Patient Management & Follow-Up Flashcards

During a follow-up, a patient demonstrates vaulting on the sound side during prosthetic swing phase. The most likely cause is:

Answer: Prosthesis is too long

Vaulting (rising on the toe of the sound limb) is a common compensation for a prosthesis that is too long and cannot clear the floor during swing.

A patient on a negative-pressure suspension system reports recurrent liner pistoning and skin shear. The practitioner should first evaluate:

Answer: Liner condition, valve function, and seal integrity

Pistoning in a suction suspension system is most commonly caused by liner wear, a faulty valve, or compromised seal integrity.

When a patient's prosthetic prescription is transferred to a new prosthetist at follow-up, what information is most critical to communicate?

Answer: Current K-level, component specifications, socket measurements, and functional goals

Clinical continuity requires transferring functional classification, component details, socket data, and goals to ensure equivalent care.

A diabetic patient with a transtibial prosthesis presents at follow-up with a non-painful wound at the anterior distal tibia. The correct immediate action is:

Answer: Discontinue prosthetic use and refer to the wound care team

Non-painful wounds in diabetic patients indicate peripheral neuropathy; prosthetic use must be discontinued to prevent worsening and medical referral is urgent.

At a follow-up visit, a patient with a shoulder disarticulation prosthesis reports difficulty controlling elbow flexion. Which component should the practitioner assess first?

Answer: Excursion and force of the control cable system

Elbow flexion in a body-powered shoulder disarticulation prosthesis is driven by the control cable, so excursion and force must be assessed first.

A patient returns for a follow-up 2 years after fitting and reports decreased satisfaction with their prosthesis. Which validated outcome measure best captures patient-centered satisfaction with a lower limb prosthesis?

Answer: Prosthesis Evaluation Questionnaire (PEQ)

The Prosthesis Evaluation Questionnaire (PEQ) is a validated, prosthesis-specific tool designed to measure patient satisfaction and functional outcomes.

During a pediatric orthotics follow-up, the parents report the child has begun walking on tiptoe outside of the AFO. This finding suggests the need to evaluate for:

Answer: Gastrocnemius-soleus contracture development

Toe-walking outside the AFO indicates possible development of gastrocnemius-soleus tightness that requires assessment and intervention.