Chapter 32 Prosthetics
OVERVIEW.
A prosthesis is an artificial mechanical or electrical body part used to replace a missing one; the word literally means “placed instead.”1
SUMMARY: CONTRAINDICATIONS AND PRECAUTIONS.
Overall, prosthetic sources will often indicate whether patients are poor candidates for prosthetic training; contraindications are not frequently listed. Gitter and Bosker2 indicate that a prosthetic candidate should have a reasonable cardiovascular reserve, adequate wound healing, good soft tissue coverage, sufficient range of motion and strength, motor control, and learning ability to use the prosthesis. With borderline cases, less costly trials (e.g., rigid dressing [removable] with pylon and foot) can be considered. Based on an older, 1977 retrospective review, Couch3 identified dementia and debility as two contraindications for a prosthesis. Depending on the type of prosthesis, other concerns include skin grafts, skin hypersensitivity, short stump length,3 blindness,3 and commitment to the rehabilitation process. General prosthetic concerns as well as guidelines for ICEROSS Socket Systems and Patella Tendon Bearing Socket are noted below.
