Buy below knee prostheses (transtibial prostheses)
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Below knee amputation (transtibial amputation) is by far the highest incidence of all amputations. It can be a result of disease (such as diabetes and other related vascular/circulatory conditions), trauma, infection, tumors (cancer) or congenital abnormalities.
As the anatomical knee joint is still present, below knee amputees generally regain very good mobility and can often return to active and relatively normal lifestyles. As there is no prosthetic knee joint component needed, the cost of a below knee prosthesis is also significantly lower compared to an above knee amputation.
There are many different socket designs, suspension systems (for attachment of the prosthesis) and prosthetic feet designs that can be selected from. The role of the prosthetic practitioner is to guide each patient in the most ideal selection of options, within each patient’s relevant budget.
Below Knee amputees generally regain very good mobility and can often return to very active and relatively normal lifestyles. Irrespective of the reason for amputation, the prosthetic principles and structural components of below knee prosthesis is in essence the same and constitutes generally of the following:
– without any cosmetic covering
– covered with cosmetic foam and cosmetic stocking
– covered with high definition silicone cover
– with “hybrid” cosmetic covering where only the prosthetic foot is covered with high definition silicone cover and the rest of the prosthesis mechanical components are exposed
Amputation
After the formalisation of the amputation, a compressive dressing or rigid dressing will be applied immediately after amputation to prevent swelling of the residual limb (stump) tissues. Controlling swelling is important as swelling of the soft tissues causes pain and can result in the suture site and stitches being put under undue tension.
Residual Limb – immediately post-operation. The suture line visible at front where muscle and skin are attached to form a soft tissue pad over the bone.
A wound dressing bandage is placed around the limb – the rigid dressing underneath the limb about to be closed.
The rigid dressing applied. Air is sucked out of the rigid dressing, causing it to compact and rigidify.
Compression Therapy
After approximately 7 – 10 days, the wound dressing and compression dressing will be removed. The sutures can often be removed after approximately 14 days, depending on the suture site healing. For diabetic or vascular insufficiency patients, the healing may take a little longer.
Compression therapy of the residual limb can commence once the sutures have been removed. The compression therapy has the following advantages:
- It helps to control swelling
- By controlling swelling, it helps to reduce pain
- By controlling swelling, it promotes wound healing
- It reduces and shapes the residual limb soft tissues to be ideal for prosthetic fitting
- It therefore speeds up the rehabilitation process.
Compression therapy can be done by means of elastic bandages wrapped around the residual limb, or better, by means of silicone compression liners. The silicone liners are easier to apply and give consistent graduated compression (higher at the bottom – gradually getting less at the top).
Casting, Manufacture and Fitting of Diagnostic Prosthesis
The diagnostic socket can serve as an interim prosthesis for short-term use to help further shape and reduce the volume of the residual limb. As the name implies, the diagnostic socket also serves to help determine any socket fitting problems, areas of residual limb discomfort and the correct alignment of definitive prosthesis.
Taking measurements and casting the residual limb to manufacture the prosthetic socket.
Below Knee Prosthesis with ‘’Diagnostic Socket’’ to determine comfortable socket fit and correct dynamic alignment.
Fitting of Final (Definitive) Leg Prosthesis
Once the residual limb volume and shape has stabilised, the definitive prosthesis can be manufactured. The correct alignment of the diagnostic or interim prosthesis can be transferred to the definitive prosthesis. The prosthetic components used in the diagnostic prosthesis (such as the foot, suspension lock and other attachment components) can be used in the definitive prosthesis. It is therefore simply a replacement of the prosthetic socket.
Cosmetic Covering of leg prosthesis (if applicable)
If the patient desires a cosmetic cover for the prosthesis, it will be the final procedure in the completion of the definitive prosthesis. This can be a simple foam shaped cosmesis covered with a cosmetic stocking, a basic silicone ‘’skin’’ or a high definition silicone “skin” cover that matches the skin colour, skin profile, toes and nails of the contra-lateral limb.
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