Amputee and limb loss Glossary

abduction: Motion of a limb or body part away from the median plane of the body. The resulting effect can cause problems with proper gait and/or ambulation and may prolong the rehabilitation process, especially in cases of lower extremity limb loss—adduction is its opposite.

acquired amputation: Limbs surgically removed due to disease or trauma.

ADA: The Americans with Disabilities Act enacted in 1990 and prohibits discrimination on the basis of disability in employment; to be protected by this Act, one must have a disability or have a relationship or association with an individual with a disability.

adherent scar tissue: Usually formed during the healing process, the scar tissue sticks to underlying tissue such as muscle, fascia or bone and may cause pain or lessen the ability for a full range of motion; it also can limit proper fit of the socket. Massage techniques can be employed to combat irritation and/or inflammation, working to soften the hardened tissue.

AE: (above-the-elbow): A specific level of amputation—aka transhumeral of upper arm bone.

AFO: Ankle-Foot Orthosis; device that encompasses the lower leg and foot.

AK: (above-the-knee): A specific level of amputation—also known as transfemoral.

alignment: Position of the prosthetic socket in relation to the components and body weight line. Alignment can be adjusted to accommodate patient specific needs.

ambulation: The action of walking or moving. For lower extremity amputees, rehabilitation is primarily concerned with helping the patient achieve proper gait and/or ambulation.

amelia: Medical term for the congenital absence or partial absence of one or more limbs at birth. Amelia can sometimes be caused by environmental or genetic factors.

amputation: The loss or absence of all or part of a limb.

anterior: The front portion of a shoe or foot.

AOPA (American Orthotic and Prosthetic Association): Founded in 1917. AOPA is a national trade association committed to providing business services and products to O&P professionals.

architectural barrier: Barriers such as stairs, ramps, curbs, etc. that could obstruct a person’s ability to walk or mobilize in a wheelchair.

assistive/adaptive equipment: Devices that assist in activities or mobility (i.e., wheelchair ramps, hand bars/rails, car and home modifications, canes, crutches, walkers, adaptive utensils and other similar devices). Devices that assist in performance or mobility, including ramps and bars, changes in furniture heights, environmental control units and specially designed devices.

atrophy: A wasting away of a body part, or the decrease in size of a normally developed extremity or organ, due to a decrease in function and/or use.

BAK: Bilateral above knee. Also referred to as Bilateral transfemoral or above knee (AK).

BE (below-the-elbow): A specific level of amputation—aka transradial or bones between wrist and elbow.

bilateral amputee: A person who is missing or has had amputated both arms or both legs. For example, a person that is missing both legs below-the knee is considered a bilateral BK.

biomechanics: Applying mechanical principles to the study of human movement; or the science concerned with the action of forces on the living body.

BK (below-the-knee): A specific level of amputation—aka transtibial or bones between ankle and knee.

BOC (Board for Orthotists/Prosthetists Certification): BOC is an agency that certifies orthotists, prosthetists, orthotic and mastectomy fitters and accredits their facilities.

body image: The awareness and perception of one’s own body in relation to both appearance and function.

body-powered prosthesis (upper extremity): An arm prosthesis powered by movement in the upper extremity portion of the body, specifically the muscles of the shoulder(s), neck and back. The motion of these movements is then captured by a harness system that generates tension in a cable, allowing a terminal device (hook or prosthetic hand) to open and close.

CAD/CAM – Computer Aided Design and Computer Aided Manufacturing: The use of computing programs, components and equipment for digital capture of anatomy, modifying and designing geometry and creating products through additive (3D printing) and subtractive processes.

CAPO: Canadian Association of Prosthetists and Orthotists.

causalgia: A persistent, often severe burning pain usually resulting from injury to a peripheral nerve.

check or test socket: A temporary socket, often transparent, made over the plaster model to aid in obtaining proper fit and alignment for patient specific function of a prosthesis.

Chopart amputation: Named for François Chopart, French surgeon, 1743-1795. It is a disarticulation at the midtarsal joint of the foot, leaving a stump that is able to withstand weight bearing without a prosthesis. Recent studies, however, devalue this type of amputation, instead preferring the similar Syme’s amputation.

C-Leg: The Otto Bock C-Leg features a swing and stance phase control system that senses weight bearing and positioning to provide the knee’s microprocessor information about the amputee’s gait, thus promoting smoother ambulation. The outer shell houses a hydraulic cylinder, microchip, and rechargeable battery. The first of what is now of many computerized prosthetic knees. Another computerized prosthetic knee is Ossur’s Rheo.

Codes: HCPCS, CPT, ICD10, A,K and L-Codes: Diagnostic and reimbursement codes used in the prosthetic/healthcare industry to identify what services and/or devices were provided.

Congenital Amputee: Individual born missing a limb(s). Technically, these individuals are not Amputees, but are considered to be “Limb Deficient.”

congenital anomaly: A birth malformation such as an absent or poorly developed limb. (See amelia and phocomelia)

Congenital Deficiency: Condition present at birth, when all or part of a limb fails to develop normally.

contracture: The tightening of muscles around a joint, restricting the range of motion and suppressing muscular balance.

Control Cable (Bowden Cable): A cable system taken from the aircraft industry to control the operation of a prosthetic arm. Can also be used for lower extremity prostheses and orthotic systems as well.

contralateral: Originating in or affecting the opposite side of the body.

Compression garments: Orthotic garments that have gradient compression to aid in edema control, veinous return and circulation. Compression garments come in various strengths measured by millimeters of mercury (mmHG). Compression garments are often not covered by insurance.

Copay or Copayment: a payment made by a beneficiary for health services in addition to that made by insurance provider(s). Copays or Copayments are a fixed fee you pay when you receive covered care like an office visit or pick up prescription drugs.

Cosmesis: The outer, aesthetic covering of a prosthesis, usually made of foam or a rubber like material. Foam cosmeses are almost always covered by a cosmetic stocking. Used to describe the outer, aesthetic covering of a prosthesis.

CP (Certified Prosthetist): A person who has passed certification standards as set by a prosthetist certifying body.

CPO (Certified Prosthetist/Orthotist): A person who has passed certification standards as set by a prosthetist/orthotist certifying body.

custom fit: Fitting an individual with a device that is made from an image of the individual’s anatomy and fabricated according to the needs of that individual.

Custom shaped cover: An inner protective cover of meant to appear similar to shape of the missing limb.

debridement: The removal of necrotic, infected or foreign material from a wound.

definitive prosthesis or permanent prosthesis: The definitive prosthesis is fabricated after fit and alignment of the preparatory or temporary socket for the missing limb or part of a limb, meeting standards for comfort, fit, alignment, function, appearance (optional) and durability.

desensitization: To reduce or remove any form of sensitivity in the residual limb by massaging, tapping, applying heat or cold or applying vibration.

diabetic amputation: An amputation caused by complications associated with diabetes. Causes can include neuropathy, ulcers, and foot disorders. This is an acquired amputation.

Diabetic foot wear: Shoes, socks and foot orthotics that are designed to protect the diabetic foot from pressure, shear and torsion that can cause blister or pressure wounds.

disarticulation: An amputation of a limb through the joint, without cutting any bone—performed at the hip, knee, ankle, shoulder, elbow and wrist levels.

distal: (1) The end of the residual limb. (2) The end that is farthest from the central portion of the body. Distal is the opposite of proximal.

distal muscle stabilization: During an amputation, it is important to retain the maximum amount of functioning muscle to ensure strength, shape and circulation. To achieve this, the remaining muscles at the site of amputation must be secured and stabilized. Myodesis and Myoplasty are the most common techniques for achieving this stabilization.

donning and doffing: Putting on and taking off a prosthesis.

Dorsiflexion: Pointing the toe/foot upward, toward the body.

durable medical equipment (DME): Assistive devices, such as crutches, walkers or wheelchairs that are used by patients at home.

dysvascular amputation: The word is used to denote amputations that are caused or acquired from poor vascular status of a limb (i.e., ischemia). The prefix dys is Greek in origin and means abnormal, difficult, impaired or bad.

edema: Swelling of the tissues.  A type of localized swelling that is characterized by an excess of fluid in body tissues. Many amputees experience inflammatory edema (red, tender, and/or warm skin) at the residual level.

elastic wrap: An elasticized bandage used to prevent swelling and encourage shrinkage of the residual limb, thus promoting a healthy stump.

endoskeletal prosthesis: A prosthesis built using modular adjustable componentry housed inside a soft, cosmetic covering.

energy storing foot: A prosthetic foot designed with a flexible heel. The heel stores energy when weight is applied to it and releases this energy when weight is transferred to the other foot.

exoskeletal prosthesis: A prosthesis made of a hard, hollow outer shell designed for weight bearing. It is a fully functional, complete prosthesis that has no adjustability.

extension assist: A device that assists the prosthesis through the swing phase of ambulation, thus speeding up the walking cycle.

Eversion: To turn outward.

extremity: Synonymous with limb, usually referring to an arm or leg.

forequarter amputation: An amputation of the arm, shoulder, clavicle, and scapula.

functional prosthesis: Designed with the primary goal of controlling an individual’s anatomical function, such as providing support or stability or assisting ambulation.

gait: A manner of walking that is specific to each individual.

gait training: Part of ambulatory rehabilitation, or learning how to walk with your prosthesis or prostheses. Initial training is provided by prosthetist and later physical and occupational therapists for strength, coordination, balance, endurance and patient specific needs.

Hand/Mitt: Either passive or active (terminal) device used to replace the hand.

Hard Socket: A prosthetic socket made of rigid materials.

Heel Strike: The moment when the heel makes contact with the floor at the end of the swing through phase.

heterotopic ossification (HO): formation of extra skeletal bone in muscle and soft tissues. HO is a common complication of trauma and surgery.

Hip Disarticulation (HD): Amputation which removes the leg at the hip joint, leaving the pelvis intact.

HKAFO: Hip-Knee-Ankle-Foot Orthosis; device that encompasses the hip and leg aka long leg brace that provides stability during gait and free standing.

HP (hemipelvectomy): Similar in scope to the hip disarticulation, the HP also removes approximately half of the pelvis.

hybrid prosthesis: A prosthesis that combines several prosthetic options in a single prosthesis, usually for individuals who have a transhumoral (AE) amputation or difference. The most common hybrid prostheses are found in upper extremity cases where the device utilizes a body-powered elbow and a myoelectrically-controlled terminal device (hook or hand).

Hypertrophy: the enlargement of an organ or tissue from the increase in size of its cells. The increase is size and shape of muscles that can affect the fit and function of a device; opposite of atrophy

IAOP: International Association of Orthotics and Prosthetics.

Ilizarov technique: A bone fixation technique using an external fixator for lengthening limbs, correcting pseudarthrosis and other deformities, and assisting in the healing of otherwise hopeless traumatic or pathological fractures and infections, such as chronic osteomyelitis.

Insurance: Insurance providers

IPOP (Immediate Post-Operative Prosthesis): A temporary prosthesis applied in the operating room immediately following amputation. The IPOP helps control initial edema or swelling, reduces postamputation pain and protects the amputation site by enveloping the residual limb in a rigid dressing, and allows for immediate, although light, ambulatory rehabilitation.

ischemia: A localized type of anemia that results because of an obstruction in the blood supply, usually through arterial blockage and/or narrowing. This condition is usually seen in patients with poor vascular health or in diabetics that are facing complications of a comorbid disease.

Ischial Containment Socket: (SEE ischial tuberosity): The Ischial Containment socket cups the Ischial 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 have a very intimate fit and may take some time to get used to in order for it to become comfortable.

Ischial Tuberosity: The bone that protrudes from the back of the pelvis (the “butt bone”) that may get sore when sitting on a hard surface for extended periods of time.

ischium: The lower portion of the hipbone, which sometimes protrudes from the pelvis and may get sore while sitting on a hard surface for extended periods of time.

ISPO: International Society for Prosthetics and Orthotics (ISPO) has worked to develop the prosthetics and orthotics sector worldwide since its inception in the 1970s.

KAFO: Knee-Ankle-Foot Orthosis; device that encompasses from the thigh to the bottom of the foot.

KD: Knee disarticulation. Amputation through the knee joint.

kinesiology: The study of muscles and human movement.

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

LEA: Acronym for a lower extremity amputation or amputee.

Liner (roll-on liner): Suspension method used to hold the prosthesis to the residual limb and to provide additional comfort and protection for the residual limb. Roll-on liners can also accommodate some volumetric changes in the residual limb. These liners may be made of silicon, pelite, or gel substances.

Local Coverage Determinations (LCD): Medicare defined coverages for specific services and products. All private insurances somewhat follow Medicare guidelines.

LSO: Lumbosacral Orthosis; device that encompasses the lower back; low back brace.

Manual Locking: User controlled mechanism to lock a device into a position; such as a manual locking prosthetic knee in complete extension (straight) to prevent buckling and falls.

medial: Motion of a body part toward the center plane of the body.

Medicaid: a public health insurance program that provides health care coverage to low-income families and individuals in the United States.

Medicare: If your supplier accepts assignment you pay 20% of the Medicare-approved amount, and the Part B deductible applies. Medicare pays for different kinds of DME in different ways. Depending on the type of equipment:

microprocessor-controlled knee: These devices are often equipped with an onboard computer and sensors that detects full extension of the knee and automatically adjusts the swing phase of ambulation, allowing for a more natural gait.

modular prosthesis: An artificial limb assembled from components or modules usually of the endoskeletal type, where the supporting member (pylon) may have a cosmetic covering (cosmesis) shaped and finished to resemble the natural limb.

multiaxis foot: The multi-rotational axis allows for inversion and eversion of the foot, and it is effective for walking on uneven surfaces.

Myodesis: Muscles surgically anchored to end of bone.

myoelectrics: Basically, this is muscle electronics. It is a technology used mainly in upper extremity prosthetics to control the prosthesis via muscle contraction using electrical signals from the muscles to power the prosthesis.

Myoplasty: Muscles surgically anchored to opposing muscles.

Neuroma: The end of a nerve left after amputation, which continues to grow in a cauliflower shape. Neuromas can be very painful, especially when they are in places where they are subject to pressure from the prosthesis socket.

neuropathy: An abnormal and usually degenerative state of the nervous system or nerve that can lead to loss of feeling in the feet or other extremities, especially in the diabetic patient.

Nudge Control: A mechanical switch that operates one or more joints of the prosthesis.

nylon sheath: A sock interface worn close to the skin on the residual limb to add comfort and deter perspiration.

Occupational Therapy (OT): The teaching of how to perform activities of daily living as independently as possible, or how to maximize independence in the case of disability.

O&P: Abbreviation for Orthotics and Prosthetics.

orthosis: A device that is used to protect, support, control or improve function, or aid recovery of the body. that move, i.e., shoes, braces, splints, slings, etc. Orthoses is plural.

orthotics: The profession of providing orthotic devices or orthosis.

Orthotist: A patient-care practitioner who evaluates, designs, fabricates and fits orthoses (braces) and other devices to aid in the recovery of, control or support the body and/or the limbs.

osseointegration: The growth action and adhesive nature of bone tissue with titanium, which allows an individual to have a prosthesis attached so as to become part of their body’s own structure. The process was developed by Professor Ingvar Bränemark of Sweden in the 1950’s and is commonly used in dentistry and metacarpo-phalangeal (MCP) joint replacement in the hand.

Outer protective cover: A cover that goes over a custom shaped cover often that is flesh toned to match patient’s skin tone that is used to protect the prosthetic components from the elements or moisture. Covers can be made of different materials such as fabric or silicone.

Part B Medicare medical insurance: covers certain doctor’s services, outpatient care, medical supplies such as prosthetics and orthotics, and preventative services.

partial foot amputation: An amputation of the of the foot; toes, or at the metatarsal section of the foot, etc. This type of amputation is similar in scope to the Chopart amputation.

partial suction: Usually refers to the socket of an AK prosthesis that has been modified to allow the wearing of prosthetic socks.

PFFD (Proximal Femoral Focal Deficiency): A congenital anomaly where the proximal femur did not normally progress during the embryological development of the fetus.

phantom pain: Painful sensations, usually moderate, that originate in the amputated portion of the limb.

phantom sensation: This is the feeling that the missing body part is still there. It may involve uncomfortable but not necessarily painful sensations such as burning, tingling and/or itching.

phocomelia: Medical term for a congenital anomaly in which one or more limbs are missing, with the hand and/or foot attached directly to the trunk of the body.

physiatrist: A doctor of rehabilitation medicine who specializes in the comprehensive management of patients with impairments and disabilities arising from neuromuscular, musculoskeletal, and vascular disorders.

physical therapy (PT): A rehabilitative therapy that is concerned with a patient’s gross motor activities such as transfers, gait training, and how to function/mobilize with or without a prosthesis. Physical therapy can overlap with Occupational Therapy and Prosthetist prosthetic training. Therapies can include putting prosthesis on and taking off, ply sock management, care, cleaning of the prosthesis; balance, strength, dexterity, gait training for stairs, ramps and uneven surfaces and recreational activities such as riding a bicycle or running.

Pistoning (or Milking): Refers to the residual limb slipping up and down inside the prosthetic socket like a “piston”, most obvious while walking.

plantar: The bottom section or sole of the foot.

plantarflexion: When the toe/foot is pointing down, like pushing the gas pedal down, away from the median plane of the body.

ply: In this context, it refers to the thickness of stump sock material. The higher the ply number, the thicker the sock. Ply socks are used to adjust for volume changes between the residual limb and prosthetic socket by adjusting the number of ply socks to maintain total contact.

Ply Sock: Wool or cotton sock worn over residual limb to provide volume adjustment to maintain total contact between the socket interface and residual limb.

pneumatic (compressed air)/hydraulic resistance: Used in reference to knee joints that provide controlled changes in the speed of walking, or that provide the necessary resistance for the swing and stance phase of ambulation, helping the amputee achieve a more natural gait.

polycentric: Multiple-axis joint, particularly useful with a very long residual limb.

posterior: The back side of the body or part in question, i.e., posterior knee or patellar region.

prehension: The primary functions of the hand, i.e., to hold, grasp, or pinch.

preparatory prosthesis: An unfinished, functional replacement for an amputated limb, fitted and aligned to accelerate the rehabilitation process, control edema, and prepare the residual limb for the external forces associated with wearing a prosthesis on a day-to-day basis.

pressure points: Contact against skin or residual limb that produces pressure, sheer, torsion or other forces that lead to tissue injuries. Pressure points need to be addressed to avoid skin irritation such as rubbing or blocked pores or hair follicles or more serious pressure bursas, sores, and ulcers.

prosthesis: An artificial part of the body, often for a limb such as hand or a leg, that provides a functional replacement for the amputated or missing limb. Prostheses is plural.

prosthetics: The profession of providing those with limb loss or with a limb difference (congenital anomaly) a functional and/or cosmetic restoration of missing or underdeveloped human parts.

prosthetist: A person trained in the science and art of prosthetics; one who designs, builds, fits, adjusts and repairs artificial limbs. Prosthetists now entering the field are required to be educated with Master’s Degree, finish residencies and pass national certification exams and state licensure.

proximal: Nearer to the central portion of the body. Proximal (top) is the opposite of distal (bottom).

pylon: An aluminum, titanium or laminated support shaft between the socket or knee unit and the foot that provides a weight bearing meeting weight and activity level needs.

range of motion: The amount of movement a limb has in a specific direction.

reattachment surgery: The surgical attachment of a severed limb that involves reconnecting the arteries and grafting skin and muscle together. Some reattachment procedures also involve putting the patient in a hyperbolic chamber, which can cause the blood vessels, skin, muscle and nerve tissues to regenerate more quickly and completely.

rehabilitation: The process of restoring a person who has been debilitated by a disease or injury to a normal, functional life.

residual limb: The portion of the arm or leg remaining after an amputation, sometimes referred to as a residuum or the archaic term stump.

revision: Surgical modification of the residual limb.

RGO: Reciprocating Gait Orthosis; special HKAFO that allows paralyzed persons to walk step over step; generally used with crutches for balance

rigid dressing: An orthoses to protect the residual limb, usually applied in the operating or recovery room immediately following surgery for the purpose of controlling edema, protecting the incision, avoiding flexion contracture and pain.

SACH foot (Solid-Ankle Cushion Heel): The foot is made of wood with a flexible rubber shell that surrounds the wooden core. The SACH foot is usually prescribed to moderately active or less active amputees, but can be prescribed to amputees of all activity levels. SACH feet are also used in the design of foreshortened prostheses, or stubbies.

Same and Similar: This term refers to a policy whereby Medicare and Private insurance carriers may not reimburse for specific services when another service (by code) was provided within a specified time period for that service.

SD (shoulder disarticulation): An amputation through the shoulder joint.

shrinker: A prosthetic device made of elastic material and designed to help shape and control volume or swelling of the residual limb or to shrink it in preparation for a prosthetic fitting.

Shuttle or pin lock: A mechanism that has a locking pin attached to the distal end of the liner, which locks or suspends the residual limb into the socket.

single axis foot: A prosthetic foot that has a single ankle hinge for dorsiflexion and plantarflexion. Smooth transition during stance phase of gait but limited or no energy return at pre-swing phase.

Single axis knee: Free swinging knee with small amount of friction.

Socket: The portion of the prosthesis that fits around and envelopes the residual limb and to which the prosthetic components are attached.

Social worker: A professional who assists you by helping to coordinate your discharge from the hospital, overseeing and implementing any needed contact with other services or organizations, and generally preparing you for re-entry into family and community life.

Soft Socket: Inner socket liner of foam, rubber, leather, other material for cushioning the residual limb.

Split hooks: Terminal devices with two hook-shaped fingers operated through the action of harness and cable systems.

Stance control knee: These prosthetic knee joints typically offer a weight-activating friction brake that locks the knee into place during pivotal points of ambulation, offering stability and balance where needed.

stance Flexion: Mimics normal knee flexion at heel strike.

Shorties/stubbies Foreshortened Prostheses): Shorties aka as stubbies are used during and sometimes after initial ambulatory rehabilitation. They are customized to each individual and are usually made up of standard sockets, no articulated knee joints or shank, with modified rocker bottoms or SACH feet turned backward for balance and stability.

Stockinette: Tubular open-ended cotton or nylon material.

stump: A archaic term commonly used to refer to an amputated limb also known as residual limb.

Shrinker: An elastic wrap or compression sock worn on the residual limb to reduce swelling and to help properly shape the residual limb.

Suction: Provides suspension by means of negative pressure vacuum in a socket; achieved by forcing air out of the socket through a one-way valve when donning and using the prosthesis.

Suction socket: Mainly for use by AK level amputees, this socket is designed to provide suspension by means of negative pressure vacuuming. This is achieved by forcing air out of the socket through a one-way valve when donning and using the prosthesis. In order for this type of socket to work properly, the soft tissues of the residual limb must precisely fit the contours of the socket. Suction sockets work very well for those whose residual limbs maintain a constant shape and size.

Supercondular suspension: A method of holding on a prosthesis by clamping on the bony prominence above a joint, called “Condyles”.

Suspension system(s): One of many suspension systems must be used in order to keep the prosthesis attached to the residual limb. These systems are integral parts of the socket and prosthesis using various mechanical locking mechanisms, suction, sleeve, belt or lanyard straps, etc.

swing phase: This is when the prosthesis moves from full flexion to full extension. The term is usually used in reference to gait phases and for prosthetic knee unit adjustment.

Switch control: A control switch for an electronically-controlled prosthesis (see myoelectrics) that is used to regulate current from the battery to the operator.

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

Temporary or preparatory prosthesis: A prosthesis that is made soon after an amputation but after suture line is strong enough to begin fitting as an inexpensive way to help retrain a person to walk and balance while shrinking the residual limb.

TENS Unit (Transcutaneous Electrical Nerve Stimulation): The units are small, battery powered, and weigh only a few ounces. Electrodes are placed on the skin near the area of pain and are attached to the TENS unit. The idea is to disrupt the pain signal so that the pain is no longer felt.

Terminal devices: Devices attached to the wrist unit of an upper extremity prosthesis that provide some aspect of normal hand function, i.e., grasp, release, etc.

TES belt: A neoprene or Lycra suspension system for an AK prosthesis, which has a ring that the prosthesis slides into. The neoprene belt attaches around your waist by Velcro/hook and loop fastener. It is used to provide added suspension and/or control rotation.

Telemedicine: Doctor office appointment via HIPAA compliant communication such as video chat that fulfills insurance provider’s face to face visit requirement.

Therapeutic custom shoe: A shoe designed and fabricated to address an individual’s medical condition. A therapeutic custom shoe is made over a modified positive model of an individual’s foot and can be either custom-molded or custom-made.

Therapeutic recreation: This mode of rehabilitation provides instruction in returning to leisure activities.

TLSO: Thoracolumbar-Sacral Orthosis; device that encompasses the entire torso. transfers: The act of moving from one position to another (such as from sitting on a bed to sitting in a wheelchair or wheelchair to toilet).

transhumeral: or above elbow (AE) prosthesis helps to replace the function of a missing anatomical segment(s) from below the shoulder to (and including) the hand. How it is powered. Type of control system for these prostheses are dependent on the needs, functions, and goals of each patient.

Transmetatarsal amputation: An amputation through the metatarsal section of the foot bone. (See partial foot amputation).

Transtarsal Amputation: Through the tarsal (tarsus) or foot bones. (SEE “PARTIAL FOOT AMPUTATION”) .

Traumatic amputation: An amputation that is the result of an injury or accident.

Unilateral: An amputation that affects only one side of the body (opposite is sound side or bilateral if both).

Upper extremity (UE): Having to do with the upper part of the body. It is used in reference to amputees with arm or shoulder amputations.

Van Ness Rotationplasty: In this kind of reconstruction, the ankle joint is used as a substitute for the knee. By removing a portion of the femur and knee joint and bringing the ankle up to the level of the original knee, turning it 180 degrees, reattaching it to the femur and adjusting the thigh to appropriate length, a functional knee joint (formerly the ankle joint) can be achieved. The foot is then fit into a prosthetic socket and the person in question, who would otherwise require an AK amputation, functions as a BK amputee—a preferable level when considering ambulatory rehabilitation. Sometimes used for PFFD prostheses.

Variable-volume socket: A lightweight and custom-made socket. The two-piece design makes it possible to don and doff the prosthesis without subjecting the limb to unnecessary shear. The patient can adjust the socket itself as well as vary the sock ply to maintain proper fit. Socket adjustability eliminates the need to replace the preparatory socket several times before stabilization occurs.

Vascular amputation: An amputation caused by lack of blood flow to a limb or limbs (ischemia). Causes include arterial and venous catheterization, heart defects and disease, diabetes, familial coagulation defects, arterial anomalies, pressure, septic emboli, and mucocutaneous lymph node syndrome. This is an acquired amputation.

Voluntary-Closing Devices: Terminal devices that are closed by forces on a control cable; grasp is proportional to the amount of pull on the cable.

Voluntary-Opening Devices: Terminal devices that are opened by body motion and closed by elastic bands or springs.

WHO: Wrist-Hand Orthosis; device that encompasses the wrist and hand.

Wrist Unit: Component that allows interchanging, positioning and/or locking of terminal devices.

Wrist disarticulation (WD): An amputation through the wrist.

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