By Howard Choi, Ross Sugar, David E. Fish, Matthew Shatzer, Brian Krabak
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Other components The most common prosthetic wrist is the friction wrist, which allows passive pronation/supination but rotates when holding heavy objects. B/l amputees require at least one mechanical spring- 41 assisted flexion wrist for access to the body midline. Most TH prosthetic elbows have an alternator lock, which alternately locks and unlocks with the same movement. With the elbow unlocked, body movements will flex or extend the elbow using a cable; when locked, the same cable operates the TD.
SLR tests are typically negative. Tx is aggressive conservative care, possibly with lumbar bracing in a mildly flexed position. Aquatic therapy may help alleviate spinal loading and improve symptoms. Surgical decompression with or w/o fusion should be considered in pts with persistent or progressive symptoms or neurologic deficits. Lumbar zygapophyseal (facet) arthropathy - Facet arthropathy may be due to traumatic or degenerative processes. Pts typically complain of generalized LBP, sometimes with radiation to the buttocks or posterior thigh but not below the knee.
Ambulation is typically achieved via a swing-to or swing-thru gait with forearm crutches. 1,2,3 courtesy of Tan J: Practical Manual of PM&R. Mosby, 1998. 49 3. Other LEx orthoses Reciprocating gait orthosis (RGO), adult-type Special cables on this b/l HKAFO transfer hip flexion forces on one side to hip extension on the other and vice versa to provide a more “natural” appearing reciprocal gait pattern than the CSO. B/l HF is precluded by the cables during ambulation, but this mechanism can be released to allow for sitting.