After amputation, how to maintain the correct position of the stump and prevent the deformity of the stump joint?
After amputation, because some muscles of the limb are cut off, the muscle force of the limb joint movement is unbalanced. For example, the strength of the thigh stump to be closed in (hip adduction) is much greater than that of the thigh to be separated out (hip abduction), the strength of the thigh stump to be bent forward (hip flexion) is greater than that of the stump to be extended backward (hip postextension), and it is easy to form the flexion and abduction deformity of the hip joint after amputation. Once the deformity is formed, it is difficult to correct. Can seriously affect the use of thigh prostheses. For the lower leg amputee, it is easy to form knee flexion deformity (the knee joint can not be fully extended) after amputation, which will also affect the use of prosthesis.
In order to prevent the joint deformity after amputation, the following items should be paid attention to:
(1) Keep the correct position of the stump: the thigh amputee should pay attention to extend the stump flat (hip extension), and try to close to the middle of the body (hip adduction). Amputees can lie prone twice a day for 30 minutes. When lying face up at ordinary times, it should be noted that the residual limbs should not be padded up for comfort or to reduce pain, and the residual limbs should be separated or the waist should be padded up; after the leg amputation, it should be noted that the residual knee joint should be placed in the straight position, not on the thigh or under the knee pillow, not on the bed, not on the wheelchair or the crutch handle, as shown in Figure 1 。
(2) Training to maintain joint mobility: generally, one week after the operation, the amputee of thigh can face down and lie prone, and ask others to help to do gentle adduction and extension of residual limb, once or twice a day; two weeks after the operation, the amputee can start to practice on his own to extend the residual limb backward, adduction (the residual leg of thigh and the thigh of healthy side are forced to close to the middle) or hold the object, and the muscles of both buttocks are forced up and lifted up For the disabled leg and the healthy side thigh, each lifting should be continued for a period of time, and the time of continuous lifting should be gradually extended.
Amputees are hit by their weight every step of the way. If a person needs to walk 3 kilometers a day wearing a prosthesis, the prosthesis side may suffer about one million weight shocks in a year, which forms a great load on the prosthesis. In order to prolong the service life of the prosthesis as far as possible, the protection of the prosthesis should be done carefully.
(1) Keep the surface of the residual limb receiving cavity clean: when the amputee wears the prosthesis, the receiving cavity is in a wet and hot state. If it is not clean, all kinds of bacteria and molds are easy to breed rapidly and massively, forming skin infection and many kinds of dermatophytosis, and the odor of the receiving cavity is unpleasant.
The outer surface of the prosthetic receiving cavity can be wiped with a warm and hot wring towel, and then dried. The internal receiving cavity (soft receiving cavity) of the leg prosthesis can be cleaned with warm water, and the water temperature cannot be too hot to avoid deformation. The internal receiving cavity of traditional prostheses is mostly made of leather, which can be wiped with a wet wring towel soaked with soapy water like the upper leg receiving cavity. All receptacles must be dry before wearing.
(2) Spare some socks with good sweat absorption performance, and clean and replace them frequently.
(3) It is necessary to pay attention to whether there is any small crack on the upper edge of the receiving cavity. If it is found in time, ask the prosthetic technician to repair it in time, the service life of the prosthetic can be prolonged.
(4) Often pay attention to whether there is abnormal noise in the walking prosthesis. If any, it indicates that some joint parts or connection parts are damaged or loose, and should be repaired in time.
(5) the foam sponge sleeve of modern thigh bone prosthesis coat is not strong enough. If there is a crack in the front of the knee, it is necessary to glue or paste some reinforcement materials in time. In addition, this kind of artificial limb is not suitable for wearing socks with short waist and elastic mouth, and this kind of socks are easy to break the jacket of the calf.
(6) Regular inspection and maintenance: generally every half a year or a year, a comprehensive inspection and maintenance of the prosthesis should be carried out at the prosthesis making organization. It is very important to prolong the service life of the prosthesis and to reduce the various diseases of the prosthesis which are inevitable for the prosthesis to be worn for a long time.