How to Correctly Use a Prosthesis

By Pan Wang

1) First, how long after an amputation can a prosthesis be installed?

If, when removing the stitches after an amputation surgery, the wound heals well, and there is no inflammation or edema, an amputee can consider installing a prosthesis.

2) Second, what should prosthesis users pay attention to?

Lower leg amputees should focus on strengthening the flexion and extension of the knee muscles, and especially the muscle strength of the extensor (quadriceps). This will help lower leg amputees walk forcefully when wearing a prosthesis. Prosthesis users should first do standing balance training, then step training, followed by walking training, ascending and descending stairs training, slope training, and then do other adaptive training.

For amputees who are using a prosthesis after an amputation, here are the following recommendations:

1. Maintain a stable weight. Weight gain or loss that exceeds a certain range will result in a prosthetic socket that is too tight or too loose.

2. Prevent muscle atrophy of the residual limb. The amputee should do residual limb muscle training based on guidance from a physical therapist.

3. Keep the residual limb skin and prosthetic socket clean, protect the residual limb skin from inflammation, folliculitis, boils, ulcers, dermatitis, allergies and so on.
Amputees must always clean their stump and keep it dry and clean.

4. Protect the prosthesis from large external extrusions, collisions and high temperature or humidity, etc (except for waterproof prostheses).

5. If you are aware of abnormalities when wearing a prosthesis, you should immediately stop using it and promptly contact a hospital. You should not let any individual handle it or repair it yourself, as this will help avoid accidents.

3) Third, preparation before using a prosthesis.

1. Physical Preparation
(1) Improve the movement area of the upper limb joint to (eliminate contracture) and increase muscle strength.
(2) Enhance the skin strength of the residual limb (especially the weight-bearing skin).
(3) Eliminate edema in the residual limb.
(4) Enhance the muscle strength of the healthy lower and upper limbs and trunk.
(5) Improve the feeling of balance.

2. Mental Preparation
(1) The amputee should establish the idea (motivation) of using an artificial limb to walk or retrieve objects.
(2) The amputee should understand the necessity of and methods for stump care (to prevent contracture, swelling, scratches and infection).
(3) The amputee should understand the structure and function of prostheses.
(4) The amputee should understand the necessity of and methods for prosthesis maintenance.
(5) The amputee should understand the training procedures, content and purposes.

4) Fourth, the requirements for prosthesis assembly on the residual limb.

1. Residual limbs should have the appropriate length to ensure that there is sufficient leverage and good muscle control force (for forearm or upper arm amputation, 1/3 of the middle and lower border is better; for lower leg or upper leg amputation, 1/3 of the middle and lower border is better).

2. The remnant joint should retain as much of its original physiological function as possible, without exhibiting any contracture deformity.

3. The stump should not have tenderness, bone spurs, or neuromas.

4. The residual limbs should have a good skin condition that is healthy and level, with less scar adhesion and no ulcers. The skin also should have appropriate mobility and
flexibility.

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