Treatment Plan

Step 1 | Shrinkers

Once the sticthes or staples have been removed and the incision is healed, you will receive shrinker socks. You will be measure and fit by your prosthetist. The purpose of the shinker socks are to keep the leg from excessively swelling and to prepare the leg for a prosthesis. A swollen, blubuse shaped limb is normal after surgerybecause blood pools at the bottom of the leg. A bulbous limb makes prosthetic fitting difficult because the leg will not easily slide in and out of prosthesis. The shinker socks help shape the limb into a conical or cylindrical shap necessary for using a prosthesis. Shirnkers will be worn at all times but can be removed for bathing. You will be given two socks, one to wash and one to wear. If there is a lot of swelling initially, you will be given another set of shirnker in a smaller size to continue compression on the limb. As the swelling subsides thorughout the day, shinker socks will tend to slide down. You man need to pull them up several times throughout the day.

Step 2 | Cast/Measure for Preparatory Prosthesis

Once you have been in shinkers for 1-2 weeks, you limb begins to take on a cylindrical shape because the swelling coninues to decrease. At the time your physician and prosthetist will decide if you are ready for a prosthesis. It isimportant not torush into being fit with a prosthesis before you leg is physically ready.

The process of making and fitting the prosthesis may take 2-3 weeks. You will be casted or measure for a prosthetic socket. If you are casted, your prosthetist will wrap plaster of Paris bandages on your leg and then remove the cast when it harderns. Several measurements will also be taken. If you are measure for the socket, the prosthetist will take additional detailed measurements of the leg. Discuss with your prosthetist your occupational requirements, your hobbies, footwear and any other concerns you might have. This will helpyou and prosthetist determine what components or options may be the best for you initial or preparatory prosthesis. You may see a sample of what the prosthesis will look like.

Step 3 | Check Socket Evaluation

The mold or measurements taken previously will be used tomake a check socket. The socket is a clear plastic device that is a trail socket for the prosthesis. Ths sock is the interface between you leg and hte rest of the prosthesis, therefore a comfortable fitis crucial. This check socket is used to detemine if any changes need to be made before proceeding with the prosthesis. Adjustments will be amde at this time to ensure the best possible fit of the prosthetic leg. There is a certain amount of discomfort associate with wearing a prothesis. The socket should not be painful, rather most people describe the feeling as pressure. The reason a prosthesis needs to fit tightly is to support your body weight in areas on the leg that can tolerate it. The bottom of the legcannot tolerate weight bearing forces and therfore the socket pushes elsewhere on the leg in order to hold you up. If significant changes need to be made to the check socket, this step will be repeated in order to provice the most comfotable socket possible.

Step 4 | Dilvery of the Prosthesis

At the dilvery appointment, your prosthetist will make alignement adjustments to the leg in order to help you stnad onyour prosthesis comfortably. You will be instructed on how to use your prosthesis. Time spenton the prosthesis will be retstricted in order to providea break in period and to idenify any potential problems with the fit of the prosthesis. As you are breaking in you prosthesis, you will continue to wear shinker socks any time you do not have the prosthesis on. Shrinkers may be discontinued when you are up to full time use with your prosthesis. Also, in some cases, people will wear the shinkers at night if they find difficulty getting the prosthesis on in the morning due to swelling.

Step 5 | Follow Up Appointments

You will be seen 1-2 weeks afer receving your prosthesis for a checkup. Once you have gun to adapt to the leg and trust it, you will stand on the leg differently. Changes will need to be made to adjust the leg to fit you. At this time you will be evaluated to determine if you are ready for physicl therapy or if you need continued adjustments to achieve optimum fit. Once physical therapy begins you will be seen 1-2 weeks afterward for follow up. Follow up beyond this point will be monthly or or as needed.

Over the Next Year

The perparatroy prosthesis is the first prosthesis you will recieve. It is expected to last 6 months to a year. Over the course of the next year your leg will change dramatically. Swellling will stabilize and the muscles hat used to control movement of the amputated lower leg atrophy. In order to compenstate for the changes in your leg, prosthetic socks are worn and more adjustments are made to the prosthesis in order to ensure it is comfotrable and functioning properly. At some point anywhere from 6-15 months after being fit with your preparatory prosthesis, no more adjustments will be possible to the current leg tomake the leg fit the way it should. Your limb will stabilize andnot swell as much either. At this time you will be ready for your definitive prosthesis.

Definitive Prosthesis

In order to make the definitive prosthesis, you will again becasted measured and check socket will be fit. You and your prosthetist will discuss any changes that will be made for the new prosthesis. You may choose another system of suspenstion, a different foot or knee, a protective leg shape cover, or to make no design changes at all.