Of life and limb

Posted on 9 December 2015

José de Barros Viana Orthotics and Prosthetics can be found at Mediclinic Cape Gate, where he helps patients such as double amputee ten-pin bowler Winston Balada (pictured above).

What is the first step when you have to fit a recently amputated leg with a prosthesis?

The wound needs to be completely closed and healed at the suture (stitches) line. The stump then needs to be coned, which means we bandage it under a certain pressure to get rid of any swelling and reduce it as much as possible.

Does a stump need lots of medical care?
After the stump has healed completely it is usually just the coning that needs attention. After that, a patient with a well-fitting prosthesis should not experience any problems unless the skin gets irritated, and this can be treated with skin-conditioning products. It is also important to keep the stump clean. It should be washed with mild soap at least once a day and dried carefully. When taking a bath, the stump should not be submerged in water for long as it softens the skin, making it more vulnerable to injury.Wearing one or more sock around the stump will help absorb perspiration and reduce skin irritation. As the size of the stump may change, the number of socks you need may vary. The socks should be changed every day to ensure good hygiene.

How often does an adult need to change his or her prosthesis?
Initially, while the stump is still reducing, the patient may need one refit – or in extreme cases two – during the first year. After that, usually every five years.

What role does material play? Are there different price classes?
Materials and the types of parts used play a major role in the different price classes. You can get a foot for R4 000, another for R40 000. Titanium parts and carbon are preferable because they’re lightweight, but are also at least double the price of other components.

Is it true that after a long day your stump can be bruised and painful?

As with sport, one has to build up the intensity and length of time spent on the stump gradually. Otherwise a long day can cause pain and bruising, as would a bad-fitting socket or poor alignment of the prosthesis. The stump might also swell during the day due to heat or overuse, and this can cause discomfort.

Published in Orthopaedics

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