Glossary of Terms

It is important to stay up-to-date with the latest advances in Prosthetics and Orthotics. As pioneers in the industry, we are dedicated to utilizing the latest technologies to enhance the lives of amputees. Below is a list of online amputee organzations that we recommend:

AAOP (American Academy of Orthotists and Prosthetists): As a professional society of orthotists and prosthetists, the AAOP is dedicated to promoting professionalism and advancing the standards of patient care through education, literature, research, advocacy and collaboration. ABC (American Board of Certification) The ABC was formed in 1948 by a group of concerned practitioners and orthopedic surgeons who recognized the Orthotist/Prosthetist as an integral part of the rehabilitative team responsible for returning the patient to a productive and meaningful life. 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. ACA (Amputee Coalition of America) The Amputee Coalition of America was founded in 1986 and incorporated in 1989. The ACA seeks to reach out to people with limb loss and to empower them through education, support and advocacy. AD (ankle disarticuation) An amputation through the ankle joint. (see Syme’s) ADA The Americans with Disabilities Act was 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 elbow) Amputation level is above the elbow – (also known as transhumeral). AK (above knee) Amputation level is above the knee – (also known as transfemoral). alignment The position of the prosthetic socket in relation to the foot and knee. 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 cutting off of a limb or part of a limb. acquired amputation limbs surgically removed due to disease or trauma. congenital anomaly Birth malformation such as an absent or poorly developed limb. anterior The front portion of a shoe or foot. AOPA (American Orthotic and Prosthetic Association) Founded in 1917, the American Orthotic & Prosthetic Association is a national trade association committed to providing high quality, unprecedented business services and products to O&P professionals. 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. BE (below elbow) Amputation level is below the elbow – (also known as transradial). 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 knee) Amputation level is below the knee – (also known as transtibial). 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. C-leg The Otto Bock C-leg features a swing and stance phase control system that sense 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. 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 to evaluate comfort and fit prior to the final prosthesis. Chopart amputation A disarticulation at the metatarsal joint of the foot, leaving a residual limb that is able to withstand weight bearing without a prosthesis. comorbidity The presence of a coexisting or additional disease that can impact a primary disease. For example, the primary disease could be diabetes and the comorbid disease neuropathy Congenital anomaly A birth malformation such as an absent or poorly developed limb. (see Amelia and phocomelia) contracture The tightening of muscles around a joint, restricting the range of motion and suppressing muscular balance. Can restrict prosthetic rehabilitation. contralateral Originating in or affecting the opposite side of the body. cosmesis (also called cosmetic cover) Used to describe the outer, aesthetic covering of a prosthesis. CP: (Certified Prosthetist) A person who has passed certification standards as set by a prosthetic certifying body. CPO (Certified Prosthetist/Orthotist) A person who has passed certification standards as set by a prosthetic & orthotic 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. debridement The removal of necrotic, infected or foreign material from a wound. definitive, or permanent prosthesis The definitive prosthesis replacement for the missing limb or part of a limb, meeting standards for comfort, fit, alignment, function, appearance and durability. desensitization To reduce or remove any form of sensitivity in the residual limb by massaging, tapping 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. 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 a 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, respectively. dorsiflexion An upward movement or extension of the foot/toes or the hand/fingers. dysvascular amputation The word is used to denote amputations that are caused or acquired from poor vascular status of a limb (i.e., ischemia). ED (elbow disarticuation) An amputation through the elbow joint. edema 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 (also referred to as ace 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 to imitate the movements and functional capabilities of the human skeleton, with all parts and components 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 unoccupied with cosmetic concern. extension assist A device that assists the prosthesis through the swing phase of ambulation, thus speeding up the walking cycle. extremity synonymous with limb, usually referring to an arm or leg. 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. HD (hip disarticuation) An amputation through the hip joint which leaves the pelvis intact. 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 opposite of atrophy. An increase in size of a normally developed extremity or organ, due to a increase in function and/or use. 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. 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. KD (knee disarticuation) An amputation through the knee joint. kinesiology The study of muscles and human movement. lateral To the side, away from the median plane of the body. L-Codes Reimbursement codes used in the prosthetic/healthcare industry to identify what services and/or devices were provided. liner (roll-on liner) Suspension systems 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 volumetric changes in the residual limb. These liners may be made of silicone, pelite, or gel substances. lower extremity (LE) Having to do with the lower part of the body. It is used in reference to amputees with leg or foot amputations.

medial Motion of a body part toward the median plane of the body. microprocessor-controlled knee These devices are equipped with a sensor that deflects 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 During an amputation, stabilization of the divided muscles is of utmost importance, inadequate techniques resulting in weak, retracted muscles or skin that cannot tolerate the necessary pressures will obviously compromise stability. Applying the myodesis technique for distal muscle stabilization gives greater stability as it involves the direct suturing of muscle or tendon to hone. Myodesis is not recommended for ischemic patients. Instead, the surgeon will probably employ the technique of myoplasty. 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 Like myodesis, mypoplasty is a surgical technique used to foster distal muscle stabilization. In this technique, muscle is sutured to muscle and then placed over the end of the bone before closing the wound. Since it is widely accepted that myodesis offers better stabilization, the myoplasty technique is not used as often, however, for patients with poor vascular health, the myoplasty technique is preferred. neuroma When a nerve is severed during amputation, the nerve endings form a mass (neuroma) reminiscent of a cauliflower shape. Neuromas can be troublesome, especially when they are in places that are subject to pressure from the socket. They can also cause an amputee to experience sensory phenomena in or around the residual limb, which can be aggravating and/or painful. 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. nylon sheath a sock interface worn close to the skin on the residual limb to add comfort and deter perspiration. Occupational Therapy the teaching of how to perform activities of daily living as independently as possible, or how to maximize independence in the case of a disability. orthotics the profession of providing orthotic services. orthosis A device that is used to protect, support or improve function of parts of the body that move, i.e., braces, splints, slings, etc. orthoses Plural form of “orthosis” Orthotist A skilled patient care professional who evaluates, designs, fabricates and fits orthotic devices that are prescribed by a physician. 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 Branemak of Sweden in the 1950’s and is commonly used in dentistry and metacarpo-phalangeal (MCP) joint replacement in the hand. partial foot amputation An amputation at the metatarsal section of the foot. (also called transmetatarsal amputation). physical therapy/PT : the evaluation and treatment of disease, injury or disability through the use of therapeutic exercises and modalities to strengthen muscles, improve range of motion and decrease pain. pistoning (or milking) the term used when your liner stretches resulting in your residiual limb pulling in and out - like a piston. plantar flexion Means the toe is pointing down, toward the sole. Almost like pushing the gas pedal down and simulating that position or alignment. pneumatic/hydraulic provides controlled changes in the speed of walking. polycentric multiple-axis joint, particularly useful with a very long residual limb. prehension to hold, grasp or pinch. preparatory prosthesis An unfinished functional replacement for an amputated limb, fitted and aligned in accordance with sound biomechanical principles which is worn for a limited period of time to accelerate the rehabilitation process. It is generally without cosmetic finishing and is used to expedite prosthetic wear and use; it also aids in the evaluation of amputee adjustment and component selection. prosthesis an artificial replacement for a body part. prostheses Plural form of “prosthesis” prosthetics The profession of providing cosmetic and/or functional restoration of missing human parts. Prosthetis A skilled patient care professional who evaluates, designs, fabricates and fits prosthetic devices that are prescribed by a physician. posterior The back side of the body. pylon A rigid member, usually tubular, between the socket or knee unit and the foot that provides weight bearing support shaft in an endoskeletal prosthesis. This is referred to as a “pole” in a temporary prosthesis. residual limb (slang version is called stump) a portion of limb remaining after amputation. S.A.C.H. (Solid Ankle Cushioned Heel foot component) A very basic, “passive” foot; very stable. SD (shoulder disarticuation) An amputation through the shoulder joint. shrinker A prosthetic reducer made of elastic material and designed to help control swelling of the residual limb and/or shrink it in preparation for a prosthetic fitting. single axis foot Used since the Civil War, this foot has an ankle hinge that provides dorsiflexion and plantar flexion. i.e. , toe up & toe down. The disadvantages of a single axis foot include poor durability & cosmesis. socket portion of prosthesis that fits around residual limb/stump and to which prosthetic components are attached. 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 friction device with an adjustable brake mechanism to add stability. stance flexion mimics normal knee flexion at heel strike. stockinette tubular open-ended cotton or nylon material. stump A slang word commonly used to refer to the residual limb. See residual limb stump sock wool or cotton sock worn over residual limb to provide a cushion between the skin and socket interface. stump shrinker an elastic wrap or compression sock worn on a residual limb to reduce swelling and shape the 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. 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. Most of these systems are integral parts of the socket and prosthesis. swing phase This is when the prosthesis moves from full flexion to full extension. This term is usually used in reference to prosthetic knee units. 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 end weight bearing. temporary prosthesis A prosthesis that s made soon after an amputation as an inexpensive way to help retain a person to walk and balance while shrinking the residual limb (see IPOP). 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 provides 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 ring that the prosthesis sides 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. 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. TLSO (Thoracolumbar-Sacral Orthosis) An orthosis that encompasses the entire torso. transtarsal amputation An amputation through the tarsal section of the foot bones. (also called partial foot amputation) transfemoral amputation : Amputation level is above the knee (also called AK). transhumoral amputation Amputation level is above the elbow (also called AE). transmetatarsal amputation An amputation through the metatarsal section of the foot bones (also called partial foot amputation). transradial amputation Amputation level is below the elbow (also called BE). transtibial amputation Amputation level is below the knee (also called BK). traumatic amputation An amputation that is the result of an injury. unilateral An amputation that affects only one side of the body (opposite of bilateral). 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. 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 catherization, 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.