 100mm down - this determines
third point b. Connect point a with point b - this determines Scarpa's Triangle.
Make your choice of measures according to the siz e and condition of the stump.
~10-15 mm

~30 mm

(1 - 2 - 3)
a
c 1 - HEIGTH OF ANTERIOR MEDIAL EDGE ~ 30 mm
2 - ANTERIOR WALL IS IN 105° WITH MEDIAL WALL
3 - HEIGTH OF SCARPA'S TRIANGLE ~ 100 mm
4 - DEPTH OF SCARPA'S TRIANGLE ~ 6-10 mm
~100 mm

~25 mm

5-7°
b 25 mm ~ 6-10 mm
VERTICAL

LINE OF PROGRESSION

(2 - 4)

90°
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 TF RECTIFICATION: LATERAL VIEW

Lateral wall
Width of proximal lateral edge is approx. 8 mm.
Edge of lateral wall is higher than posterior shelf about 60mm for long and
medium stumps and 80 mm for short stumps.
Rectify aspect of the lateral wall between trochanter and distal femoral end to
provide femoral support and initial adduction 5-7°. If case of needs to bring
circumferences to desired, rectify mostly this aspect.
(1 - 2) Take off plaster above trochanter and posterior, to apply pressure at these
60-80 mm

aspects.
Never rectify zone of trochanter.
Make your choice of measures according to the size and condition of the stump.

1 - WIDTH OF LATERAL EDGE ~ 8 mm

2 - HIGTH OF LATERAL EDGE 60-80 mm
3 - WALL WITH ADDUCTION 5-7°
(shown on anterior and posterior views)
4 – PRESSURE AT PROXIMAL POSTERIOR ASPECT
FROM TROCHANTER
VERTICAL

5° (1)
LINE OF PROGRESSION

18 mm
~8mm

(4)
90 °
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CIRCUMFERENCE (C / 3.14) / 2
PERINEAL AP MEASURE
TF RECTIFICATION:
280 45
300 48 CORRELATION OF THE
320 51 DIMENSIONS
340 54 ML = Stump circumference at "0" level
360 57 devided by 3.14
380 61
AP = ML devided by 2
400 64
420 67
440 70

460 73
480 76
500 80

520 83
540 86
560 89

580 92
600 96
620 99 19
 REDUCTION FOR FIRM TRANSFEMORAL STUMP
CIRCUMFERENCE - 5% of C - 3% of C - 1.5% of C - 1% of C - 1% of C
PERINEAL PERINEUM 50 mm 100 mm 150 mm 200 mm

280
300 15 9 5 3 3
320

340
360 18 11 5 4 4
380

400
420 21 13 6 4 4
440

460
480 24 14 7 5 5
500

520
540 27 16 8 5 5
560

580
600 30 18 9 6 6
620 20
 REDUCTION FOR FLASK TRANSFEMORAL STUMP
CIRCUMFERENCE - 6% of C - 3.5% of C - 2% of C - 1.2% of C - 1.2% of C
PERINEAL PERINEUM 50 mm 100 mm 150 mm 200 mm

280
300 18 11 6 4 4
320

340
360 22 13 7 4 4
380

400
420 25 15 8 5 5
440

460
480 29 17 10 6 6
500

520
540 32 19 11 6 6
560

580
600 36 21 12 7 7
620 21