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Prosthesis and Crutch walking

The document discusses prosthetics and crutch walking. It defines prosthetics as artificial devices that replace missing body parts, describing different types including transfemoral, transtibial, transradial and transhumeral prosthetics. It also discusses crutch walking, defining crutches as orthopedic devices that assist weight bearing during leg injuries. Different crutch walking gaits are described including 4-point, 3-point and 2-point gaits. Patient education on crutch use and precautions for crutch walking are also summarized.

Healthcare◦
PROSTHESIS AND CRUTCH WALKING PREPARED BY :- LITHA THOMAS Asst. Professor SNC By:- Litha Thomas, Asst Prof, Sumandeep Nursing College, SVDU
INTRODUCTION :- • Prosthesis are typically used to replace parts lost by injury (traumatic) or missing from birth (congenital) or to supplement defective body parts. • It is a sophisticated tool, designed to enhance the level of independence activity and mobility of the patient Litha Thomas, Asst Prof, Sumandeep Nursing College, SVDU
DEFINITION :- • In medicine Prosthesis Is An Artificial Device Extension That Replaces A Missing Body Part. • The type of prosthesis depends on what part of the limb is missing. • There are four main types of artificial limbs. Litha Thomas, Asst Prof, Sumandeep Nursing College,
TYPES OF PROSTHESIS • Trans femoral prosthesis • Trans tibial prosthesis • Trans radial prosthesis • Trans humeral prosthesis Litha Thomas, Asst Prof, Sumandeep Nursing College,
Transtibial prosthesis • A Transtibial prosthesis is an artificial limb that replaces a leg missing below the knee. Transtibial amputees are usually able to regain normal movement more readily than someone with a transfemoral amputation, due in large part to retaining the knee, which allows for easier movement. • In the prosthetic industry a trans-tibial prosthetic leg is often referred to as a "BK" or below the knee prosthesis. Litha Thomas, Asst Prof, Sumandeep Nursing College,
Transtibial prosthesis Litha Thomas, Asst Prof, Sumandeep Nursing College,
Transfemoral prosthesis • A Transfemoral prosthesis is an artificial limb that replaces a leg missing above the knee. • Transfemoral amputees can have a very difficult time regaining normal movement. • In general, a transfemoral amputee must use approximately 80% more energy to walk than a person with two whole legs. This is due to the complexities in movement associated with the knee. • In the prosthetic industry a trans-femoral prosthetic leg is often referred to as an "AK" or above the knee prosthesis. Litha Thomas, Asst Prof, Sumandeep Nursing College,
Transfemoral prosthesis Litha Thomas, Asst Prof, Sumandeep Nursing College,
Transradial prosthesis • A Transradial prosthesis is an artificial limb that replaces an arm missing below the elbow. • In the prosthetic industry a trans-radial prosthetic arm is often referred to as a "BE" or below elbow prosthesis Litha Thomas, Asst Prof, Sumandeep Nursing College,
• Two main types of prosthetics are available. a) Cable operated limbs work by attaching a harness and cable around the opposite shoulder of the damaged arm. b) The other form of prosthetics available are myoelectric arms. These work by sensing, via electrode, when the muscles in the arm moves, causing an artificial hand to open or close. Litha Thomas, Asst Prof, Sumandeep Nursing College,
Transradial prosthesis Litha Thomas, Asst Prof, Sumandeep Nursing College,
Transhumeral prosthesis • A Transhumeral prosthesis is an artificial limb that replaces an arm missing above the elbow. • Transhumeral amputees experience some of the same problems as trans femoral amputees, due to the similar complexities associated with the movement of the elbow. This makes mimicking the correct motion with an artificial limb very difficult. • In the prosthetic industry a trans-humeral prosthesis is often referred to as a "AE" or above the elbow prothesis. Litha Thomas, Asst Prof, Sumandeep Nursing College,
Transhumeral prosthesis Litha Thomas, Asst Prof, Sumandeep Nursing College,
Direct bone attachment / osseointegration • Osseointegration is a new method of attaching the artificial limb to the body. This method is also sometimes referred to as exo-prothesis, or endo-exoprosthesis. • The stump and socket method can cause significant pain in the amputee, which is why the direct bone attachment has been explored extensively. The method works by inserting a titanium bolt into the bone at the end of the stump. Litha Thomas, Asst Prof, Sumandeep Nursing College,
• After several months the osseo integration to the titanium bolt and an abutment is attached to the titanium bolt. The abutment extends out of the stump and the artificial limb is then attached to the abutment. Litha Thomas, Asst Prof, Sumandeep Nursing College,
CARE OF PROSTHESIS:- • Donning and Wearing The Prosthesis • Care of residual limb • Treat Swelling and volume fluctuation • Maintain Heel Height • Maintain Personal Hygiene • Daily Cleansing • Regular Examination • Socket Care • Exercise and ConditioningLitha Thomas, Asst Prof, Sumandeep Nursing College,
CRUTCH WALKING PREPARED BY :- LITHA THOMAS Asst. Professor SNC Litha Thomas, Asst Prof, Sumandeep Nursing College,
DEFINITION • Crutches are orthopedic devices created to assist in weight bearing when a patient has a leg injury or weakness in the lower extremities. Litha Thomas, Asst Prof, Sumandeep Nursing College,
PURPOSE • They are used to assist in weight bearing when a patient has sustained an injury to the leg, knee, ankle, or foot, such as a fracture or severe sprain. • Crutches are also used following surgery on the leg, knee, ankle, or foot. • Forearm crutches are used to provide stability and moderate support when a patient has generalized weakness in the lower extremities, such as for a patient with cerebral palsy. Litha Thomas, Asst Prof, Sumandeep Nursing College,
Measurement of crutches: • There are different methods used to measure the length of the crutches for a patient. • With the patient lying in bed, measure from the anterior fold of axilla to the heel of the foot on the same side (with the shoes on) and add 5 cm.(2 inches). • While the patient is in a standing position, measure from 5 cm from the anterior fold of the axilla to a point 14 cm (6 inches) lateral to the heel (with the shoes on). • Substract 40.5 cm or 16 inches from the patients total height. Litha Thomas, Asst Prof, Sumandeep Nursing College,
Types of crutches • Forearm crutches:- • Underarm crutches:- • Strutters • Platform • Leg Support Litha Thomas, Asst Prof, Sumandeep Nursing College,
Parts of crutches • AXILLARY PAD • HAND GRIP • RUBBER TIP Litha Thomas, Asst Prof, Sumandeep Nursing College,
TYPES OF CRUTCH WALKING • 4 point • 3 point gait • 2 point gait • Swing through gait • Swing to gait • Tripod gait Litha Thomas, Asst Prof, Sumandeep Nursing College,
4 point crutch gait • Indication:- Weakness in both legs or poor coordination. Can bear partial pressure on both legs • Pattern Sequence:- (a) tri pod position:- (b) Right crutch forward (c) Left foot forward (d) Left crutch forward (e) Right foot forward. • Advantages:- Provides excellent stabilty as there are always three points in contact with the ground • Disadvantages:- Slow walking speed Litha Thomas, Asst Prof, Sumandeep Nursing College,
Litha Thomas, Asst Prof, Sumandeep Nursing College,
3 point crutch gait • Indication: Inability to bear weight on one leg. (fractures, pain, amputations) • Pattern Sequence: (a) Tripod position • (b) Both crutches and the non-weight bearing foot are placed forward • (c ) Weight bearing foot is placed forward. • Advantages: Eliminates all weight bearing on the affected leg. • Disadvantages: Good balance is required. Litha Thomas, Asst Prof, Sumandeep Nursing College,
Litha Thomas, Asst Prof, Sumandeep Nursing College,
2 point • Indication: Weakness in both legs or poor coordination. • Pattern Sequence: (a) Tripod Position • (b) Left crutch and right foot are placed forward • (c) Right crutch and the left foot are placed forward Advantages: Faster than the four point date. • Disadvantages: Can be difficult to learn the pattern. • Litha Thomas, Asst Prof, Sumandeep Nursing College,
Litha Thomas, Asst Prof, Sumandeep Nursing College,
Swing through gait • Indications: Inability to fully bear weight on both legs. (fractures, pain, amputations) • Pattern Sequence: this gait both crutches are placed ahead of the patient and the patient then swings through the crutches and advances to a position in front of the crutches. • Advantage: Fastest gait pattern of all six. • Disadvantage: Energy consuming and requires good upper extremity strength.Litha Thomas, Asst Prof, Sumandeep Nursing College,
Swing to gait • Indications: Patients with weakness of both lower extremities. • Pattern Sequence: Both Crutches are placed ahead of the patient and the patient then swings forward to the crutches. • Advantage: Easy to learn. • Disadvantage: Requires good upper extremity strength. Litha Thomas, Asst Prof, Sumandeep Nursing College,
Tripod gait • Indications: Initial pattern for patients with paraplegia learning to do swing to gait pattern. • Pattern Sequence: Advance the left crutch, then the right crutch, then drag both legs to the crutches • Advantage: Provides good stability. • Disadvantage: Very energy consuming. Litha Thomas, Asst Prof, Sumandeep Nursing College,
PATIENT EDUCATION • Crutch walking • Sitting • Standing • Climbing up stairs • Going down stairs • Daily maintenance Litha Thomas, Asst Prof, Sumandeep Nursing College,
PRECAUTIONS :- • Take care on slick or wet surfaces (i.e., the kitchen and bathroom). • Be careful of throw rugs; they should be taken up. • Never hop around holding on to furniture; it may slide or fall. • Keep the crutches near you so they are always in reach. • Wear low-heeled shoes that will not slip off (i.e., sneakers). • For the first few days, a strong belt may be worn to allow someone to assist you. • Be careful of ramps or slopes, as it is a little harder to walk. • If falling, throw the crutches out to the side and use your arms to break your fall. To get up, get into a sitting position. Back up to a stool or low chair. Put your hands backwards on to the chair. Bend the "good" leg up. Pull with your hands and push with the "good" leg to get up onto the chair. • If not allowed to take weight on the "bad" leg, hop up with the "good" leg. • Do not remove any parts from your crutches, including the rubber tips. Litha Thomas, Asst Prof, Sumandeep Nursing College,
Litha Thomas, Asst Prof, Sumandeep Nursing College,