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The time elapsed immediately after surgery until the incision line is fully healed (and prosthetic fitting can begin) varies for each patient. It is especially important to prevent falls, strengthen muscles and reduce swelling prior to prosthetic fitting. It is great to be connected with a prosthetist in this stage so you can begin discussing your goals and the type of prosthesis you will receive. Education is very important at this stage, because the more you know about your recovery, the likelihood that you will be successful. It is also great to have someone in your corner that you can call if you have questions about your recovery. P&O Care practitioners will monitor your healing progress and report back to your physician if you should have any difficulties.Read more
It is crucial that you do not fall on your residual limb during the healing stage. A fall can cause trauma and severe pain to your residual limb. Often, a fall can delay the prosthetic fitting by approximately 3 months! P&O Care offers several types of residual limb protectors to prevent trauma to your residual limb should you accidently fall.
Physical therapy and muscle strengthening exercises are also important during this stage. It’s important to remember that no prosthesis (no matter how fancy or expensive) can do the walking for you; you must have the muscle strength to use it!
During the healing stage, your physician will monitor your healing and remove the sutures or staples within 4-6 weeks after surgery. Typically, after the sutures or staples have been removed, your prosthetist will fit you with a prosthetic shrinker. A shrinker is a type of compression garment that provides even compression to your limb to reduce swelling and prepare your limb for your prosthesis. When the incision line has fully healed (no scabs) and the swelling has reduced, we are ready to begin fitting you with your prosthesis. The average (uncomplicated) healing time from surgery to prosthetic fitting is approximately 8-12 weeks.
The prosthetic fitting process includes the impression (casting), fabrication and fitting of your prosthesis. The entire process takes approximately 2-3 weeks to complete, consisting of at least three appointments with your prosthetist.
When your residual limb is fully healed (no scabs are present), a plaster impression (cast) of your limb will be taken. If you’ve ever broken a bone before, you’ve probably worn a cast. This cast is a little different because once hardened, the cast is immediately removed. Just like a baker needs a pan or a mold to bake a cake, your prosthetist needs a mold of your leg to create a custom prosthesis just for you.
The prosthetic socket is the single most important component to comfortable prosthesis and successful fitting. That’s why, at P&O Care, we take great pride in our casting process. While there have been recent advancements in computer aided techniques (such as CAD-CAM) for building prosthetic limbs, we have found that best outcomes are a result of direct, hands-on plaster casting. We believe that no computer can match the expertise and skilled practitioners and adhere to the foundation of the prosthetic field, hand plaster casting as opposed to computer scanning or measurements alone.
Not all hand casting is alike. At P&O Care, we use plaster, as opposed to fiberglass.
The white, creamy plaster (think: old school plaster casts from the 1950’s) allows your prosthetist to truly capture your residual limb and receive direct feedback about sensitive areas on your limb, placing more pressure on the areas that you can tolerate snug pressure and relieving the areas that cannot tolerate pressure. The traditional plaster casting process takes approximately an hour and we believe, creates the most best representation of a residual limb.
On the other hand, fiberglass (think: the neon casts used today), are a less messy and much quicker alternative to plaster casting, also captures the residual limb but cannot possibly create a mold with as much attention to detail as traditional plaster casting. A fiberglass casting process takes less than 5 minutes. Therefore, at P&O Care fiberglass is not used for to create prosthetic sockets. We don’t believe in short cuts and neither should you.
You have a choice in your prosthetic care. Do you know exactly how your prosthesis is made? If you don’t you should ask. From casting to delivery, you have a right to know. We welcome questions. We want to be transparent. That’s why we gladly allow patients to observe what happens in our in-house fabrication labs.
Approximately one week after casting, you will take your first steps with a test or check socket. You will learn to take your first steps within the parallel bars, which allow you to use your hands to gently apply your weight on the prosthesis. Just like a dental temporary, a temporary prosthetic check socket allows your prosthetist to ensure maximum comfort and function of the prosthesis.Read more
Your prosthetist will teach you how to put on and take off the prosthesis as well as ensure it is snug, comfortable and the proper height. A test socket is typically made of a clear or semi-transparent plastic that can be easily molded and adjusted with heat. Your prosthetist will make markings on the clear device to denote changes to be made for your final device. Also during the test fitting appointment, your prosthetist will “align” your prosthesis. Aligning involves small adjustments of the prosthetic components to maximize the efficiency, comfort and walking mechanics of your prosthesis. After the adjustments have been made during the test fitting, your prosthetist will return to the fabrication lab with the test socket and complete your final device. The test socket fitting typically lasts one to two hours.
Approximately one week after your check socket fitting, you will receive your new prosthesis! Your prosthetist will review how to properly use and walk with your new prosthesis. During the final delivery, your prosthetist will again check the height, and make sure that it is comfortable and functioning properly. A new prosthesis is like a new pair of shoes and often a “break in period” or “wearing schedule” is used toRead more
help you become more accustomed to your new device.
Next, you will begin physical therapy (also known as gait training) with a physical therapist for several weeks.
Your prosthetist will teach you the basics of walking with your prosthesis, however we strongly encourage working with a physical therapist to get the most out of your prosthesis. A physical therapist can help fine tune your gait mechanics and increase your confidence and strength. P&O Care can help you find a physical therapy group that is experienced and convenient.
In the beginning, you will practice walking and weight shifting in your prosthesis within the parallel bars. As you become stronger and more confident with your new prosthesis, you may begin to use a walker or a cane outside the parallel bars. Should you need any adjustments to your prosthesis during your physical therapy session, your prosthetist may be able to visit you to make adjustments on-site! Read more about our mobile units here.Read more
After you have been working in physical therapy for a few weeks, a follow up visit will be scheduled at P&O Care to make sure that you prosthesis is comfortable and working properly. Then you will see your prosthetist as needed. We strongly recommend follow up appointments at 6 month or yearly intervals to make sure everything is fitting correctly and you have the proper socks and supplies. Maintaining a good relationship with your prosthetist is vial to your prosthetic success. We believe in relationships that matter and devices that fit.
Note: Many experienced or existing prosthetics users do not require physical therapy after they receive their first prosthesis.