O&P Definitions

O&P Definitions

4/16/1998

I have read the recent comments on orthotics and language with
considerable interest since I happen to be one of those anal retentives
who think there is value in using language correctly. But only if you
place value on the ability to communicate ideas with a semblance of
accuracy.

Frankly, I do not give a damn what word the professionals in the O&P
field opt to use to refer to something---I have often referred to my
prosthesis as a 'prosthetic device' and it does not surprise me to hear
the word orthotic used in a similar fashion. After all, I know what
you're talking about and that, in the last analysis, is the goal. As an
amputee I do want and need to know to what a prosthetist refers when
they use a word that has bearing on my treatment. It is part of my
responsibility as an amputee to have a clue.

When amputees, regardless of whether they are veterans or newbies, come
on-line they encounter a plethora of terms and acronyms that have little
meaning to them and frequently inhibit understanding of the dialogue.
With that in mind, the following is often posted to AMP-L for the
benefit of those who takes words seriously. If you wish to copy for your
patients (I know, am I a patient or a client?---don't give a hoot as
long as you make me a comfy socket.), please have at it.

Wayne Renardson
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We have some new subscribers to AMP-L who might find this helpful...from
the past...

In light of the emergence of almost official AMP-L lexicographers, it is
time to revisit the FAQ. Kindly know that definitions are often
ambiguous and if you disagree with a definition, think you can improve
upon it, or make more it concise, please let me know privately. Spelling
corrections are most welcome. Clear, concise definitions in the amputee
lexicon are of benefit to us all.

Wayne Renardson
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AMP-L FAQ on Definitions:

That are many terms used in the amputee community that are confusing to
recent and even veteran amputees coming on-line. Not only are some of
the terms murky, but within the community there is some debate about the
meaning of some terms and how they can best be used to accurately covey
meaning. Prosthetists have their own language, and it is nice to have
some definitions when reading their prose. But beware---ambiguity
abounds.

Language evolves over time, as will this FAQ. The following will help
serve as a foundation for those unacquainted with the terminology. The
definitions have been stolen from a variety of sources. Anyone wishing
to add definitions is welcome to do so.
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AE: above elbow amputation

AK: above knee

Adherent Scar Tissue: Scar tissue formed in the healing process which
                       sticks to underlying tissue such as muscle or
                       fascia or bone.

BE: below elbow

VSBE: very short below elbow

Bilateral: both sides---legs or arms.

BK: below knee

Congenital: a birth anomaly such as a missing or different limb

Cosmesis: an odd term used to describe the outer, aesthetic covering of
          a prosthesis. Refers to the appearance of the prosthesis,
          whether a naturalistic treatment is attempted.

Disarticulation: an amputation through a joint: commonly the hip,
                 shoulder, knee, ankle, elbow, or wrist.

Dorsiflexion: pointing the toe/foot upward, toward the body

Endoskeletal Prosthesis: one built more like a human skeleton with
                         support and components on the inside and a
                         cosmetic cover on the outside.

Exoskeletal Prosthesis: a prosthesis that is hollow on the inside with a
                        hard outer surface to bear weight built more
                        like a human leg or arm with support components
                        on the inside and a cosmetic cover on the
                        outside.

Donning and Doffing: putting on and taking off a prosthesis.

HP: Hemi-pelvectomy: an amputation where approximately half of the
                     pelvis is removed

HD: Hip Disarticulate - Entire leg removed

Ischial Tuberosity: the large sitting bone

Lateral: to the side, away from the mid-line of the body

Medial: toward the mid-line of the body

Myoelectrics: literally muscle electronics. Technology used in prosthetic
              for upper-extremity amputees; used in prosthetic hands and
              elbows to control the prosthesis via muscle contraction
              using electrical signals from the muscles to the
              prosthesis.

Myoplasty (muscles anchored to opposing muscles)

Myodesis -referring to muscles anchored by sutures through the bone
         Note: before the above anchoring procedures were adopted there
         was much greater atrophy (wasting) of muscles resulting in
         reduced function of the stump.

Neuroma: the end of a nerve left after amputation. The nerve will
         continue to grow in a circular pattern and can be troublesome,
         especially when trapped in scar tissue. A small mass or ball
         formed as nerve fibers continue to grow after being severed in
         the amputation.

Orthotics :the profession of providing devices to support and straighten
          the body.

Orthosis :the singular for a supportive device. Orthoses is plural.

Orthotic is mostly used as an adjective. However it can also be used as
a noun. The usage of the noun form has historically been limited to arch
supports and was coined by the podiatric field---re: a foot orthotic.

The noun form of the word is not generally accepted by Orthotists or the
Orthotics profession and is, in fact, frowned upon. Please don't call
your support an orthotic. It will send chills up the spine of every
respectable orthotist. Well, you can, but you won't be on the money.

Partial Foot: an amputation on the front part of the foot

Plantarflexion: pointing the toe or foot down, toward the sole

Preparatory Prosthesis: stage between temporary and permanent
                        prosthesis, using transparent diagnostic test
                        socket and special fitting techniques to
                        accurately fit the prosthesis so problems can be
                        eliminated before it is cloned for the permanent
                        prosthesis.

Prosthesis: An artificial part of the body. In the case of amputees,
            usually an arm or a leg.

Prosthetics: the systematic pursuit of providing cosmetic and /or
             functional restoration of missing human parts.

Prosthetist: a person involved in the science and art of prosthetics;
             one who designs and fits artificial limbs.

Posterior: the back side of the body or part in question---ie: Posterior
knee or patellar region.

PTB: Patellar Tendon Bearing BK Prosthesis. The Condyles are the
     proximal (near) ends of the tibia and fibula. My socket is a PTB
     with additional weight on the condyles. This gives 3 major points
     of contact, the patellar tendon, lateral condyle (fibula) and
     medial condyle (tibia).

Early Prosthetic Fitting.
------------------------
A procedure in which a preparatory prosthesis is provided for the
amputee immediately after removal of the sutures.

Modular Prosthesis.
------------------
An artificial limb assembled from components, usually of the
endoskeletal type where the supporting member, or pylon, is covered with
a soft foam or other light material shaped and finished to resemble the
natural limb.

Definitive, or Permanent Prosthesis.
--------------------------------------
A replacement for a missing limb or part of a limb which meets accepted
standards for comfort, fit, alignment, function, appearance, and
durability. Some amputees think this result is as rare as kryptonite.

Check or Test Socket.
---------------------
A temporary socket, often transparent, made over the plaster model to
aid in obtaining a proper fit.


Preparatory Prosthesis. An unfinished functional replacement for an
---------------------- amputated limb, fitted and aligned in accordance
                        with sound biomechanical principles and worn
                        for a limited period of time to accelerate the
                        rehabilitation process.

Prosthetic Feet
---------------
SACH:

Single Axis Cushion Heel---or Solid-Ankle Cushion Heel: foot used since
the Civil War. It is based on an ankle hinge that provides dorsiflexion
and plantarflexion. The disadvantage of a single axis foot includes poor
durability & cosmesis;

Multiaxis foot: allows inversion and eversion and rotation of foot and
                is good for work on uneven surfaces at the expense of
                overall utility and weight.

Energy Storing: designed with a flexible keel and may perhaps become the
                new standard for general use. They are designed with a
                cantilever spring and are best for young & athletic
                patients.

Pylon. A rigid member, usually tubular, between the socket or knee unit
        and the foot to provide support. Often what is referred to as a
        pole in a temporary prosthesis; the weight bearing support shaft
        in an endoskeletal prosthesis.

Ramus: the middle portion of the pubic bone, in the crotch area. the
       front middle portion of the pubic bone, palpated just above the
       genitals

Residual Limb: remaining portion of a limb after amputation

Rigid Dressing.
---------------
A plaster wrap over the stump, usually applied in the operating or
recovery room immediately following surgery, for the purpose of
controlling edema (swelling) and pain. It is preferable, but not
necessary, that the rigid dressing be shaped in accordance with the
basic biomechanical principles of socket design.

Shrinker: a prosthetic reducer made of elastic material and designed to
          help control swelling of the residual limb.

Stump: a word commonly used to refer to the residual limb.

Supercondular Suspension: a method of holding on a prosthesis by
                          clamping above a joint.

Symes: An amputation through the ankle joint that retains the fatty heel
       pad portion and is intended to provide end weight bearing.

Temporary Prosthesis: a prosthesis made soon after an amputation as an
                      inexpensive way to help retrain a person to walk
                      and balance while shrinking the residual limb.

Transtarsal amputation: through the tarsal (tarsus) or foot bones

Normal Shape/Normal Alignment (NSNA) - also know as a narrow ML socket:
First described by Ivan Long, this socket more closely approximates the
shape of the musculature of a residual limb, when compared to a quad
socket.

The sides, or medial/lateral measurement is tightened down to squeeze
the residual limb, with most of the squeezing taking place on the
outside or lateral side. This helps control the rotation of the socket
by putting pressure along the fleshy area of the leg that can handle
some side to side pressure.

Long's Line was also first described by Ivan Long, and has to do with
the location of the foot in relation to the head and distal end of the
femur and is used in alignment. It is a straight line from the head of
the femur, though the distal end of the femur down to the center of the
heel of the prosthetic foot.

The Ischial Containment Socket is a derivative of the Narrow ML, as a
special attempt is made to form a little pocket for the ischium to sit
in:

The ischium is a bone that protrudes from your pelvis that may get sore
when sitting on a hard surface for extended periods of time.

An Ischial Containment (IC) socket cups this bone on the inside and back
as well as the bottom to accomplish two things: 1) By cupping, or
containing this bone inside the socket, the socket tends not to shift
laterally (outside) when weight is put on it, making walking more
efficient. This style of socket can be _very_ intimate and may take some
time to get used to in order for it to become comfortable.

TEC: Total Environmental Control liner

A TES belt is a suspension system that has a neoprene ring which the
prosthesis slides into. There is a neoprene belt that attaches around
your waist by velcro (uhh, hook and loop fastener). It usually gives
good suspension but can be hot in a warm climate.

VSP - Vertical Shock Pylon - Shock absorber on the Reflex
      VSP model prosthetic foot

AE - Above Elbow
BE - Below Elbow
Symes - amputation at the ankle or through the foot

DAK - Double AK

ACA - Amputee coalition of America
ADA - Americans with Disabilities Act