A prosthesis is an artificial means that replaces a segment of the musculoskeletal system from an anatomical and functional point of view.
Prostheses can be internal or external. Internal prostheses are those applied inside the body through surgery.
External prostheses or orthopedic prostheses are an artificial means that replaces a limb or part of it lacking in morphology and, as far as possible, in function.
The prostheses are applied to subjects undergoing upper or lower limb amputation due to severe soft tissue and/or skeletal trauma, vascular disease, infection, malignant tumors of the skeleton or bones. soft tissues and congenital malformations. Today, thanks to modern technologies, more and more sophisticated models have been created.
Modular leg prosthesis (transtibial) with classic socket
Leg prosthesis with rigid carbon socket and poliform cuff, with lateral wings above the condyles for containment and suspension; a cotton pillar cover should be worn on the skin before the cap. The modular structure can be made of steel (no longer used due to its weight), titanium, aluminum and carbon. The veneer completes the prosthesis. The foot normally used is fixed in rubber (Sach), but carbon fiber feet of different types can be applied.
Modular leg prosthesis (transtibial) with TEC urethane cuff with and without pin
Prothèse de jambe avec emboîture rigide en carbone et manchette en uréthane TEC. Le bonnet TEC se porte directement sur la peau, il ne fait pas transpirer, il protège la peau des abrasions et des frottements et offre un maximum de confort aux patients de tous âges et pour tous les niveaux d'activité. Il existe deux alternatives : capuchon de douille avec ergots bas et manchon de suspension TEC Prolink ou capuchon de douille avec goupille avec système de verrouillage.
Modular leg prosthesis (transtibial) with TEC urethane bath cuff
Leg prosthesis with rigid carbon socket and TEC urethane cuff. The TEC helmet is worn directly on the skin, it does not cause sweating, it protects the skin from abrasions and chafing and offers maximum comfort for patients of all ages. The modular system, for the ankle joint, allows the foot to be positioned at 90° for walking or at approximately 30° for swimming. This component can also be used in traditional transfemoral bath prostheses.
Thigh prosthesis (transfemoral) with classic quadrangular socket
Thigh prosthesis with quadrangular resin socket with classic pneumatic seal. The modular components and the knees are of different materials and types depending on the needs of the patient and the type of prescription.
Thigh prosthesis (transfemoral) with flexible socket for ischial compression
Thigh prosthesis with flexible socket with ischial contention with pneumatic joint and rigid support socket. The socket with ischial contention and subtrochanteric support has a more physiological shape than the quadrangular and is generally more comfortable. The modular components and the knees are of different materials and types, depending on the needs of the patient and the type of prescription.
Thigh prosthesis (transfemoral) with TEC urethane cuff with pin
Thigh prosthesis with urethane cuff and pin locking system. The rigid socket can be with ischial or quadrangular contention. This type of socket is particularly suitable for geriatric patients as it allows easier placement of the prosthesis (also possible in a seated position) and is extremely comfortable. The modular components and the knees are of different materials and types, depending on the needs of the patient and the type of prescription.
Electronic knee C-leg – Otto Bockn
The C-Leg with electronically controlled hydraulic system is the first in the world to be completely controlled by microprocessors. Electronic sensors detect the data necessary for the safety of the stance phase and the control of the swing phase. With C-Leg, the rhythm gets closer and closer to the physiological rhythm. C-Leg meets all safety and functionality requirements. With the C-Leg knee, walking with the prosthesis becomes an automatic process that does not require continuous attention or concentration. Safety in all phases of walking: this is the objective of the researchers who developed the 3C100 C-Leg knee. It is now possible to move and walk serenely, managing to descend a flight of stairs by alternating right foot and left foot, even if it is steep, in addition, steep ramps and uneven terrain will no longer be a problem. C-Leg automatically adapts to all situations and the contralateral limb is not overloaded.
Static and dynamic adjustments
After wearing the transfemoral prosthesis and becoming familiar with the socket, it's time to try walking around.
Rarely all the settings of the prosthetic joint are perfect the first time: static (fixed posture) and dynamic (moving posture) components come into play that must be adjusted during the fitting to find the fit optimum.
By settings, I mean the height of the prosthesis, the correct inclination of the foot, the knee, the speed and amplitude of the opening and closing of the latter rather than translations forward or behind all the hooks, from the socket attachment to the ankle attachment.
Each component plays a fundamental role in walking and nothing should be left to chance.
Modern knees (from hydraulics to electronics to the most sophisticated bionic knees) then have other settings that need to be adjusted to achieve maximum comfort.
Each of us has our way of walking and the prosthesis should not change it but support it and, as far as possible, try to improve it.
Relying on professionals is crucial: often details that we do not perceive jump to the eyes of an expert who will know how to remedy them quickly by proposing adapted solutions.Estimated time: indefinite because extremely subjective.
The seemingly endless wait
Waiting for the construction of the final socket – and therefore the prosthesis itself – is without doubt the most boring moment of the whole day.
This phase begins when we approve everything from the plug to the adjustments that were made in the previous testing phase (don't rush to burn time and take the time needed to complete them, even whole days if it is necessary).
Remember one thing: during the try-in, it is always possible to modify the statics and dynamics of the prosthesis very easily.
On the other hand, it is different to ask for major modifications on a final tank: widening or shrinking it is a difficult undertaking when the carbon and resin skeleton is completed.
Don't worry and don't take on too much responsibility though: you can always go back, but an assessment error that could have been guessed before will now waste your time and possibly money.
All that remains is to wait for the next stage and pass the time in the most relaxing way possible.The bulk is done.Estimated time: even half a day, depending on clinic availability.
Final walk tests
The prosthesis is almost complete: the socket is well formed, resistant and much more welcoming.
The materials have different comfort, and wearing it will make you feel different from the temporary tank. Portions of even softer material are added to the pressure points (ischium) and abrasion (groin) for maximum comfort.
Try it and try it again dozens of times in every situation: walk down the street, climb a flight of stairs, face a descent, sit still for a while. Wear it and take it off as many times as you want: it is often enough to wear it half a centimeter further forward or backward to experience different sensations.
Final finishing touches
This phase is not obligatory: it is the phase in which each of us chooses to leave the prosthesis "bare", protected by a cover or to cover it with a reinforced foam which simulates the thickness of your healthy leg.
Coat the prosthesis with foam
A choice widely used here in Tunisia due to a different cultural heritage compared to other countries where disability is seen in a much more natural way and not as a shame to be hidden.
ADVANTAGES: aesthetically identical to natural, it protects the knee in the event of a fall or slight friction.
Leave the prosthesis free without covering it (or use a cover)It is a very fashionable choice in Anglo-Saxon countries (in the United States no one dresses them anymore). It allows a smoother walk (the knee has no friction). The prosthesis is lighter and more manageable, it also allows better inspection (and possibly cleaning) of all its components.
However, the prosthesis is more exposed to knocks and scratches and you should not worry about what people think as soon as they see it: you will probably not go unnoticed so it is good to prepare well from a psychological point of view and not to be caught off guard.