TransPelvic/Hip Disarticulation_Clinical Decision Making [Ch. 11} Flashcards Preview

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Flashcards in TransPelvic/Hip Disarticulation_Clinical Decision Making [Ch. 11} Deck (21)
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Many transpelvic/hip disarticulation aputations are performed due to:

  • Malignant LE bone tumors


Most common causes of amputation at hip disarticulation level (descending order): [5]

  • Tumor
  • Infection
  • Vascular Disease
  • Trauma
  • Congenital abnormalities
  • [2:1 male to female ratio}


Common complication of hip disarticulation surgery:

  • Infection


Patients with hip disarticulation/transpelvic amputation need to maximize:

  • upper extremity strength
  • abdominal strength
  • LE strength


Patients with a hip disarticulation need to initiate a _________  ______ ____ to initiate swing phase.

  • Posterior pelvic tilt


With a hip disarticulation, balance training is important to enable the patient to:

  • transfer independently
  • apply and remove the prosthesis
  • ambulate safely


The transpelvic socket:

  • encases the abdominal cavity
  • provides hard wall to enclose and compress the abdominal viscera so that they can accept weight bearing pressures
  • Extends superior to the 10th rib to allow vertical loading


Weight transfer in the transpelvic socket is to the:

  • Ischial tuberosity and buttock of the remaining leg


The hip disarticulation socket:

  • Encloses the ischial tuberosity and gluteal muscles for weight bearing
  • Extends over the ilium to provide suspension
  • Encloses the opposite pelvis
    • to assist in mediolateral trunk stability
  • Contains reliefs over anterior and posterior iliac spine


Little to no bandaging is needed with a transpelvic or hip disarticulation amputation. [True/False]

  • True
    • Very little edema associated with these amputations


Primary hip disarticulation sockets in use [3]:

  • Canadian
  • Diagonal
    • suitable for short transfemoral amputations at the level of the greater trochanter
  • Total Contact Suction Socket
    • most common
    • allows better stabilization of the prosthesis


Endoskeletal prostheses are preferred due to:

  • Lighter weight
  • interchangeable and adjustable features
  • improved cosmesis


Where is the hip joint attached in the Canadian and Total Contact Suction Socket, and why is it attached there?

  • The hip joint is attached to socket anteriorly
    • this causes the weight line to fall behind the hip and in front of the knee to assist with extension


A spring loaded hip joint that shortens the effective length of the limb which allows the wearer to swing the limb forward without having to vault.

  • Hip flexion bias system


A component  which is an elastic strap that passes behind the hip and in front of the knee which functions to limit hip flexion and assist with knee extension:

  • Stride Length Control Strap


Type of knees commonly used in transpelvic/hip disarticulation:

  • Stance control knee
    • resists knee flexion in excess of 15 degrees
    • Disadvantage: must be non-weight bearing for more than 15 degree knee flexion to occur
      • This makes it difficult to weight shift for sitting
  • Polycentric axis (four bar) knee
    • center of rotation that changes or adapts to the degree of knee flexion
    • Advantage:
      • shortens during swing phase to aid in toe clearance
      • If this component has pneumatic control it also helps control excessive heel rise and terminal swing impact


A component which enables the prosthetic leg to be crossed over the sound leg:

  • Rotator adapter
    • assists with getting in and out of an automobile


Lateral trunk bending  toward the prosthetic side may be normal [true/false].

  • True
    • transpelvic/hip disarticulations are often made 1.25 cm shorter for easier foot clearance.


The individual with the hip disarticulation weight bears:

  • On the ischium of the amputated side


The individual with the transpelvic amputation weight bears:

  • On the ischium and buttock of the sound side


Prosthesis length may be determined by:

  • For a hip disarticulation:
    • Checking the bilateral iliac crest heights
  • For a transpelvic amputation
    • Checking the lower rib height