NEW AMPUTEE GUIDELINES

AVERAGE TIMELINE

– POST-OP SURGERY (WEEKS 1-4)

– Healing of the residual limb

– Meet your prosthetist

– Pre-prosthetic treatment

– EVALUATION (WEEKS 4-8)

– Consultation with your prosthetist

– Receive Rx for a prosthesis

– Measurement/casting

– FITTING/DELIVERY (WEEKS 8-12)

– Test fitting of prosthesis

– Fine-tuning fit, alignment, and gait

– Delivery of prosthesis and supplies

POST-OP GOALS

Immediately following your amputation, these will be the steps taken prior to fitting your prosthesis. Our main priority during this time will be healing and protecting the amputation site.

– WOUND HEALING

– Complete closure of the suture site

– PAIN MANAGEMENT

– Phantom pain – nerve pain common post-amputation. Consult your physician if it occurs or worsens

– LIMB RESHAPING

– Fit with shrinkers to reduce edema and achieve proper shape for prosthetic fitting

– Shrinkers:

– Wear 23 hours/day if tolerated, only taking off for bathing and bandage changes

– Wash after every use

– Not uncommon for shrinkers to stretch out over time requiring a downsize with reduction of limb volume. Contact your prosthetist if this occurs

– REMOVAL OF SUTURES/STAPLES 

– Usually several weeks after amputation. The surgeon will release you for prosthetic treatment

– PT/OT FOR STRENGTH AND MOBILITY

– Ask your physician for therapy or exercise recommendations

– DESENSITIZATION OF THE RESIDUAL LIMB

– Light rubbing/tapping of the residual limb to prepare for prosthesis

– Ask your prosthetist for exercises to improve tolerance

PROSTHETIC TREATMENT

Once the amputation site is healed and the sutures are removed, it is time to begin the fabrication and fitting process for your prosthesis. These are the upcoming appointments you can expect:

– EVALUATION 

– Fill out required documentation

– Discuss with your activities of daily living, occupation, and prosthetic goals

– Formulate a plan of care for the prosthesis including design and function specific to the patient’s needs and functional ambulation (a.k.a. K) level

– Fit with shrinkers (if not already done)

– MEASUREMENT/CASTING

– Done once the limb is completely healed and in an appropriate size and shape

– This captures the shape and size of the residual limb to ensure a good fit

– DIAGNOSTIC FITTING

– Fabricate and fit a temporary (diagnostic) socket to ensure proper fit

– Adjustments are done now to improve initial fitting fit

– DYNAMIC ALIGNMENT

– Fine-tune the alignment of the prosthesis to improve gait mechanics

– Further optimize the fit and function of the prosthesis

– DELIVERY

– Delivery of finished (definitive) prosthesis

– Educate the patient on wear and care of prosthesis and supplies

– FOLLOW-UPS

– Improve fit and/or function of the prosthesis

– Receive new supplies

ADDITIONAL INFORMATION

– K LEVELS – K-Levels dictate the type of componentry chosen for your prosthesis. Your referring physician will need to document this in your medical records when prescribing the prosthesis. It is not uncommon for new amputees to start at a lower K-Level before progressing to higher levels with prosthetic intervention and rehab therapy.

– K0 – Bed-bound; Prosthesis not medically necessary

– K1 – Limited Ambulator; Able to transfer and walk on level surfaces at one speed

– K2 – Home-Ambulator; Able to walk on uneven surfaces, and small barriers

– K3 – Unlimited Community Ambulator; Able to vary speed on all surfaces

– K4 – Unlimited; Typical demands of child, active adult, or athlete