Many amputees are very concerned about the process and precautions of prosthesis assembly and don't know where to assemble it. In view of this kind of problem, I will open a separate post to summarize it for your reference.

Chapter 1: Optimal Assembly Cycle of Prosthetics

This is related to the cause of amputation. The so-called amputation is to cut off and cut off a part of a limb.

The reason for amputation is

1. Injury and its sequelae.

2. Peripheral blood circulation disorder.

3. Malignant tumor

4. Inflammation

5. Nervous system diseases

6. Congenital malformation and obvious leg length inequality

When we talk about the best assembly period, the best assembly period for trauma patients is two weeks to two months.

Fracture patients should be reexamined three and a half months after operation to see if the broken leg can bear the weight. If yes, consider going to the prosthetic company to assemble the prosthesis in the fourth month.

For patients with peripheral blood circulation disorder, the cavity should be loose and the prosthesis should not be too tight.

Patients with malignant tumor should be fitted with artificial limbs after the third course of chemotherapy to improve their mobility and enhance their immunity.

Patients with osteomyelitis need not be too obsessed with leg protection. If they can protect their legs, they can save their lives. No special requirements.

Patients with congenital malformation should seek the advice of orthopedic surgeons, say hello in advance, and ask the technicians of prosthetic companies about the ideal amputation site.

Chapter II: Amputation site

Also known as amputation plane, we divided different types of prostheses according to different amputation planes.

Lower limb amputation grades are divided into:

Hemipelvic amputation-hemipelvic prosthesis

Hip amputation-hip amputation prosthesis

Above-knee amputation (thigh amputation)-thigh prosthesis

Knee amputation-knee amputation prosthesis

Amputation below the knee (leg amputation)-artificial leg

Ankle amputation-ankle amputation prosthesis

Partial foot amputation-hemiprosthetic foot

Upper limb amputation grade:

Hemishoulder amputation-hemishoulder amputation prosthesis

Shoulder amputation-shoulder amputation prosthesis

Upper arm amputation-upper arm prosthesis

Elbow amputation-elbow amputation prosthesis

Forearm amputation-forearm prosthesis

Wrist amputation-wrist amputation prosthesis

Hemiankle amputation-cosmetic zipper hand

Finger amputation-cosmetic finger

Chapter III: Selection criteria of artificial limbs

This is a big problem. Patients with different amputation sites have corresponding selection criteria. I will choose the main part, if only the pronunciation. It takes time to type on a mobile phone.

Section 1: Selection criteria of artificial limbs

In fact, to put it bluntly, the selection criteria for prosthetic legs are:

Choose full-length arm, carbon fiber skeleton, pedal with foot center and foot shell separated.

Only in this way can we ensure that the prosthesis and the good foot are completely equal in length, the walking stride is equal, and there is no time difference between the steps.

When walking on your forehead, your arms and pelvis will not rise and fall, and you will not see a limp.

In fact, there are many business languages when every sentence is decomposed.

In the market, the assembly price of prosthetic legs meeting this requirement will not be lower than 15000 yuan.

Although the detachable prosthesis is expensive to install, the cost of future maintenance is very low and the bionic effect is good.

Therefore, the quality of life needs to choose the right prosthesis, not the cheaper the better.

A good pedal has six movements on three sides of the ankle joint.

Dorsal flexion and plantar flexion in sagittal plane

The adduction and abduction in the horizontal plane are also called pronation and supination.

Inversion and eversion in the frontal plane.

The most classic pedal of this kind is the function king of American CPI.

Section 2: Selection criteria of thigh prosthesis

Knee amputation prosthesis has joints specially used for knee amputation, and the bending structure of knee joint must be as low as possible.

For example, 3R 106 and 3R60 hydraulic joints of ottobock are all suitable for patients with knee amputation.

It doesn't matter whether patients with medium and long residual limbs choose joints or not. Pneumatic or hydraulic four-bar pneumatic knee joint or multi-axis geometric locking knee joint can be used.

Short stump must use multi-axis pneumatic or hydraulic knee joint with lock.

Let me talk about thigh prosthesis joints: knee joints are all mechanical joints. Adding pneumatic, hydraulic and intelligent control units to mechanical joints means pneumatic knee joint, hydraulic knee joint and intelligent knee joint. However, some knee joints have multi-axis geometric locks or single bearing re-locking devices.

In fact, the length of each person's stump is different, and the shape of the amputation plane is also different. Whether there is a skin graft or not depends on the residual limb first, and then recommend a suitable prosthetic assembly scheme within the patient's purchasing power.

In fact, the lighter the prosthesis, the better, so the key point is that the minimum standard for amputees to choose thigh prosthesis is actually light, labor-saving, safe and comfortable.

Lightweight means: the weight of the joint itself is low, and the alloy knee joint we import now is light and durable.

Labor-saving means: choose pneumatic or hydraulic assisted knee joint.

Safety refers to: multi-axis knee joint with geometric lock, or load-bearing self-locking knee joint, manual unlocking knee joint, etc. This kind of knee joint allows patients to go downstairs alternately without falling off slopes, buses and steps. If you are not worried about walking and falling, can you walk boldly, so that your gait will be more natural.

Comfortable means: accepting the adaptability of cavity and residual limb, I will develop the basic knowledge of cavity material and mouth shape respectively. Connecting cavity technology is very important. If done well, the patient will walk naturally and go further. This is that as a technician, I will constantly improve my skills and better serve the patients with triple paralysis.

To sum up, in fact, if conditions permit, patients with thigh amputation choose multi-axis geometric lock pneumatic or hydraulic knee joint+carbon fiber energy storage pedal. Only in this way can the value of prosthesis be reflected, which is the standard for the selection of patients with above-knee amputation.

For example: ottobock 3R60/3R60-Pro double hydraulic elastic buckling safety knee joint +ottobock 1C30 light carbon fiber bionic foot+plate or resin receiving cavity,

It's a prosthetic leg for thigh patients with no regrets.

Another example is Osso Toto? Seven-axis geometric lock knee joint type 2000+ Osean Shu Scud? +plate or resin socket is also the choice of perfect prosthesis.

Section 3: Selection criteria of forearm prosthesis

Forearm amputation: We refer to the prosthesis between 6cm below the elbow and wrist amputation.

For patients with forearm amputation, I suggest assembling two artificial limbs, one is a cosmetic hand and the other is a forearm single-degree-of-freedom myoelectric hand.

Cosmetic prosthesis can be directly made into a cavity and connected to the cosmetic hand (mainly a light, realistic and natural hand shape, and can also be held in any hand shape).

The second is a single-degree-of-freedom myoelectric prosthesis, which is flexible in operation and can be extended and contracted freely.

Forearm myoelectric hand brands include domestic brands:

Shanghai kesheng

Danyang prosthesis

Danyang Jingbo

Groot

Imported brands include

American Utah player

Otto Bok, Germany

British style

The national RSL is steeper.

At the same time, patients with forearm stump can have a new choice for the cavity technique, that is, using Ossur or Otto Bock's upper limb silicone sleeve to suspend the prosthesis, which can straighten the prosthesis and complete the internal rotation and external rotation.

Section 4: Selection criteria of upper arm prosthesis

Above the elbow joint, it is recommended to choose the beautiful bone hand first. How can I put it? The myoelectric hand is too heavy, so the upper arm has to use a two-degree-of-freedom myoelectric prosthesis. There is a motor at hand and a motor at the elbow joint, and the switching speed is very slow. If a good hand can do it, there is no need to use artificial limbs.

Beautiful hands are different. They are realistic in appearance and light in weight, and will not go out with empty sleeves.

The recommended configuration is:

Resin or plate storage cavity+Shanghai Kesheng metal skeleton+Hong Kong royal custom beauty hand skin.

It is necessary to measure and compare the size of patients' healthy hands.

Section 5: Selection criteria of hip amputation prosthesis

Hip amputation prosthesis actually increases the cost of a hip joint based on thigh prosthesis.

Chapter 4: Selection of prosthetic connector.

The lighter the prosthetic accessories, the better. This prosthetic company doesn't want to talk about it, nor does it let patients know too much.

I only talk about the selection criteria:

The link parts on the cavity should be imported with steel seal number or accessories produced by regular manufacturers, and the materials are titanium alloy and alloy steel.

There are alloy steel and aluminum alloy pipe joints.

One end of the connecting rod has a joint, the best carbon fiber shaft and titanium alloy head.

Followed by all-aluminum alloy pipe body and aluminum alloy pipe head, which is light and strong. For example, Ossur's aluminum pipe and Otto Bok's aluminum pipe are the best choices, so it is not necessary to entangle carbon fiber rods too much, and aluminum is enough as a connecting rod.

The thigh prosthesis can emphasize the need for carbon fiber rods, and the calf prosthesis is not needed at all, because the length of the residual limb+the height of the high ankle pedal+the height of the hanging cavity of 2cm is too low for the height of the connector.

In fact, the weight of titanium alloy and alloy steel with good connectors is very different, and the price is also 1 ~ 2000 yuan. If patients blindly ask for cheap prostheses, the prosthetic company can't give you a good link easily.

This requires the sincere recommendation of the prosthetic company, and the amputee can pay the corresponding money.

Chapter VI: Outer Packaging of Prosthetics

If the outer packaging of the calf and thigh prosthesis is sponge, it will be very realistic according to the good leg curve when grinding, and the sponge should be compressed with elastic bandage in advance before grinding. Just polish it and wear socks directly.

The second is foam packaging, which is not very beautiful, but it can be waterproof to the outside world and the ankle will not be deformed when wearing socks. This kind of packing is adopted in Britain, China and Germany.

The third is to use silicone fake skin or spray waterproof paint.

In fact, the outer packaging of artificial limbs does not need to be waterproof. You can't swim with a prosthetic, and you can't take a bath with a prosthetic with tens of thousands of dollars. Think back. How many times do you get caught in the rain a year?

Germans use 3R95W for bathing, which is their luxury. Tens of thousands of dollars.

Chapter VII: Life span and warranty period of artificial limbs;

Many patients think that the life span of artificial limbs is a lifetime, and many patients think that the more expensive artificial limbs are, the longer their life span is, which is wrong.

1. Warranty period and service life of prosthesis:

The warranty period of fingers, zipper handles and silicone half feet is 12 months, and the service life is about 3~5 years.

The warranty period of leg prosthesis, hip prosthesis and knee prosthesis is two years made in China and three years imported, including half a year for foot skin. The actual service life is about 3-5 years for domestic products and 5-7 years for imported products.

The warranty period of forearm and upper arm myoelectric hand is one year, and that of imported hand is two years. The service life is about 5 years, and the leather coat is guaranteed for half a year. If it is broken, it will be replaced.

The warranty period of smart legs is five years.

It's not that the more expensive it is, the longer its service life is, but that it has good effect and full functions, on the contrary, the subsequent maintenance cost is higher.

The theoretical basis of using artificial limbs is to detect how long the life span is. The international quality standard is 3 million times, equivalent to one step at a time, equivalent to a life span of about 5 years. After amputation, the patient's activities are reduced, which can increase the life of the prosthesis. The quality standard is 3 million times, and the actual test may be 5 million times, so the service life may be about 8 years. The use time of the prosthesis should be judged according to his own activity. According to the current experience, most of them can last at least 8 years-10 years.

Chapter 8: Duration of Prosthesis Assembly:

Prosthetics don't have to wait until there is no phantom limb pain.

The training time of prosthetic company is generally about 0/5 day for calf/kloc-,about 25 days for thigh prosthetic training, one month for hip amputation and one and a half months for patients with double thighs.

The upper arm prosthesis can be discharged within one week,

Half a foot, half a hand and plastic fingers can be used at any time without hospitalization.

Chapter 9: Materials of Containers:

At present, there are three kinds of materials for making prosthetic socket:

1, connecting plate cavity (imported and made in China, white flesh color), plate weight less than 90km, resin cavity higher than.

2. The resin receiving cavity (domestic resin and imported resin, hard resin and soft resin) has long legs and limbs, and the upper arm prosthesis is made of resin.

3. The carbon fiber receiving cavity (also made of resin, only the socks are replaced with carbon sleeves) is mostly used for the outer cavity frame of calf prosthesis and thigh prosthesis.

That is to say, different amputees, different weights and different lengths of residual limbs choose different materials for the receiving cavity. Treat it differently and don't overdo it.

The quality of cavity is related to the level of mold repair by technicians, not to the material.

Of course, the gait effect of prosthesis is also related to the condition of residual limb. For example, the thigh stump is short, so it is unrealistic to walk out of the normal gait.

Chapter 10: Choice of Prosthetic Brand

Many patients ask what brand of prosthesis is good, so I will make a summary for this kind of problem.

In fact, the selection criteria of prostheses in different amputation parts are different, and it is difficult to do everything without prosthesis accessories suppliers, so each has its own fist products. We still classify according to parts, according to domestic brands and imported brands:

1, upper arm prosthesis: the elbow is the beauty hand of Hong Kong Royal Prosthetics, and the best myoelectric hand is the product of Shanghai Kesheng.

The choice of forearm hand is the same as that of upper arm prosthesis, and the best imported ones are British bionic hands steeper and touch. Followed by the products of Otto Bok in Germany.

The best product for cosmetic finger half-palm zipper hand is Hong Kong Royal Prosthesis. Domestic products are the products of Longkang Human Body Simulation Institute.

The best hip joints of lower limb prosthesis are Otto Bok joint and McGrady spherical hip joint.

Otto Bok and Osso's products have the highest market share in the knee joint market.

The best pedal is Ossur's product.

The best silicone sleeve is Ossur's product.

Half-foot prosthesis: silicone half-foot prosthesis is the best of Hong Kong Royal Prosthesis, and carbon fiber half-foot prosthesis is the best of Otto Bok and Osso.

Chapter 11: Matters needing attention in amputation.

It is necessary to consider the residual function and quality of life of patients' limbs after operation to decide whether to implement amputees at the amputation level.

No matter where the amputee is, try to keep the length of the stump.

Chapter 12: How to Match and Choose Prosthetics under Different Amputation Conditions?

A: The residual limb condition, physical condition, working and living environment and activity level all affect how to choose a prosthesis.

First of all, we should correctly accept the empty form. Among them, patients with residual limb scar, obvious bone mass and blood circulation disorder, such as vasculitis and diabetic amputation, need to use soft silicone sleeve to protect the residual limb, especially those with diabetes and vasculitis. Once the residual limb is injured, it is especially difficult to recover. Silicone sleeve is currently recognized as the best protection measure.

For some active young amputees, you can choose high-impact prostheses, such as using carbon fiber feet with stronger energy return ability to achieve faster walking and movement speed, and using hard silicone rubber sleeves to improve the suspension ability of prostheses and reduce piston movement, which can not only protect the skin, but also stabilize the soft tissue of residual limbs and improve the stability of movement.

Chapter 13: What is the level of prosthetic limbs in China? What is its position in the world?

A: First of all, the prosthesis should be divided into two parts, the receiving cavity and the component. The receiving cavity is customized according to the human body, and the components are randomly assembled according to the patient's situation.

At present, China's cavity technology is in line with international standards. International companies cooperate with prosthetic societies and do a lot of training every year. This form of learning can quickly transfer foreign new technology to domestic parts, so the development of prosthetic limbs popular in China is still good.

Functional prosthetic components mainly rely on imports, including imported hydraulic knee and ankle joints, as well as some excellent foreign products such as intelligent and dynamic prostheses to meet the needs of amputees at all levels, including sports prostheses needed by some disabled athletes. But at present, China is learning from foreign product technology and developing its own products, including intelligent lower limb prostheses and intelligent upper limbs.

Chapter 14: What is an intelligent prosthesis? What's the difference with ordinary prostheses?

A: Ordinary prostheses can't perceive the environment, stairs and slopes. They mainly rely on the patient's own ability to control the walking speed through air pressure and hydraulic pressure, and have a certain range of walking speed response, which is very different from intelligent prostheses.

Intelligent prosthesis has the ability to perceive and judge the environment, and has the functions of learning, pace response and millisecond jump. Among them, the dynamic prosthesis can achieve the same force as the muscle. Osso's newly developed intelligent prosthesis can realize active movement by combining with the induction electrode under soft tissue, and the product will also be on the market in the near future.

Chapter 15: What are phantom limb sensation and phantom limb pain? Do you need treatment?

A: It is mainly related to trauma. Phantom limb sensation and phantom limb pain are two different states. The phantom limb feeling is to feel that the amputated part still exists and you can feel where you are.

Phantom limb pain is mainly traumatic, mainly caused by surgery, and there is also a psychological factor. Some people are particularly afraid of pain. If you touch the amputated part of this person, he will feel pain, but he will not feel pain if he touches it himself. The pressure inside him causes pain, and the outside world is due to the magnetic field.

Ossur and McGrady have a silicone sleeve, and plan to avoid the pain caused by the magnetic field. The main principle is to shield the interference of magnetic field to residual limb. However, the best way is to carry out rehabilitation training, find a professional rehabilitation doctor and carry out rehabilitation training in a rehabilitation hospital. Then, try to install artificial limbs and wear artificial limbs. Daily walking phantom limb pain will gradually reduce, and some people will feel weaker and weaker after treatment.

Psychological factors depend on the guidance of psychologists, the best treatment, rehabilitation treatment, prosthetic treatment and psychological guidance.