Prosthetics and Orthotics

What is prosthetics and orthotics?

In prosthetics, we use artificial limbs (prostheses) to enhance function and improve the quality of life of people who have lost their limbs. Our prosthetics services involve designing and constructing a customised prosthesis to match your needs and lifestyle.

In orthotics, we use external braces (orthoses) to support body parts that have been weakened by injury, disease, or disorders of the nerves, muscles, or bones.

Orthoses are custom designed and may be used on the upper and lower limbs, feet, cranium or spine. Examples of the different types of orthoses include:

• Spinal orthoses
• Knee-ankle-foot orthoses
• Ankle-foot orthoses
• Foot orthoses

Why do you need prosthetics and orthotics?

Prosthetics and orthotics can help to improve the function and quality of life of individuals, according to their unique needs.

Prosthetics

Protheses can help people with:

• Mobility issues such as walking, running and jumping
• Daily challenges such as eating, writing and dressing
• Occupational tasks such as hammering and painting

Orthotics

Orthoses can help children and adults with:

• Scoliosis
• Cerebral palsy
• Spastic movement
• Life-threatening neck injuries
• Knee or hip disarticulations, dislocation or subluxation
• Positional plagiocephaly, where an infant’s head develops an abnormally flattened shape and appearance
• Foot conditions, such as:
  • Erratic movements in the foot
  • Drop-foot, where the front of the foot drops due to weakness
  • Low-tone pronation, where feet are turned outward due to muscle weakness and low arches formed
  • High-tone pronation, where feet are turned outward due to increased muscle tone and high arches formed
  • Outward turning feet
  • Inward turning feet

What are the risks and complications of prosthetics and orthotics?

Prosthetics and orthotics may involve the following risks and side effects:

Prosthetics

In general, increased skin temperatures of the residual limb may lead to:

• Blisters
• Sweating
• Heat rash
• Abrasions
• Contact dermatitis
• Painful ingrown hair

Upper-limb prostheses

If you are receiving upper-limb prostheses, you may experience:

• Blisters
• Abrasions
• Rashes

Lower-limb protheses

If you are receiving lower-limb prostheses, you may experience:

• Chronic swelling
• Dark red discolouration
• Bulbous end on the limb
• Aggressive overgrowth of abnormal skin tissue
• Problems with postural alignment
• Muscle imbalances and strains
• Gait abnormalities

Orthotics

When using external braces, you may experience:

• Blisters
• Calluses
• Skin irritation
• Fungal infections
• Pressure and diabetic ulcers

What can you expect in prosthetics and orthotics?

Your specialist will conduct a physical examination to observe the following:

• Bone deformities
• Pain or discomfort
• Range of movement
• Physical functioning
• Increased or decreased muscle tone
• Associated conditions and interventions

They will also ask you questions about your mobility challenges. Next, they will take measurements or create a casting. Your specialist will then recommend devices, some of which are available off the shelf and others that may need to be ordered, custom-designed or modified.

After your specialist has received the device, they will:

• Arrange a fitting session with you
• Fit the device to ensure that there is minimal discomfort
• Show you how to remove and put on the device
• Advise you on how long to wear the device
• Advise you on how to respond to skin conditions, should you experience any

As you progress in your treatment plan, your device may need to be further evaluated, modified or replaced during subsequent appointments.

Care and recovery after prosthetics and orthotics

Even when a prosthesis or orthosis is properly fitted, the initial breaking-in period can be uncomfortable and frustrating for you.

Below are some guidelines to help increase your comfort level.

• Make sure the device is held securely and not too loose. Loose-fitting devices rub and cause skin irritation.
• Monitor your skin quality and look out for soreness, redness, blisters, calluses or swollen areas. Ask your specialist how to toughen the area of skin in contact with the device.
• Periodically inspect your device for cracks and signs of wear and tear. Look for parts that may need to be replaced.
• Follow the device maintenance regimen for proper cleaning, care and storage.

If your skin becomes raw or visibly broken down, do not wear the device until your skin heals. If you experience excessive perspiration, especially in the feet, changing socks 1–2 times a day will help.