AMPUTATION-PTB SOCKET ALIGNMENT
SUMMARY
1. AP alignment: 5o flexion for efficient movement & prevention of pressure injuries. If a patient has 15o of hip flexion contracture, create a socket with 15o knee flexion.
2. Use Thomas test to detect hip flexion contractures.
3. Heel lever is 1/3 posterior & toe lever is 2/3 anterior.
4. Toe lever: having the socket too far forward causes a shortened toe lever. Acts as eccentric plantar-flexors. If the toe lever is too long, the patient feels like 'walking up-hill'.
5. Heel lever: acts as eccentric dorsiflexors.
6. ML alignment: 5o abduction; foot directly under the socket. Foot may be inset or outset (provides more stability). Malalignment leads to 2 pressure point injuries.
Reference(s)
Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.
