What is the amputation level called when cuboid is cut in half and everything distal from navicular is removed?
100
Smaller area of support, changes in weight bearing, absorption of rotation, muscle imbalance, no toe off.
What are the functional losses of more proximal PF amputations?
100
Lisfranc
What is the amputation level performed between the cuneiform and cuboid and on the other side metatarsal bones?
100
Good cosmesis, ankle function, lighter, not so hot.
What are the advantages of a below ankle socket design?
100
Copenhagen.
What is the capitol of Denmark?
200
Equinovarus.
What is the most common deformity for more distal PF amputation levels?
200
Pronators have lost their insertions so supinators are stronger.
What is the reason for supination tendency in more distally amputated stumps?
200
With X-ray or palpating the stump. LLD gives some information too.
How a prosthetist can define the amputation level of a patient?
200
To get the correct inner shape of the patients shoe and get correct alignment with that shoe.
What is the purpose of EVA plate under heel in casting?
200
Mirror table and blue print.
What can be used to check pressure on the sole of the foot?
300
Dorsiflexors have lost their insertions but plantarflexors inserting to calcaneus are still intact.
What is the reason why calcaneus moves posteriorly in more distal PF amputation levels?
300
Increase hip and knee flexion during swing phase.
What can you do to avoid toe drag if the dorsiflexors are not working?
300
Full end bearing.
What is the biggest advantage of a PF amputation compared to TT amputation?
300
Some weight can be transmitted to the patellar tendon area.
What can be done if the end bearing is not possible?
300
Equinus deformity and LLD.
What are the factors affecting the plantar thickness of the heel in a PF prosthesis?
400
Arthrodesis have been done and some parts of the bones have been cut away.
Why Chopart level amputated leg can be shorter than the sound side?
400
Because it reduces the GRF during initial contact.
Why is it an advantage if a PF amputee can plantarflex the ankle.
400
Hindfoot pronates.
What happens if in (more proximal amputation levels) the apparently supinated forefoot is left uncorrected in prosthesis?
400
Weight needs to be transmitted proximally beacuse of tissue problems in distal weight bearing area. Forces during toe off are too big. Limit motion in the ankle. Control equinovarus deformity.
What are the indications for long socket design?
400
Good stability. Bigger area results less pressure.
What are the advantages of the long socket design?
500
Base of 1st metatarsal bone and medial cuneiform bone.
What is the insertion of tibialis anterior?
500
10 degrees dorsiflexion.
What is the amount of dorsiflexion needed to achieve normal gait?
500
Normalize gait in toe-off, improve balance, correct supination.
What are the aims of a PF prosthetic fitting?
500
To get the weight to 1st mtp area during toe off.
What is the purpose of a forefoot wedge in more proximal PF amputation levels?
500
Patients who will not have full end bearing or cannot stand during casting, or if non load bearing is needed to correct calcaneal varus.