Clinical Application & Patient Care Flashcards

In a patellar-tendon-bearing transtibial socket, which area is pressure-sensitive and typically requires relief?

Answer: Fibular head

The fibular head is a bony prominence over the peroneal nerve and must be relieved, while the other areas tolerate load or provide counterpressure.

A transtibial prosthesis user reports distal-end pain and a sense of sinking into the socket late in the day. What is the most appropriate first intervention?

Answer: Add sock ply to compensate for limb volume loss

Daily residual limb volume loss lets the limb bottom out, and adding socks restores fit.

A transfemoral prosthesis user shows lateral trunk lean toward the prosthetic side during stance. Which socket-related cause is most likely?

Answer: Inadequate lateral wall adduction support

Without adequate lateral wall support holding the femur in adduction, the hip abductors cannot stabilize the pelvis, so the trunk leans over the prosthesis.

What is the preferred initial orthotic management for active (fragmentation-stage) Charcot neuroarthropathy of the midfoot?

Answer: Total contact cast or CROW walker

During the active phase the foot must be immobilized and offloaded with a total contact cast or CROW to prevent progressive collapse.

A patient has isolated foot drop from common peroneal nerve palsy, with intact sensation, good mediolateral ankle stability, and no spasticity. Which orthosis is most appropriate?

Answer: Posterior leaf spring AFO

A posterior leaf spring AFO provides swing-phase dorsiflexion assist for isolated dorsiflexor weakness without restricting the rest of the gait.

A TLSO such as the Boston brace is generally indicated for adolescent idiopathic scoliosis in which situation?

Answer: Cobb angle 25-40 degrees in a skeletally immature patient

Bracing is most effective for moderate curves (about 25-40 degrees) while significant growth remains.

Which positioning instruction best prevents contracture in a patient with a new transtibial amputation?

Answer: Keep the knee extended and avoid pillows under the residual limb

Prolonged knee flexion leads to knee flexion contracture, which compromises prosthetic fitting and gait.