12/09/2025
Transtibial Stump Preparation For Prosthesis
Step 1: Post-Operative Wound Care
Immediately after surgery, the stump must be kept clean, dry, and properly dressed. The dressing should be applied under sterile conditions to prevent infection. Any signs of delayed healing, excessive bleeding, or infection should be reported promptly.
Step 2: Edema Control and Stump Shaping
Once the wound begins to heal, swelling must be reduced to prepare for prosthetic fitting. This is achieved by:
• Elastic bandaging applied in a figure-of-eight fashion from distal to proximal with graded pressure.
• Shrinkers or silicone liners to maintain uniform pressure and avoid a bulbous stump.
• Rigid removable dressings or an Immediate Post-Operative Prosthesis (IPOP), which not only reduce edema but also protect the stump and allow for early mobility.
Step 3: Skin Care
The patient should wash the stump daily with mild soap and water, then dry thoroughly. Gentle moisturizing helps maintain skin integrity, but oily creams should be avoided before donning a prosthesis. Daily inspection using a mirror ensures early detection of redness, abrasions, or ulcers.
Step 4: Positioning and Contracture Prevention
To avoid knee flexion contractures, patients should be discouraged from prolonged sitting with the knee bent or resting the stump on a pillow. They should be encouraged to lie in the prone position for several minutes daily. This maintains full hip and knee extension for better prosthetic control.
Step 5: Muscle Strengthening and Mobility Training
The patient should undergo strengthening exercises focusing on:
• Quadriceps and hamstrings for knee stability.
• Hip extensors and abdominals for gait efficiency.
Early mobility training with crutches or walkers develops balance and confidence, preparing the patient for prosthetic gait training.
Step 6: Desensitization of the Stump
As healing progresses, hypersensitivity is reduced through:
• Gentle tapping and massage.
• Rubbing the stump with soft to coarse textures.
• Vibration therapy when available.
These techniques improve tolerance of socket pressure.
Step 7: Psychological Support and Education
Amputation can be emotionally overwhelming. Counseling, peer support, and education about prosthetic rehabilitation are crucial for acceptance and motivation. The patient should be made aware of the rehabilitation timeline and expected outcomes.
Step 8: Pre-Prosthetic Training
Before receiving the prosthesis, the patient practices:
• Standing balance exercises in parallel bars.
• Weight-shifting drills to prepare for prosthetic gait.
• Safe use of crutches or walking aids.
“At Prorth Prosthetics, we guide our patients through every stage of stump preparation, ensuring proper healing, shaping, strengthening, and training. This comprehensive approach leads to an optimal prosthetic fitting and excellent rehabilitation outcomes.”
