11

International Committee International Committee of the Red Crossof the Red Cross

Polypropylene TechnologyPolypropylene Technology

Manufacture of Lower Limb Prostheses in PPManufacture of Lower Limb Prostheses in PP

TF STATIC ALIGNMENTTF STATIC ALIGNMENT

22

33

44

SWING PHASE: OSCILLATION OF THE SHIN

VISIBLE INTERNAL OR EXTERNAL ROTATION OF KNEE

MID SWING PHASE

55

- INCORRECT INITIAL KNEE ROTATION

- INCORRECT SOCKET FITTING

- INCORRECT SOCKET ALIGNMENT

- INSUFFICIENT SUSPENSION OR INCORRECT LOCATION OF THE SILESIAN BELT

PROSTHESIS

SWING PHASE: OSCILLATION OF THE SHIN

VISIBLE INTERNAL OR EXTERNAL ROTATION OF KNEE

MID SWING PHASE

66

- WEAK AND FLABBY STUMP

PATIENT

SWING PHASE: OSCILLATION OF THE SHIN

VISIBLE INTERNAL OR EXTERNAL ROTATION OF KNEE

MID SWING PHASE

77 WALKING BASE IS TOO WIDE

SWING PHASE: ABDUCTED GAIT

88

- PROSTHESIS IS TOO LONG

- INSUFFICIENT SOCKET ABDUCTION - INSUFFICIENT LATERAL FEMORAL SUPPORT - MEDIAL SHELF IS TOO HIGH

- EXCESSIVE SUSPENSION OR INCORRECT LOCATION OF THE SILESIAN BELT

PROSTHESIS

WALKING BASE IS TOO WIDE

SWING PHASE: ABDUCTED GAIT

99

- SHORT STUMP

- ABDUCTORS CONTRACTURE - PAIN IN PERINEAL AREA

- INSECURE BALANCE

- BAD GAIT HABIT

PATIENT

WALKING BASE IS TOO WIDE

SWING PHASE: ABDUCTED GAIT

1010

PROSTHESIS CURVES LATERALLY

SWING PHASE: CIRCUMDUCTION

1111

- PROSTHESIS IS TOO LONG

- EXCESSIVE PLANTAR FLEXION

- INSUFFICIENT SUSPENSION (PISTONING)

- INCORRECT SOCKET FITTING

- EXCESSIVE SUSPENSION OR INCORRECT

LOCATION OF THE SILESIAN BELT

- INSUFFICIENT ABDUCTION OF THE SOCKET

- MEDIAL SHELF IS TOO HIGH

- ANTERIOR DISPLACEMENT OF THE SOCKET

- EXCESSIVE KNEE AXIS FRICTION

- EXCESSIVE STRENGTH OF THE EXTENSION AID

PROSTHESIS

PROSTHESIS CURVES LATERALLY

SWING PHASE: CIRCUMDUCTION

1212

PROSTHESIS CURVES LATERALLY

SWING PHASE: CIRCUMDUCTION

- ABDUCTORS CONTRACTURE

- INSUFFICIENT HIP FLEXION

- WEAK QUADRICEPS

- FEAR OF TOUCHING THE GROUND

- PAIN IN PERINEAL AREA

- BAD GAIT HABIT

PATIENT

1313

EXCESSIVE ELEVATION OF PELVIS AND SHOULDERON THE PROSTHETIC SIDE

SWING PHASE: ELEVATION OF THE PELVIS

1414

- PROTHESIS IS TOO LONG

- EXCESSIVE PLANTAR FLEXION

- ANTERIOR DISPLACEMENT OF THE FOOT

- INSUFFICIENT SUSPENSION (PISTONING)

- INCORRECT SOCKET FITTING

- ANTERIOR DISPLACEMENT OF THE SOCKET

- EXCESSIVE KNEE AXIS FRICTION

- EXCESSIVE STRENGTH OF THE EXTENSION AID

PROSTHESIS

EXCESSIVE ELEVATION OF PELVIS AND SHOULDER

ON THE PROSTHETIC SIDE

SWING PHASE: ELEVATION OF THE PELVIS

1515

- INSUFFICIENT HIP FLEXION

- WEAK QUADRICEPS MUSCLES

- FEAR OF TOUCHING THE GROUND

- BAD GAIT HABIT

PATIENT

SWING PHASE: ELEVATION OF THE PELVIS

EXCESSIVE ELEVATION OF PELVIS AND SHOULDER

ON THE PROSTHETIC SIDE

1616

LATERAL INCLINATION OF THE TRUNKON THE PROSTHETIC SIDE

SWING PHASE: LATERAL TRUNK BENDING

1717

- PROSTHESIS IS TOO SHORT

- EXCESSIVE ABDUCTION OF THE SOCKET

- INSUFFICIENT LATERAL FEMORAL

SUPPORT

- MEDIAL SHELF IS TOO HIGH

PROSTHESIS

LATERAL INCLINATION OF THE TRUNKON THE PROSTHETIC SIDE

SWING PHASE: LATERAL TRUNK BENDING

1818

- WEAK ABDUCTOR MUSCLES

(TRENDELENBURG SYNDROME) OR

ABDUCTORS CONTRACTURE

- SHORT STUMP

- HYPER SENSITIVE STUMP

- INSUFFICIENT BALANCE

- BAD GAIT HABIT

PATIENT

SWING PHASE: LATERAL TRUNK BENDING

LATERAL INCLINATION OF THE TRUNKON THE PROSTHETIC SIDE

1919

HEEL CONTACT: OSCILLATION OF THE FOOT

VISIBLE OSCILLATION OF THE FOREFOOT

2020

HEEL CONTACT: OSCILLATION OF THE FOOT

- HARD HEEL CUSHION

- EXCESSIVE EXTERNAL FOOT ROTATION

- INCORRECT SOCKET ALIGNMENT

PROSTHESIS

VISIBLE OSCILLATION OF THE FOREFOOT

2121

HEEL CONTACT: OSCILLATION OF THE FOOT

- SHORT STUMP

- WEAK AND FLABBY STUMP

- EXCESSIVE HEEL STRIKE

PATIENT

VISIBLE OSCILLATION OF THE FOREFOOT

2222

HEEL CONTACT WITH THE GROUND IS TOO SHORT

HEEL CONTACT: EARLY HEEL ROLLOVER

2323

- ANTERIOR DISPLACEMENT OF THE SOCKET

- INSUFFICIENT FLEXION OF THE SOCKET

- EXCESSIVE DORSAL FLEXION

- HARD HEEL CUSHION

PROSTHESIS

HEEL CONTACT WITH THE GROUND IS TOO SHORT

HEEL CONTACT: EARLY HEEL ROLLOVER

2424

- WEAK GLUTEAL MUSCLES

PATIENT

HEEL CONTACT: EARLY HEEL ROLLOVER

HEEL CONTACT WITH THE GROUND IS TOO SHORT

2525

SLAP OF THE FOREFOOT ON THE GROUND

HEEL CONTACT: FOOT SLAP

2626

- SOFT HEEL CUSHION

- EXCESSIVE PLANTAR FLEXION

PROSTHESIS

SLAP OF THE FOREFOOT ON THE GROUND

HEEL CONTACT: FOOT SLAP

2727

- WEAK HIP EXTENSORS, NOT PROVIDING SUFFICIENT ANTERIOR KNEE STABILITY

PATIENT

HEEL CONTACT: FOOT SLAP

SLAP OF THE FOREFOOT ON THE GROUND

2828

DECELERATION PHASE: TERMINAL IMPACT

VISIBLE KNEE SHOCK

2929

DECELERATION PHASE: TERMINAL IMPACT

- INSUFFICIENT FRICTION OF KNEE AXIS

- EXCESSIVE STRENGTH OF THE EXTENSION AID

- EXTENSION BUFFER IS TOO HARD

PROSTHESIS

VISIBLE KNEE SHOCK

3030

DECELERATION PHASE: TERMINAL IMPACT

- EXCESSIVE ACCELERATION FORCE

- BAD GAIT HABIT

PATIENT

VISIBLE KNEE SHOCK

3131

HEEL RAISE PHASE: LUMBAR HYPER LORDOSIS

VISIBLE ANTERIOR LUMBAR BEND

3232

HEEL RAISE PHASE: LUMBAR HYPER LORDOSIS

- INSUFFICIENT FLEXION OF THE SOCKET

- PROSTHESIS IS TOO LONG

- ISCHIAL SEAT IS TOO HIGH OR ANTERIORLY INCLINED

PROSTHESIS

VISIBLE ANTERIOR LUMBAR BEND

3333

HEEL RAISE PHASE: LUMBAR HYPER LORDOSIS

- HIP FLEXORS CONTRACTURE

- ISCHIUM PAIN

- POSTURAL PROBLEM

- BAD GAIT HABIT

PATIENT

VISIBLE ANTERIOR LUMBAR BEND

3434

MID SWING PHASE: VAULTING

RAISE OF THE BODY BY EARLY EXCESSIVE PLANTAR FLEXION ON THE SOUND SIDE

3535

MID SWING PHASE: VAULTING

- PROSTHESIS IS TOO LONG

- EXCESSIVE PLANTAR FLEXION

- INSUFFICIENT SUSPENSION (PISTONING)

- INCORRECT SOCKET FITTING

- MEDIAL SHELF IS TOO HIGH

- ANTERIOR DISPLACEMENT OF THE SOCKET

- EXCESSIVE FRICTION IN KNEE AXIS

- EXCESSIVE STRENGTH OF THE EXTENSION AID

PROSTHESIS

RAISE OF THE BODY BY EARLY EXCESSIVE PLANTAR FLEXION

ON THE SOUND SIDE

3636

MID SWING PHASE: VAULTING

- FEAR OF TOUCHING GROUND

- VERY SENSITIVE OR PAINFUL STUMP

- BAD GAIT HABIT

PATIENT

RAISE OF THE BODY BY EARLY EXCESSIVE PLANTAR FLEXION

ON THE SOUND SIDE

3737

ACCELERATION PHASE: UNEVEN AND RAPID HEEL RAISE

EXCESSIVE AND RAPID ELEVATION OF THE HEEL

3838

ACCELERATION PHASE: UNEVEN AND RAPID HEEL RAISE

- INSUFICIENT FRICTION OF THE KNEE AXIS

- INSUFFICIENT STRENGTH OF THE EXTENSION AID

- POSTERIOR DISPLACEMENT OF THE SOCKET

PROSTHESIS

EXCESSIVE AND RAPID ELEVATION OF THE HEEL

3939

ACCELERATION PHASE: UNEVEN AND RAPID HEEL RAISE

- GAIT IS TOO FAST

- EXCESSIVE HIP FLEXION - BAD GAIT HABIT

PATIENT

EXCESSIVE AND RAPID ELEVATION OF THE HEEL

4040

TRANSVERSAL VIEW: UNEVEN STEP LENGTH

SHORT STEP ON PROSTHETIC SIDE

4141

TRANSVERSAL VIEW: UNEVEN STEP LENGTH

- ANTERIOR DISPLACEMENT OF THE SOCKET

- EXCESSIVE FLEXION OF THE SOCKET

- PISTONING ACTION

- EXCESSIVE FRICTION OF THE KNEE AXIS

- EXCESSIVE STRENGTH OF THE EXTENSION AID

PROSTHESIS

SHORT STEP ON PROSTHETIC SIDE

4242

TRANSVERSAL VIEW: UNEVEN STEP LENGTH

- SHORT, WEAK OR PAINFUL STUMP

- GAIT FEAR

- LIMITED HIP FLEXION -EXTENSION

- WEAK QUADRICEPS MUSCLES

PATIENT

SHORT STEP ON PROSTHETIC SIDE

4343SHORT STEP ON SOUND SIDE

TRANSVERSAL VIEW: UNEVEN STEP LENGTH

4444

- INSUFFICIENT FLEXION OF THE SOCKET

- EXCESSIVE PLANTAR FLEXION

- INSUFFICIENT FLEXION OF THE KNEE

- EXCESSIVE STRENGTH OF THE EXTENSION AID

PROSTHESIS

SHORT STEP ON SOUND SIDE

TRANSVERSAL VIEW: UNEVEN STEP LENGTH

4545

- SHORT, WEAK OR PAINFUL STUMP

- HIP EXTENSORS CONTRACTURE

- LIMITED HIP FLEXION - EXTENSION

- INSUFFICIENT STABILITY

- PROBLEMS WITH SOUND LEG

PATIENT

TRANSVERSAL VIEW: UNEVEN STEP LENGTH

SHORT STEP ON SOUND SIDE