Prosthesis (i.e. – artificial body members) – parts thereof – or ai – Leg – Socket holder
Patent
1994-10-18
1997-07-29
Willse, David H.
Prosthesis (i.e., artificial body members), parts thereof, or ai
Leg
Socket holder
623 38, 602 63, A61F 262, A61F 278
Patent
active
056517920
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD
The present invention relates to rehabilitative devices especially suitable for amputated limbs, and more particularly to a lower limb prosthetic assembly for immediate post-operative application in above knee amputations, below knee amputation and knee disarticulations.
BACKGROUND OF THE INVENTION
The loss of a lower extremity, even by careful surgical amputation, has profound physical and psychological consequences to the patient. It has long been known to remedy some of these consequences by providing a permanent prosthetic device to restore to the patient part of the function once performed by the lost limb. It is now generally accepted, however, that early post-operative weight bearing may be extremely valuable in both the physical and psychological rehabilitation of the amputee. By resuming ambulation with partial or full weight-bearing at an early stage, postural reflexes can be maintained, even while the residual stump is healing and being readied for a definitive fitting of a permanent prosthetic device.
Many advantages are offered by fitting a prosthetic device immediately after amputation. These include early ambulation, more rapid healing of the amputation site, decreased post-operative pain and edema of the stump, shorter hospitalization times, earlier fitting of a definitive prosthesis and a general improvement of the physical condition of the patient by preventing hypostatic pneumonia, phlebothrombosis, disuse weakness and psychological depression. The immediate post-operative prosthetic device thus aids the amputation team (consisting of the surgeon, the physiatrist, the prosthetist and the physical therapist) in the efficient treatment of the amputee.
Until recently, the amputation site was treated post-operatively with disposable soft compressive dressings, non-removable rigid dressings, or with so-called removable rigid dressings made from a plaster or fiberglass cast. These last were considered "removable" because they could be pulled off of the stump and then replaced upon it after inspection of the stump.
Both the removable and non-removable rigid dressings permitted partial or full weight-bearing through a temporary prothesis until the amputation wound had healed. For example, some rigid dressings served as prostheses sockets to which temporary prosthetic supports were attached. Such constructions were disadvantageous, however, in that they required that the full weight of the patient be borne on the amputation stump, interfering with patient healing and making it painful for the patient to use the prosthetic device. This was true even of pneumatic dressings; while soft and removable, they were still used in conjunction with rigid sockets, and so put the full weight of the patient on the stump.
Moreover, prior prostheses formed by embedding supports in rigid dressings were unitary and inflexible, making them difficult for patients to use. A prosthetic device which is painful or difficult to use does not get used at all, to the detriment of the patient.
The prior rigid dressings had other drawbacks. For example, to allow inspection of the amputation wound, the so-called removable rigid dressings were merely pulled off the amputation stump, causing very great pain to the patient and generating so much friction as to traumatize the amputation wound and the skin of the stump. Even when a felt pad was positioned between the stump and the rigid cast, the intense pain of removal and replacement discouraged patients from having their wounds inspected daily. Daily inspection, of course, is an indispensable part of proper amputation patient care.
Another drawback arose from the fact that removable rigid dressings were generally applied immediately after the amputation operations, while the patients were still on the operating table. Application of plaster cast or glass fiber dressings detrimentally affected patients because of the great amount of heat evolved during the curing of the casts. The problem was of particular concern because residual limbs already experience comp
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