Understanding Your Prosthetic Written Exam Results

Obtain feedback from patient and/or caregiver to evaluate outcome (e.g., wear schedule/tolerance, comfort, ability to don and doff, proper usage and function. Assess patient’s function and note any changes. Assess fit of prosthesis with regard to strategic contact and to anatomical relationships to prosthesis to determine need for changes relative to initial treatment goals. Address evidence of excessive skin pressures or lack of corrective forces and formulate plan to modify prosthesis accordingly. Revise treatment plan based on assessment of outcomes.

At a follow-up visit for a patient who was fit with a body powered transhumeral prosthesis, they complain that they are not able to open the terminal device with the elbow fully flexed. One possible solution to this problem is to:

1. Add a cross back strap to the harness

2. Add an elbow flexion assist component

3. Add additional rubber bands to the terminal device

4. Tighten the control attachment strap

A patient is seen for an initial follow-up after receiving a transfemoral prosthesis. They are ambulating with an abducted gait. What is the MOST likely prosthetic cause?

1. Prosthesis is too short

2. Foot is too inset

3. Prosthesis is too long

4. Knee flexion resistance is too strong

A patient is seen for follow-up for their PTB-SC prosthesis with pelite liner. The alignment of the prosthesis is good, however the patient states that the socket feels less secure recently and you note a gap between the socket and their limb at the lateral proximal brim. What is the MOST appropriate adjustment to address this problem?

1. Increase the thickness of the liner at the lateral proximal aspect

2. Increase the thickness of the liner at the medial proximal aspect

3. Increase sock ply thickness

4. Add padding to the medial tibial flare

A patient who has missed multiple follow-up appointments for their transtibial prosthesis is seen. The patient has been noncompliant with hygiene instructions and has developed a Wagner Grade 2 ulcer on the anterior distal end of their residual limb. The practitioner’s PRIMARY responsibility at this time is to:

1. Modify the prosthesis and suggest the patient follow-up with their physician

2. Modify the prosthesis and schedule a two-week follow-up appointment

3. Inform the patient to take a break from using the prosthesis and follow-up in two weeks

4. Instruct the patient to discontinue use of the prosthesis and notify the physician