Early Post-Operative Management

Role of the Lower Extremity Prostheses

IPOP

Patients are initially fitted with a IPOP (immediate post-operative prosthesis) within 2-3 hours of amputation for edema management. Use of IPOPs can also promote wound/suture healing and minimize risk for falls when WB in the preparatory prosthesis.

Ipop

The IPOP is fitted under anesthesia. Patients with fragile diabetes and advanced vascular disease may not be candidates for a IPOP, and will use soft dressings to help manage edema and promote healing.

Shrinkers are pull-on type socks which can offer swelling management when rigid dressing is removed (needs to be worn 24 hours/day

Preparatory Prosthesis

The type of preparatory prothesis is determined by the MD. This test prosthesis is fit as soon as suture is healed. The function of the prosthesis is to continue to reduce edema and allow for adjustability at the final fit and prosthesis type is determined. A patient may need multiple sockets as the side of the limb is reduced and it lacks complete cosmetic finish. Patients are often altering their gait as they learn to ambulate, so adjustability of the prosthesis is key.

Common pressure areas include condyles, fibula, tibial tuberosity, and posterior aspect of the knee

 

Role of Physical Therapy

Interventions post-amputation are directed at maximizing function and minimizing complications that result in poor prosthetic fit. The rehab team works closely with the patient to monitor skin, manage swelling, prevent falls, and recondition for the energy cost associated with donning/doffing and ambulating with a prosthetic limb.