Orthoses are devices used to support existing body parts to improve function, while prostheses replace missing limbs. Orthoses are used to relieve pain, support weight, provide support, prevent and correct deformities. They come in static and dynamic varieties. Prostheses replace missing limbs through amputation, which may be traumatic or surgical. Amputations are indicated for dead, dying, dysvascular, dangerous, deformed or nuisance limbs. The Jaipur Foot is a flexible, waterproof prosthesis for below-the-knee amputees that allows squatting and sitting cross-legged.

1. ORTHOSES AND
PROSTHESIS

2.  ORTHOSES
 Device used to support an existing
part of the body so as to improve the
function of the part.

3. USES
 1. RELIEVE PAIN : immobilisation : painful
joint
 2. RELIEVE WEIGHT : un-united fracture
 3. PROVIDE SUPPORT : fractured spine
 4. PREVENT DEFORMITY : poliomyelitis
 5. CORRECT DEFORMITY : Volkmann’s
ischaemic contracture
 6. IMPROVE COSMESIS

4. IDEAL FEATURES OF AN
ORTHOTIC DEVICE
 Should be :
1. Strong
2. Light
3. Simple
4. Easy to use (Wear and manipulate)
5. Functionally satisfactory
6. Cosmetically acceptable

5. INTERNATIONAL
TERMINOLOGIES
 Depending on extent of support
 AFO : Ankle-foot orthoses, KAFO: Knee-
ankle-foot orthoses
 HKAFO : Hip- knee-ankle-foot orthoses
 HO : Hand orthoses WHO : Wrist-
hand orthoses
 HWEO : Hand- wrist- elbow- orthoses
 CO: Cervical orthoses
 CTLSO: Cervical-thoracic-lumbar- sacral
orthoses

7.  TYPES
 STATIC: Used to support, prevent and
correct deformities
 DYNAMIC: Assists in movements

8.  AMPUTATIONS
 ABLATION OF A LIMB IS CALLED
AMPUTATION
AMPUTATIONS : TRAUMATIC OR
SURGICAL

10. INDICATIONS
 DEAD LIMB : Crushed limb,
gangrenous limb
 DYING LIMB : Spreading
gangrene,infection
 DYSVASCULAR LIMB : Peripheral vascular
disease (diabetic foot)
 DANGEROUS LIMB : Infections, tumors
 DEFORMED LIMB : Gross congenital
anomaly,defects
 DAMN NUISANCE : Congenital
deformities, nerve injury

11.  TYPES
 OPEN AMPUTATION : guillotine
amputation
 CLOSED AMPUTATION

12. SURGICAL PROCEDURE
 1. Determine the level of amputation: decided by:
  Extent of disease
  Anatomical principles : save joint
  Efficient function with prosthesis : Length of
stump
 2. Apply tourniquet (indications to be noted)
 3. Skin and muscle incised 1-2 inches distal to level
of bone cut
 4. Vessels : Large : Identified and ligated : Double
ligatures
Small : Cauterised

13.  5. Nerves : Pulled on and cut cleanly
with new sharp blade
 6. Bone : Cut at level decided for
amputation
 7. Drainage tube kept in place before
closure of wound in layers

14.  AFTER CARE
1. Dressings
2. Compression bandage
3. Elevation of the limb
4. Stump excercises
5. Prosthetic fitting and training : after stump
‘matures’: 3 months

16. COMPLICATIONS
 1. Haematoma
 2. Infection
 3. Skin necrosis
 4. Neuroma
 5. Phantom limb sensation
 6. Joint deformities

17.  AMPUTATIONS IN CHILDREN
 1. Disarticulation preferred
 2. Requires revision
 3. Tolerate artificial limbs better

18.  COSMETIC
 FUNCTIONAL
 BODY POWERED
 MYOELECTRICAL
 PARTS OF A PROSTHESES
 1. Socket
 2. Socket suspension
 3. Joint
 4. Prosthetic extension
5. Terminal device

19. JAIPUR FOOT
 Through a process of trial and error, with a lot of feed-back from
village amputees, Dr. Sethi developed a design that was more suited
to the traditions, poverty, and environment of rural India.
 The Jaipur foot-piece is heat-molded in iron forms in which pieces
of wood are covered with vulcanized rubber.
 It is very flexible, water-proof, and looks real (with toes, veins, and
skin color).
 The foot is fixed to a lightweight aluminum shank crafted by
traditional tinsmiths.
 The above-the-knee limb has a swivel knee joint that permits
comfortable squatting and cross-legged sitting.

23. THANKS…..