This presentation by from the International Committee of the Red Cross describes initial alignment for transtibial prosthetic fabrication in lower limb amputee prosthetic fitting.

1. 1

2. 2
1/2 ML 1/2 ML
1/2AP1/2AP
MEDIAL FOOTLINE
LINEOFPROGRESSION
LM
TT INITIAL ALIGNMENT: TRANSVERSAL VIEW
22-25mm
II
- PARALLEL
II
II
A
P
II
MEDIALWALL
5-7°

3. 3
SHORT STUMP:
LESS THAN 1/3 OF THE
ANATOMICAL LENGTH;
NORMAL POSITION: ABDUCTION = VALGUM
MEDIUM STUMP:
FROM 1/3 TO 2/3 OF THE
ANATOMICAL LENGTH;
NORMAL POSITION: NEUTRAL
MEDIO-LATERAL PLACEMENT OF PP CUP
5 - 10 mm
0 mm
5 - 10 mm
L
M
TT INITIAL ALIGNMENT: ANTERIOR VIEW
LONG STUMP:
MORE THAN 2/3 OF THE
ANATOMICAL LENGTH;
NORMAL POSITION: ADDUCTION = VARUM

4. 4
SHORT STUMP
FLEXION : 10°-15°
MEDIUM STUMP
FLEXION : 5°-7°
22- 25 mm30- 35 mm 22- 25 mm
ANTERO-POSTERIOR PLACEMENT OF THE PP CUP
TT INITIAL ALIGNMENT: MEDIAL OR LATERAL VIEW
LONG STUMP
FLEXION : 0°- 5°

5. 5
NEUTRAL
TT INITIAL ALIGNMENT: MEDIAL OR LATERAL VIEW
HIGH HEEL = PLANTAR FLEXION NO HEEL = DORSAL FLEXION
VERTICALITY OF THE TUBE
ACCORDING TO HEEL HEIGHT

6. 6
SUPINATION = VARUMPRONATION = VALGUM NEUTRAL
TF INITIAL ALIGNMENT: ANTERIOR VIEW
VERTICALITY OF THE TUBE
ACCORDING TO SOLE CONDITION

7. 7
TUBE IS VERTICAL
MEDIUM STUMP
BRIM IS HORIZONTAL
POSITION IS
NEUTRAL
CUP IS HORIZONTAL
PLUMBLINE IS IN THE CENTER
HEIGHTISCORRECT
TT INITIAL ALIGNMENT: ANTERIOR & POSTERIOR VIEW

8. 8
TUBE IS VERTICAL
FOOT MEDIALISATION 5-10 mm
BRIM IS HORIZONTAL
ADDUCTION OF THE SOCKET
CORRESPONDS WITH THE
VALGUM OF THE STUMP
LATERALISATION 5-10mm
CUP IS HORIZONTAL
LONG STUMP
TT INITIAL ALIGNMENT: ANTERIOR & POSTERIOR VIEW

9. 9
TUBE IS VERTICAL
FOOT LATERALISATION 5-10 mm
BRIM IS HORIZONTAL
ABDUCTION OF THE SOCKET
CORRESPONDS WITH THE
VARUM OF THE STUMP
MEDIALISATION 5-10mm
CUP IS HORIZONTAL
SHORT STUMP
TT INITIAL ALIGNMENT: ANTERIOR & POSTERIOR VIEW

10. 10
TUBE IS VERTICAL
1/2 AP
FLEXION = 5°
CUP IS HORIZONTAL
1/31/31/3
MEDIUM STUMP
ANTERIORISATION :
MEDIUM AND LONG STUMPS - 22-25 mm
SHORT STUMP - 30-35 mm
TT INITIAL ALIGNMENT: LATERAL VIEW