Prosthetic Services

The fitting of a prosthesis is truly an art form.  We can provide complex solutions where other companies have failed.  The clinical team at Biomatrix utilizes the latest biomechanical management, materials, and technology to restore function and permit normal motion after your amputation. The qualified staff will select, design, and fabricate the appropriate prosthesis to fit your specific lifestyle and needs after your amputation.  We invite you to experience the difference.

Prosthetic Services

The Prosthetic Process

Amputation Levels Lower Extremity

Amputation

Amputation surgery may be necessary if an injured or diseased limb is not expected to heal and the patient’s life is endangered as a result. Possible causes of this include circulation issues, infections, accidents, cancer, or a congenital malformation of the limb. In these cases, it is usually known well in advance that an amputation will become necessary. In contrast, sometimes it is necessary to amputate unexpectedly.  An example of this is secondary to a severe injury following an accident.

The term amputation level is used to describe the location at which the body part is amputated.  The amputation level is determined by the doctor before the operation and is based on the reason for the amputation. For planned interventions, a prosthetist may be consulted as well to clarify which amputation level is suitable for subsequent fitting of the prosthesis.

Before the Amputation

Initial Evaluation

If you will have a planned amputation surgery, you will be examined in detail several times before the surgery. Your doctors will explain what will happen both during and after the operation. If you’ve had a traumatic accident, your conversations will occur after the surgery.  During these discussions, you will have the opportunity to ask your physician and prosthetist any questions which are important to you. It’s a good idea to take notes of what you want to ask before the discussions to ensure you don’t forget anything.

initial evaluation
exercise

Exercises

If possible, you should begin performing therapy exercises you’ll use after amputation surgery prior to your surgery taking place.  This will strengthen your muscles in advance and prepare you for the upcoming rehabilitation.  The training of such activities can make the experience after the operation considerably easier on you.  Ask your doctor and your physical therapist which exercises are right for you.  

Support

We also recommend that you talk with peers who have also undergone amputation surgery. It is good to hear how others deal with the situation, and in many cases, they’ll also be able to share tips on prosthetic management and activities of daily living. Talk to your therapy team about connections with local peer support groups.  

Support

Following the Amputation

Immediately after the procedure, the sole focus will be on your recovery and the healing of your residual limb. Both are important so that you can start rehabilitation soon and be fitted with a prosthesis.  Your residual limb will be treated with a special wound healing bandage. Your doctor’s main goal here is to quickly heal the wound that was caused by the operation and to prepare your residual limb for the future prosthesis.

The focus during the initial period after the operation is on three treatment goals: You should have little to no pain, your residual limb should be able to bear weight, and you should be able to move your residual limb optimally in all directions.

The focus during the initial period after the operation is on three treatment goals: You should have little to no pain, your residual limb should be able to bear weight, and you should be able to move your residual limb optimally in all directions.

wound healing

Wound Healing of the Residual Limb

After the amputation, your leg will have likely been treated with ace bandages, a compression shrinker, or a rigid removable dressing/cast (RRD).  A shrinker is designed to control the swelling and shape the limb in preparation for a prosthesis.  An RRD serves the same purpose, but also offers protection to the surgical site.  With the aid of pressure applied to the residual limb over a large surface area, swelling (edema) of the residual limb can be reduced and the residual limb can be formed for the future prosthetic fitting. This compression of the residual limb contributes to being able to do your prosthetic fitting as soon as possible and to making it easier to adjust your prosthesis. In addition, compression aids circulation in the residual limb. This reduces the amount of pain and results in improved healing of the scar.

During this period, compression and massage therapy are important in helping the scar tissue remain soft and pliable—while simultaneously developing the ability to bear weight so that it’s possible to wear the prosthesis.  In most cases, the amputation wound will close and form a scar within the first three to four weeks. But even if the scar looks like it has healed well from the outside and only the color of the scar tissue is changing slightly, complete healing of the scar will take significantly longer. 

During this period compression, and massage therapy are important in helping the scar tissue remain soft and pliable—while simultaneously developing the ability to bear weight so that it’s possible to wear the prosthesis.

The Rigid dressing protects the limb from trauma and is removable for wound inspection.

With the aid of pressure applied to the residual limb over a large surface area, swelling (edema) of the residual limb can be reduced and the residual limb can be formed for the future prosthetic fitting. This compression of the residual limb contributes to being able to do your prosthetic fitting as soon as possible and to making it easier to adjust your prosthesis. In addition, compression aids circulation in the residual limb. This reduces the amount of pain and results in improved healing of the scar.

Various techniques such as elastic bandages, compression socks or silicone liners are used for compression therapy

The Prosthesis and Rehabilitation

Your treatment team will decide when you can start with intensive rehabilitation based on how your recovery progress.  During your rehabilitation process, you will be supported by a rehabilitation team that could include doctors, physical and occupational therapists, a prosthetist, and nursing staff. These professionals are there to support you and to ensure that you are well prepared. During the rehabilitation, you will learn how to properly care for your residual limb, as well as the rest of your body.

Before you can wear a prosthesis, your residual limb must be healed and have attained the proper shape. This means that all fluids that accumulated due to the operation have been removed through compression therapy.  Once your residual limb has healed and you are in good health again, the process of fitting your preparatory prosthesis will begin.  Even before this stage, however, your prosthetist will likely meet with you to better understand your needs and wishes. In addition, he or she will assess your residual limb shortly after the amputation and find out if an interim prosthesis is appropriate for you.  Your prosthesis will be devised to accommodate your level of physical fitness and health, the amputation level, the demands you place on the prosthesis and your professional and private environment. It will help restore a large part of your mobility and contribute to your ability to manage your life without help from others. By wearing your prosthesis, you’ll help avoid postural and balance problems that can arise due to the missing weight of your amputated leg. In addition, you also avoid excessive strain and long-term damage to your sound leg by wearing your prosthesis.

Prosthetic Fitting
Interim / Preparatory Prosthetic

Interim/Preparatory Prosthesis

Once your residual limb has been properly formed and can bear weight, you may be fitted with an early or interim prosthesis. In some cases, an initial prosthesis may be fit about 10 days after a lower limb amputation. With such an immediate fitting, some weight can be applied to the residual limb early on and the first walking exercises can be started. However, this type of prosthesis is not suited to all amputations. Your doctor, physiotherapist, and prosthetist will decide together if this is an option for you. If such an early fitting is possible for you, you will receive an interim prosthesis, which is designed for initial walking and standing exercises.

The interim prosthesis helps you to perform standing and walking exercises early on. In addition, your prosthetist gets to know your individual ideas and needs, which provides them with important information about which prosthetic components are suited to you. They will then fabricate/fit the prosthetic socket and adjust the prosthesis to your unique needs.

After prosthetic components for you have been determined, the prosthetic socket will be made and then finally aligned to best fit your walking style and ability. The proper fit of the socket is extremely important—just like a shoe, if it doesn’t fit well, you won’t be able to walk correctly.

You’ll begin to practice using your prosthetic leg. At first, you’ll learn how to put the prosthesis on and take it off (donn and doff) as well as take care of it. Later, you’ll learn how to walk with the prosthesis, which is known as gait training. During this time, you may undergo several trial fittings with your Prosthetist to make sure the socket and alignment are correct, and everything works as well as possible.

Definitive Prosthesis

Once your limb has stabilized and you have completed wearing your preparatory prosthesis, you will progress to receiving your definitive or permanent prosthesis.  Getting your definitive prosthesis is a similar process to when you were given your preparatory prosthesis. Your prosthetist will obtain the necessary molds, measurements, and information to proceed with its fabrication.  The options that are available for the definitive prosthesis cover every aspect of design and construction. Various socket designs, joint technology, suspension systems, as well as different prosthetic foot technology will be determined by your prosthetist.  The final prosthesis provided will be engineered and dynamically aligned for optimal performance, appropriate for your exact function, whether it may be for community ambulation or sports activities.

When appropriate, some of the original components selected by your prosthetist for your preparatory prosthesis may also be suitable for your definitive prosthesis.  You have spent months undertaking rehabilitation training and will be familiar with the response and use of these components.  If you feel comfortable and safe, you may wish to continue their use. 

Your definitive prosthesis will frequently have a cosmetic finish.  This covering may be made of a soft or rigid foam and gives the prosthesis a natural appearance, typically matching the previous shape. The outer coloring is typically incorporated into a nylon or a rubberized prosthetic skin that is applied over the cosmetic cover. The prosthesis can then be finished to match your sound side.

Definitive Prosthesis
Physical Therapy

Physical Therapy

The goal of rehabilitation training with a physical therapist is to help you gain as much mobility and independence as possible.  Your therapist will help you learn how to manage the overall prosthesis.  This includes putting the prosthesis on and taking it off, getting up and sitting down, and balance and gait training.

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Biomatrix Orthotics and Prosthetics

 

Troy Office

1116 E Big Beaver Rd.

Troy, Mi 48083

(586) 773-1400

 

Mt. Clemens

24432 Crocker Blvd

Clinton Twp, MI 48036

(586) 463 – 3600

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