Prostheses are prescribed for and custom made to a person who has
had a complete or partial amputation of the upper or lower extremity.
The absence of a limb can be congenital or acquired; it can be secondary
to any number of musculoskeletal, circulatory or “systemic”
disorders. An amputation is labeled/named by the level of the surgical
or congenital amputation. For example, a below the knee amputation
is between the ankle and the knee (this is also referred to as a transtibial
Over the years your choices for prosthetics have increased tremendously.
There are many styles and designs to help us make prostheses that
are right for you. Some components are universal to lower extremity
prostheses and others are specific to a particular level.
The components that make up each individual prosthesis are chosen
based on your preference, height, weight, activity level, and type
of activities. The Prosthetist will use this information and discuss
with you all the appropriate componentry choices.
Our Team Approach
Our ABC certified Prosthetists use a team approach to help you reach
your functional, recreational and vocational goals. We work with you,
your family, therapist, doctor, and insurance company to make sure
that all realistic goals can be achieved with the help of the appropriate
Lower Extremity Prostheses
Lower extremity prostheses are either endoskeletal or exoskeletal.
This refers to the location and type of supporting structure between
the amputation and the floor.
- An exoskeletal prosthesis is shaped like the
contralateral (opposite) side and is hard the full length of the
prosthesis to the top of the foot. The hard material is the supporting
structure of the prosthesis and is typically hollow on the inside
to save weight.
- An endoskeletal prosthesis is shaped like the
contralateral side but is soft from the end of the amputation to
the top of the foot. The components between the amputation and the
foot are metal (steel, aluminum or titanium) and allow for permanent
adjustability in height, and angles. In this system components can
be easily changed in or out for different or replacement components.
Types of Lower Extremity Prostheses
- Immediate Post Operative Prostheses (IPOP) are
fit directly after surgery. They are generally prescribed when your
doctor wants you to get up and start walking right away. It immediately
starts to shape and reduce the size of the amputation, as well as
reduce the possibility of knee contractures following surgery. This
prosthesis can be custom made or custom fit from an off the shelf
item. A custom fabricated IPOP is molded over the amputation and
appropriate post-surgical bandages and drainage. An adjustable unit
is attached to the mold and then a pylon or pipe is the connection
between the adjustable unit and the foot. This system is changed
as often as the Doctor requests, but generally every 7-10 days until
the first prosthesis is prescribed. When the mold is removed the
amputation is inspected to make sure that it is healing well.
- A Preparatory prosthesis is generally the first
prosthesis that you would be fit with. The components used may be
the same as those for a definitive prosthesis but the preparatory/temporary
will not include a cosmetic cover, that is to say that the components
between the amputation and the floor will be exposed. A preparatory
prosthesis is generally prescribed when it is expected that the
amputation is going to change significantly and will require the
portion that fits the amputation (the socket) to be re-molded to
maintain an appropriately fitting and therefore functioning prosthesis.
- A Definitive prosthesis is the prosthesis that
is fit after your amputation has undergone reduction in volume and
change in shape of the amputation following surgery and/or IPOP
fittings. It is fit because the amputation has changed so significantly
that the first prosthesis is no longer fitting or functioning appropriately.
This prosthesis will be more cosmetic in appearance. The amputation
may have reduced enough that the size and shape of the amputated
side is closer to that of the unaffected side. It may take time for
your body to become accustomed to the components of your prosthesis
as your activity level changes. The way that a prosthesis stays
on the extremity is referred to as suspension.
There are several different ways to suspend a prosthesis. The type
of suspension is determined by the componentry choices, style of
amputation, patient preference, experience or activity level. The
Prosthetist you see will be happy to help you choose the best method
of suspension for your prosthesis.