During the first consultation, your prosthetist will evaluate your limb, the level of healing achieved and how ready you are to proceed with the next phase. Once your prosthetist is satisfied with the condition of your residual limb, the measuring, designing and manufacturing of the first prosthesis can begin. As a rule, the sooner the construction of your prosthesis starts, the shorter your rehabilitation is likely to be. A thorough evaluation will follow in which the prosthetist reviews your physical condition and the level of your amputation, and discusses your wishes as regards specific physical capabilities, for example:
- Do you usually walk on flat terrain?
- Do you walk mainly indoors?
- Are there inclines and declines near your house?
- Do you often climb stairs?
- Do you often walk outdoors?
- Do you take part in sport?
The answers to these questions will help the prosthetist determine which combination of components suits your activity level the best. Some components are designed to support less active people struggling to maintain the ideal balance of safety, comfort and mobility. Others cater for people who are keen to become increasingly mobile and return to their regular activities. There are also components specifically designed to enable exceptionally active people to engage in high-impact endeavours and cope with increasing levels of impact, so that they can aspire to more challenging and potentially rewarding activities.
Fitting a prosthesis is both a science and an art
The goal of the prosthesis is to provide its user with the most natural movement and function possible. While no prosthesis is going to be quite as good as a natural limb, prosthetic improvements in recent years have allowed people with limb loss to enjoy more physical freedom than what was previously possible. The fitting and fabrication of the prosthesis is both a science and an art. Each prosthetist will have his or her own fitting style, fabrication techniques and opinions of what might be the best for you.
The two most important aspects of fitting a prosthesis are the design of a well-fitting socket with optimal suspension and the correct alignment of the prosthetic components with the residual limb. This is why a good prosthetist always takes special care to custom-manufacture a socket that fits your residual limb perfectly and ensures that the components are aligned correctly.
The continuous changing of the the residual limb
The residual limb will undergo its own process of healing and changing shape, as it stabilises over time. This is due to a combination of factors, the main one being fluid changes. First of all, the muscles in the limb will atrophy (shrink) since they aren’t functioning the way they used to. You may gain or lose weight, or you may lose muscle tone. However, once you start walking again, you’ll build back some of that muscle tone and perhaps return to your normal weight.
Due to the changing shape of your residual limb, the socket attaching your prosthetic leg to your residual limb will, at some point, no longer fit perfectly, which may have a negative effect on safety, energy consumption and comfort, among other things. There are ways to compensate for this, for instance by putting extra socks over your residual limb, but eventually a new socket will have to be manufactured to accommodate the changes. This might have to be done several times during the period following surgery.