INTRODUCTION

TO
PROSTHETICS

DR. SHOAIB KAYANI (PT)

DPT (KING EDWARD MEDICAL UNIVERSITY)
MS-OMPT (RIPHAH INTERNATIONAL UNIVERSITY)
PGC NEUROLOGY . PGD ORTHO REHAB
WE WILL COVER:

INTRODUCTION TO PROSTHETICS
PROSTHETIC PRESCRIPTION
FABRICATION OF THE PROSTHESIS
THE SOCKET (CASTING, POSITIVE
MOULD AND RECTIFICATION)
KNOWLEDGE OF PROSTHESIS
• The Physiotherapist is not required to understand all the technical aspects of the prosthesis and
fitting but should have a knowledge of the following:
• Proper prosthetic fit and alignment –
This will enable the therapist to evaluate if the cause for gait deviation and pain is as a result
of the prosthesis.
• Function of the different prosthetic components –
To be able to teach the patient to use the prosthesis optimally and to apply the correct gait
training strategy (see for e.g. different types of knees), and avoid pitfalls (for e.g.
loading the prosthetic toe might unlock a specific knee joint).
• Correct donning of the prosthesis and what to do if the socket sits uncomfortably.
PROSTHETIC PRESCRIPTION
• Prescription of a prosthetic is a multidisciplinary process that
includes at least the user, Prosthetist and physiotherapist.
• During the prescription process the team decides on the:
– Type of device that should be fabricated
– Socket design
– Various types of components
– Choice of suspension
FABRICATION OF THE PROSTHESIS
• The fabrication of the prescribed prosthesis also goes through various stages
that could influence considerably the rehabilitation and the physiotherapy
program planned after the first fitting.
• These fabrication steps are:
– Casting
– Positive mould
– Rectification
– Assembling
– Alignments
– Cosmetic
PROSTHETIC COMPONENTS
 THE SOCKET (CASTING, POSITIVE MOULD AND RECTIFICATION)
PROSTHETIC SOCKET
•The primary interface between the amputee's residual limb and the ground
•A good, comfortable fit is required to ensure a positive outcome is reached in an
amputees rehabilitation
CASTING
•The Prosthetist takes the measurements for the socket using plaster bandages to
create a cast
POSITIVE MOULD
•The cast created is filled with plaster powder to create a positive mould.
RECTIFICATION
•The positive mould is then modified to optimize the socket fit
•The socket is then shaped over the mold to create the custom socket, this is referred
to as a laminated socket.
 THE SOCKET (CASTING, POSITIVE MOULD AND RECTIFICATION)
• A “check”/diagnostic socket is sometimes fabricated before creating the
definitive socket
• This socket is usually transparent, allowing the clinician a complete
view to evaluate the fit and make changes.
• Multiple fittings are at times necessary to assure the best possible design
with a comfortable and effective fit.
• Generally sockets are made out of plastic either thermoplastic or with
thermosetting, called laminated sockets.
• Laminated sockets can be reinforced with fibre glass, carbon fibre, or
nylon
THE SOCKET (CASTING, POSITIVE MOULD AND RECTIFICATION)

• Because it is the interface between the device and residual limb, the
quality of the socket design is key and decides on user’s comfort and
his/her ability to control the appliance.
• A user will never walk properly and will never reach the agreed goal
of the rehabilitation plan if the quality of the socket fit is not
satisfactory regardless of the material used (plastic, resin or carbon).
• The quality of the fit depends entirely on the work of the Prosthetist
and his/her capacity to insure precise measurements during casting and
suitable rectification of the positive mould to distribute forces over the
socket where needed.
• The socket is the crucial interface that is the foundation for connecting the prosthesis directly
with your residual limb.
• The shape of your limb is captured by wrapping it in plaster to create an exact mold of every
detail of your limb. The cast will then be used to make a positive replica of your limb. This
mold will be the basis for creating the completed socket system.