Properly putting on a prosthetic leg is a fundamental skill for individuals with limb loss. Correctly donning a prosthesis ensures a secure fit, preventing skin irritation and allowing for effective mobility. This process impacts comfort, function, and the long-term health of the residual limb.
Preparing Your Residual Limb and Prosthesis
Before putting on a prosthetic leg, careful preparation of both the residual limb and the prosthetic components is necessary. Inspect the residual limb daily for any skin issues such as redness, sores, or blisters. Cleaning the residual limb daily with mild soap and water, then thoroughly drying it, helps maintain skin health and prevents issues caused by moisture accumulation.
The liner, a barrier between skin and socket, requires daily cleaning with mild soap and water, followed by thorough rinsing and air drying. This prevents the buildup of sweat, dead skin cells, and bacteria that can lead to odor, irritation, or infection. The prosthetic socket should be cleaned regularly, using lukewarm water and mild soap, then allowed to air dry completely overnight.
Prosthetic socks are an important part of achieving a proper fit. They come in various thicknesses, measured in “ply,” and are used to manage volume fluctuations in the residual limb that can occur throughout the day. Selecting the appropriate number of prosthetic socks helps create a snug fit, reduces friction, and provides cushioning for comfort and preventing skin breakdown.
Step-by-Step Donning Techniques
The method for putting on a prosthetic leg varies by suspension system, but the goal is a secure and intimate fit within the socket. Fully seat the residual limb within the socket for all techniques.
Pin Suspension
For pin suspension, invert the gel liner and roll it onto the residual limb. Ensure no air pockets are trapped and the pin aligns straight. Insert the limb into the prosthetic socket; the pin engages a locking mechanism. If prosthetic socks are used, ensure the sock material does not interfere with the pin’s engagement.
Suction Suspension
With suction suspension systems, roll a gel liner onto the limb, ensuring no air is trapped. The prosthesis incorporates a one-way valve that expels air as the limb is inserted, creating a vacuum seal. Some systems may use a donning or pull sock to help draw the limb fully into the socket, which is then removed once the limb is seated. An airtight seal is essential for this suspension.
Sleeve Suspension
Sleeve suspension involves a gel-like sleeve that rolls over the knee and onto the thigh, or over the residual limb and onto the socket, to create a seal. After the liner and any necessary prosthetic socks are applied, place the limb into the socket. Roll the suspension sleeve down from the thigh over the top edge of the prosthetic socket and onto the liner, creating a secure connection and a vacuum-like seal. Rolling the sleeve while standing can help prevent wrinkles and ensure a smooth application.
Ensuring a Secure and Comfortable Fit
Once the prosthetic leg is on, assess its fit for security and comfort. A well-fitting prosthesis should feel like a snug glove, providing full contact with the residual limb without excessive movement, pinching, or strangulation. There should be even pressure distribution, and the user should feel stable when standing and moving.
Signs of a poor fit include persistent pain, localized pressure spots, rubbing, or a feeling that the limb is moving excessively within the socket. Skin irritation, such as redness, blisters, or sores, also indicates an improper fit. If the prosthesis feels loose, adding prosthetic socks can help fill the void and improve the fit. Conversely, if it feels too tight, removing a sock might provide relief. Fine-tuning of the socket fit is possible as the limb’s volume changes throughout the day. Monitoring the fit and making minor adjustments with socks can help maintain comfort and prevent skin issues.
When to Seek Professional Guidance
While self-management of prosthetic fit through sock adjustments is common, certain situations warrant professional intervention from a prosthetist or healthcare provider. Persistent pain or discomfort that does not resolve with minor adjustments indicates the prosthesis needs professional evaluation. Skin breakdown, including rashes, bruises, open wounds, or blisters, should prompt a visit to the prosthetist, as these can lead to infections.
Changes in residual limb volume that cannot be managed effectively with prosthetic socks indicate the socket no longer fits properly. Difficulty walking, maintaining balance, or an altered gait suggests the prosthetic alignment may be off. Unusual noises from the prosthesis, like squeaking or clicking, can signal mechanical issues. Regular check-ups with a prosthetist ensure the prosthesis continues to fit optimally and functions correctly over time.