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Sirindhorn School of Prosthetics and Orthotics

CASE PRESENTATION
TRANSTIBIAL
PROSTHESIS \

Presented By
Wina 037

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CONTENTS

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HISTORY

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HISTORY
CURRENT DEVICE

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CURRENT DEVICE

OProblems
O Socket Loose
O Cuff suspension is torn
O Sach foot is torn
O Cosmesis
ASSESSMENT

Skin condition Scars on condylar area, callus present on


the patella, distal end of stump and
darkened skin on the weight bearing
areas.
Stump length Short
Tissue consistency Atrophy of stump
Distal padding Prominent distal bone 7
ASSESSMENT

RANGE OF MOTION MANUAL MUSCLE


(ROM) TESTING (MMT)
Hip Joint L R Hip Joint L R
FLEX. (125) 125 90
FLEX. 4 3
EXT. (15) 10 15
EXT. 4 4
ABD. (45) 40 45
ADD. (30) 25 30 ABD. 4 4
INT.ROT. 40 45 ADD. 4 4
(45) INT.ROT. 4 4
EXT.ROT 40 45
EXT.ROT 4 4
(45)

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ASSESSMENT

RANGE OF MOTION MANUAL MUSCLE


(ROM) TESTING (MMT)
Knee Joint L R Knee Joint L R
FLEX. (130) 130 90 FLEX. 4 4
EXT. (0) 0 0 EXT. 4 4

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ASSESSMENT

RANGE OF MOTION MANUAL MUSCLE


(ROM) TESTING (MMT)
Ankle Joint L R Ankle L R
Joint
D.Flex (20) 20 - D.Flex 5 -
P.Flex (45) 45 -
P.Flex 5 -
Inv.(30) 20 -
Inver. 5 -
Ever.(25) 25 -
Ever. 5 -

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ASSESSMENT

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ASSESSMENT
Frontal plane

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ASSESSMENT
Sagittal plane

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PRESCRIPTION
Real & Ideal prescription

Structure: Exoskeleton

Design PTB socket

Socket Resin Lamination

Suspensio Cuff suspension


n

Foot SACH foot

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INITIAL FITTING

Problem
Problem Cause
solving
Excessive pressure - Insufficient plaster Added padding at
on fibular neck buildup during popliteal area and
modification PTB
Excessive adduction - Reduced the
of socket adduction angle
15by
FINISHING

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Final Fitting

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FINAL FITTING

Problem Problem solving


Excessive compression on Removed padding at
hamstring popliteal area and increased
padding 6mm on tibial flare.

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OUTCOME
Frontal plane

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OUTCOME
Sagittal plane

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O If prosthesis has any problem, patient should

PATIENT contact to prosthetist directly instead of making


any adjustments.
EDUCATION
O Patient needs to apply 3 ply socks, on patella
area before donning the prosthesis.
O Patient needs to train himself and practice
walking with the new leg as much as possible.

Follow-up plan : One week later.


3months and then once a year.

Yas
Frontal plane DISCUSSION

New prosthesis
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Sagittal planeDISCUSSION

New prosthesis 2
DISCUSSION

ng on uneven terrain with New pros


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