OPCA 1065 - Lower Extremity Prosthetic Theory and Fabrication

Credits: 5
Hours/Week: Lecture 1 Lab 8
Course Description: This class emphasizes the design and fabrication of lower-limb prostheses. Lower extremity prosthetic topics include partial foot, Syme/ankle disarticulation, transtibial, transfemoral, knee and hip disarticulation. Activities include preparing negative molds and positive plaster models, rectifying residual limb models, fabricating diagnostic sockets, and transferring to a definitive prostheses. Emphasis is placed on safe use of tools, equipment, and materials, as well as developing strong fabrication and finishing skills. Students must be able to perform physical tasks to complete course requirements.
Prerequisite(s): OPCA 1055   with a grade of C or higher, or concurrently enrolled
Corequisite(s): None
Recommendation: Concurrently enrolled in OPCA 1055  , OPCA 1075  , OPCA 1085  , and OPCA 1095  

Major Content

1. Safety
2. Medical terminology relating to lower-extremity prosthetic treatment
3. Lower-extremity amputation levels and anatomy
   a. amputation levels
   b. anatomy relevant to prosthetic design
4. Lower-limb prosthetic design variations
   a. exoskeletal and endoskeletal structural systems
   b. transtibial socket designs: PTB, TSB
   c. transfemoral socket designs: quadrilateral, IC, sub-ischial
   d. suspension options: sleeve, anatomical, suction, elevated vacuum, locking liners (pin/lanyard), joint & lacer
   e. partial foot prostheses: toe fillers, “Chicago” boots, tubercle-height AFO-integrated / clamshell designs
   f. prosthetic foot categories: SACH, single-axis, multi-axis, dynamic response, direct-mount
   g. prosthetic knee categories: single-axis, multiaxial linkages; control mechanisms (mechanical and fluid friction, weight-activated stance brake, locking, microprocessor)
   h. alignment principles for prosthetic knees and feet, including relevant anatomy and reference lines (e.g., TKA line)
5. Implement Treatment Plan: Partial Foot Fabrication

a. negative mold and positive model preparation
b. positive model rectification, including Category I and II modifications
c. thermoform materials over positive model and add filler
d. shape and finish to fit in a shoe
 

6. Implement Treatment Plan: Transtibial, Pin Systems
   a. negative mold and positive model preparation
   b. positive model rectification, including Category I and II modifications
   c. socket lay-up
   d. socket lamination
   e. installation of pin-lock mechanism
7. Implement Treatment Plan: Transtibial, Double-Wall Endoskeletal
   a. negative mold and positive model preparation
   b. positive model rectification, including Category I and II modifications
   c. incorporate endoskeletal attachments; bench align per work order
   d. drape-mold test socket

e. select tube clamps, pylons, and adapters to achieve build height and manufacturer-defined bench alignment
f. transfer alignment using a vertical alignment fixture, including lamination
d. finish and assemble definitive prosthesis

8. Implement Treatment Plan: Transfemoral Alignment and Transfer
   a. plaster mold rectification with Category I and II modifications
   b. perform linear, angular, and rotational adjustments using endoskeletal components.
   c. installation of suspension
   d. transfer alignment from test socket to definitive socket

e. finish and assemble definitive prosthesis

9. Fabricate cosmetic finishing
   a. fabricate soft foam cover
   b. apply protective hose and skins
10. Fabricate flexible inner socket
11. Apply volume adjustment to socket
12. Custom closed-cell foam liner fabrication
13. Perform an endoskeletal component swap without a vertical alignment fixture

1. communicate using medical terminology. (C.1.4)
2. demonstrate sound judgment regarding safety of self and others. (A.1.2)
3. demonstrate safe and appropriate use of tools. (C.1.7, C.4.0, C.4.1)
4. demonstrate safe and appropriate use of equipment. (C.1.7, C.4.0, C.4.1)
5. adhere to safety procedures and practices throughout the fabrication process. (A.1.2, C.4.0, C.4.1)
6. identify anatomy and limb loss/limb difference relating to lower-extremity prosthetics.
7. describe lower-limb prosthetic design options, including socket, suspension, foot, and knee categories needed for lower-limb prosthesis.
8. interpret prosthetic measurement forms.
9. initiate a treatment plan under the direction of a prosthetic professional. (C.2.0)
10. implement a prosthetic treatment plan for transtibial and transfemoral prostheses. (C.4.0)
11. review physical assessment information in the treatment plan. (C.2.1)
12. confirm physical assessment data is adequate to implement the treatment plan. (C.2.2)
13. determine fabrication and technical criteria from the treatment plan. (C.2.1, C.3.1)
14. select components based on the work order. (ABC, C.8.5.3.c)
15. prepare negative molds/impressions. (ABC)
16. fill negative molds/impressions. (ABC)
17. complete positive model rectification, Category I and II. (ABC, C.8.5.3.d)
18. prepare positive models for transtibial, transfemoral, and partial foot prosthetic fabrication. (ABC, C.8.5.3.d)
19. fabricate diagnostic sockets using drape and blister forming methods. (C.8.5.3.b.4)
20. align and transfer transtibial and transfemoral prostheses. (C.8.5.3.e)
21. fabricate a partial foot toe filler and integrate it into a shoe.
22. perform a component swap without altering height or alignment.
23. fabricate endoskeletal transtibial and transfemoral prostheses. (C.8.5.3.b.2)
24. fabricate prosthetic suspension.
25. fabricate a custom closed-cell liner.
26. fabrication a flexible inner socket.
27. create reliefs, voids, and volume changes using appropriate tools and techniques to achieve a desired goal.
28. fabricate cosmesis.
29. incorporate volume adjustments.
30. review and integrate manufacturer and practitioner-provided guidance, including thread-locker, and torque settings. (B.1.e.xiv.a)
31. perform mechanical testing of a prosthesis before delivery to the treating clinician. (B.1.e.xiv.b)

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