WARNING!!!

OBSERVE THE GAIT CAREFULLY FROM

ANTERIOR, POSTERIOR AND LATERAL VIEWS.
LISTEN TO THE PATIENT.
PROCEED WITH ONE ADJUSTMENT AT A TIME.
ADJUST WITH A SMALL RANGE.

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 TT DYNAMIC ALIGNMENT: ANTERIOR VIEW

NORMAL ALIGNMENT
(NO DEVIATIONS OBSERVED)

EQUAL SUPRACODYLAR
OBSERVATION DURING
COMPRESION
MID STANCE PHASE WITH
FULL WEIGTH BEARING
ON PROSTHESIS

SOCKET IS COMFORTABLE

PLUMBLINE IS IN THE CENTER

TUBE IS VERTICAL

FOOT IS FLAT
2
 TT DYNAMIC ALIGNMENT: ANTERIOR VIEW

PROBLEMS!!!
EXCESSIVE PRESSURE AT GAP
MEDIAL PROXIMAL AND
LATERAL DISTAL AREAS. DEVIATION OBSERVED
P DURING MID STANCE PHASE
GAP AT LATERAL
WITH FULL WEIGTH BEARING
SUPRACONDYLAR AREA.
ON PROSTHESIS
LATERAL INSTABILITY.

FORCES

CAUSE: 2
EXCESSIVE ABDUCTUION CORRECTION:
1
OF THE SOCKET. P 1 - ADDUCTION OF THE SOCKET
2 - TRANSLATION MEDIALLY
Avoid doing two different
TUBE IS LATERALLY adjustments at the same time!
INCLINED

PLUMBLINE IS
LATERALLY DISPLACED
FOOT IS SUPINATED
(VARUM GAIT)

3
 TT DYNAMIC ALIGNMENT: ANTERIOR VIEW

PROBLEMS!!!
EXCESSIVE PRESSURE AT
GAP
MEDIAL PROXIMAL AND
LATERAL DISTAL AREAS. DEVIATION OBSERVED
GAP AT LATERAL
DURING MID STANCE PHASE
P WITH FULL WEIGTH BEARING
SUPRACODYLAR AREA.
ON PROSTHESIS.
LATERAL INSTABILITY.

FORCES
CAUSE:
LATERAL DISPLACEMENT CORRECTION:
OF THE SOCKET. TRANSLATION MEDIALLY

TUBE IS VERTICAL

PLUMBLINE IS
LATERALLY DISPLACED

FOOT IS FLAT
4
 TT DYNAMIC ALIGNMENT: ANTERIOR VIEW

PROBLEMS!!!
EXCESSIVE PRESSURE AT
LATERAL PROXIMAL AND
MEDIAL DISTAL AREAS. GAP
DEVIATION OBSERVED
GAP AT MEDIAL DURING MID STANCE PHASE
SUPRACONDYLAR AREA.
P WITH FULL WEIGTH BEARING
ON PROSTHESIS.
MEDIAL INSTABILITY.

CAUSE: FORCES
EXCESSIVE ADDUCTION 2
OF THE SOCKET.
1 CORRECTION:
1 - ABDUCTION OF THE SOCKET
2 - TRANSLATION MEDIALLY
Avoid doing two different
TUBE IS MEDIALLY adjustments at the same time!
INCLINED

PLUMBLINE IS
MEDIALLY DISPLACED

FOOT IS PRONATED
(VALGUM GAIT)

5
 TT DYNAMIC ALIGNMENT: ANTERIOR VIEW

PROBLEMS!!!
EXCESSIVE PRESSURE AT
LATERAL PROXIMAL AND GAP
MEDIAL DISTAL AREAS. DEVIATION OBSERVED
DURING MID STANCE PHASE
GAP AT MEDIAL P WITH FULL WEIGTH BEARING
SUPRACONDYLAR AREA.
ON PROSTHESIS.
MEDIAL INSTABILITY.

FORCES
CAUSE:
MEDIAL DISPLACEMENT
OF THE SOCKET.
P CORRECTION:
TRANSLATION LATERALLY

TUBE IS VERTICAL

PLUMBLINE IS
MEDIALLY DISPLACED

FOOT IS FLAT
6
 TT DYNAMIC ALIGNMENT: LATERAL VIEW

PROBLEMS!!!
RAPID AND PREMATURE
KNEE FLEXION.
DEVIATION OBSERVED
PREMATURE FOREFOOT DURING HEEL STRIKE PHASE.
CONTACT (SLAP FOOT).

EXCESSIVE PRESSURE AT
POSTERIOR PROXIMAL AND
ANTERIOR DISTAL AREAS.
P FORCES

2 CORRECTION:
CAUSE 1: 1 - EXTENTION OF THE SOCKET
1 P 2 - TRANSLATION POSTERIORLY
EXCESSIVE FLEXION
OF THE SOCKET. Avoid doing two different
adjustments at the same time!
CAUSE 2:
ANTERIOR DISPLACEMENT
OF THE SOCKET .
SLAP FOOT

7
 TT DYNAMIC ALIGNMENT: LATERAL VIEW

PROBLEMS!!!
HYPEREXTENSION OF KNEE.

PAIN AT PATELLA AREA. DEVIATION OBSERVED

DURING MID STANCE PHASE.
EXCESSIVE PRESSURE AT
PATELLAR TENDON AND
POSTERIOR DISTAL AREAS.

FORCES

CAUSE 1 :
POSTERIOR DISPLACEMENT CORRECTION:
OF THE SOCKET. 1- TRANSLATION ANTERIORLY
2 - USE A FIRMER HEEL CUSHION
CAUSE 2 : Avoid doing two different adjustments
TOO SOFT HEEL CUSHION. at the same time!

FOREFOOT IS RAISED
(DORSAL FLEXION)

8
 TT DYNAMIC ALIGNMENT: LATERAL VIEW

PROBLEMS!!!
HYPEREXTENSION OF KNEE.

PAIN AT PATELLA AREA. DEVIATION OBSERVED

DURING MID STANCE PHASE.
EXCESSIVE PRESSURE AT
PATELLAR TENDON AND
POSTERIOR DISTAL AREAS. FORCES

CAUSE :
INSUFFICIENT FLEXION
OF THE SOCKET.
CORRECTION :
FLEXION OF THE SOCKET

HEEL IS RAISED
(PLANTAR FLEXION)

9
 TT DYNAMIC ALIGNMENT: LATERAL VIEW

PROBLEMS!!!
ABNORMAL PERMANENT FLEXION
OF KNEE. DEVIATION OBSERVED
DURING HEEL OFF PHASE.
PATIENT FEELS LIKE WALKING
"DOWN THE HEEL".

EXCESSIVE PRESSURE AT P
POSTERIOR PROXIMAL AREA.

FORCES
CAUSE 1 :
EXCESSIVE FLEXION 2
OF THE SOCKET. 1 CORRECTION:
1 - EXTENSION OF THE SOCKET
2 - TRANSLATION POSTERIORLY
CAUSE 2 :
ANTERIOR DISPLACEMENT
Avoid doing two different adjustments
OF THE SOCKET. at the same time!

10