Managing Your Below-Knee Prosthesis Information for Patients and Families

Managing your below-knee prosthesis Information for patients and families

It is very important to make sure your prosthesis fits you well. If you walk with a prosthesis that does not fit properly:

 You can develop wounds  It can take weeks or months for wounds to heal  You may not be able to wear your prosthesis while the wounds heal

Follow the tips in this handout to make sure your prosthesis fits well and your skin stays healthy.

Check the fit every time

Your limb will begin to shrink as you start to wear your prosthesis regularly. The size of your leg can also change from day to day and from hour to hour. It’s important to check the fit each time you wear your prosthesis.

Your prosthesis fits correctly if half your knee cap is in the prosthesis and half is out. The pictures below show when a prosthesis fits correctly or incorrectly. You can adjust the fit by adding or removing socks.

Use the right number of socks

You may need to change the number of socks you wear to get the right fit. Sometimes you may need to add socks after wearing your prosthesis for several hours.

Types of socks  Sheath – thin nylon sock that absorbs sweat. Not everyone uses or needs these.

 1-ply sock – the thinnest sock

 3-ply sock has a yellow band

 5-ply sock has a green band

Steps 1. Add or remove 1 ply at a time

2. Smooth out all wrinkles

3. Recheck the fit of your prosthesis

Note: It is better to wear a 3- or 5-ply sock than the same thickness of multiple 1-ply socks. This is because multiple 1-ply socks will create more wrinkles and irritate the skin. Example: replace three 1-ply socks with one 3-ply sock.

Important tips  Only use socks that are clean and dry. Dirty socks can cause skin breakdown.

 Hand-wash socks with mild soap and warm water. Hang to dry to avoid shrinking. Do not put in dryer.

 Ask your prosthetist if you have problems with too much sweat.

 Always wear your shrinker sock when you are not wearing your prosthesis. Never wear your shrinker sock with your prosthesis.

Do skin checks regularly

Always do a skin check after you remove your prosthesis. Use a mirror to look at the bottom of your limb:

 If you see red marks on bony areas that last longer than 20 minutes, check the fit. You may need to change the number of socks you wear.

 If it’s still red after changing your sock ply, stop using your prosthesis and contact your prosthetist.

If you have any questions or are unsure about the redness you see, call your prosthetist.

Call your prosthetist immediately if:

 You are having socket fitting problems that cannot be fixed by adding/removing socks

 You notice an open wound on your residual limb after wearing your prosthesis

Never adjust the prosthesis yourself. Do not:

 Trim your gel liner  Change the alignment  Put tissue or fillers inside your socket

Use the walking device recommended by your therapist

Always use the walking device (two-wheeled walker, rollator walker, or cane) recommended by your therapist.

If you use a new device without proper training, you are more likely to fall. You may also put extra pressure on your residual limb and this can cause the skin to break down.

Wearing your prosthesis

It is important to gradually increase the amount of time you wear your prosthesis. If you wear your prosthesis for too long, too soon, the skin on your limb can break down.

‘Wearing’ your prosthesis does not mean you need to stand or walk with it. Wearing your prosthesis while sitting will still help your skin get used to it.

Your therapist will help you gradually increase your activities with the prosthesis. When you first start wearing your prosthesis, you will spend more time sitting and will stand only occasionally.

Your wearing schedule

Follow the wearing schedule below to safely increase your wearing time. If you develop skin problems, you may not be able to follow this wearing schedule.

Day When to wear your prosthesis

Continue until you can wear your prosthesis all day.

Keep your body weight constant

It is very important to stay at the same body weight. If you gain or lose weight, your prosthesis won’t fit well. Even gaining 5 pounds can make your prosthesis too tight, uncomfortable and unsafe to use.

Be careful with your diet – try not to eat food with too much sugar or salt. Eating too much salt will cause swelling and may make your prosthesis feel tighter.

You should know

Your residual limb will continue to shrink for the first 2 to 3 years after your amputation. For some patients, it can take longer.

Notes ______

Unity Health Toronto cares about your health. For health information you can trust, visit us online at unityhealth.to/learn.

This information does not replace the advice you receive from your health care provider. If you have questions, ask your health care team.

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