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What should be paid attention to in the process of prosthesis design?
At present, some domestic prosthetic institutions connect amputees from hospitals to install prostheses. During this period, they do not carry out the treatment of promoting the finalization of residual limbs, and directly install formal prostheses. This is not right, which will make patients shrink quickly after wearing the prostheses, and even some patients will shrink severely one day after wearing the prostheses. Patients should ask the prosthetic institution to install one or more temporary prosthetic socket for themselves first, and then install the formal prosthetic socket when the residual limb changes little.
Precautions for children's prosthesis assembly. For children, amputation is a very pitiful thing. Because children are young and their physical and mental development is not mature, the device of prosthesis can reduce the level of amputation hindering the physical and mental development of children. Children's prostheses should be paid more attention to.
For the upper limb prosthesis or artificial hand, we should first carry out the cutting training. For the upper arm amputee, we should carry out the elbow bending, hand opening and elbow lock opening exercises. For the forearm amputee, we should carry out the control training of the manipulator. The training of the prosthesis is much more complicated and difficult than that of the lower limb. The EMG controlled artificial hand controls the grasping of the artificial hand through the EMG signal when the muscles of the residual limb contract. In order to make prosthetic hand play a role in patients' daily life, it is necessary to guide the training correctly. In order to train the operation of artificial hand, let the patient be familiar with the control side system principle of artificial hand. In post training, sponge block and paper cup are often used as the initial training objects. Later, it will be changed into leather block, wood block, and then the block shape will be changed into a circle. After grasping and relaxing skillfully, you can carry out the training of dressing, dressing and daily life activities.
Many amputee friends have this view that it will take a long time to install the prosthesis after the amputation. The reason for these friends is that the residual limb after the amputation is edematous, not shaped, and the residual limb will shrink after the installation of the prosthesis. After amputation, there is edema in the residual limb, and the residual limb will shrink after the installation of the prosthesis. However, the prosthesis should be installed as early as possible, and the temporary prosthesis should be installed first to promote the shaping of the residual limb, so as to lay the foundation for the installation of the formal prosthesis.
Children with upper limb amputation, especially those with double upper limb amputation, should be equipped with hook shaped prosthetic hand with better efficacy as early as possible to recover their self-supporting career and learning ability, otherwise, they will not only suffer from stunted body, but also suffer from poor intellectual development. For children with lower limb amputation, in the prosthesis device and application, we must consider the development achievements: the prosthesis with a slower development of the stump than that of the healthy side and a suitable length will be much shorter half a year or a year later, so that the prosthesis can be longer and temporarily padded under the healthy foot, even if the prosthesis with a structure that can be easily changed in length is selected Higher, it will be removed after the healthy limb grows; for the children with leg amputation, it should be noted that the skeleton of the stump develops faster than the skin of the stump, sometimes it can break the skin, and one skeleton on the outside of the stump develops faster than one on the inside, which is more likely to cause skin damage or puncture at the tip of the skeleton.
After 1-2 weeks, the amputee can use the temporary prosthesis for the following training before using the intelligent prosthesis to avoid discomfort after wearing the intelligent bionic leg. The specific training contents are as follows:
1. Wear prosthesis: Modern prosthesis requires patients to wear and remove as simple as possible. First, the stump should be covered with one or more layers of hosiery, which can be extended longitudinally to prevent the soft part of the stump from slipping down during the cutting, and then wear the soft prosthesis, which should be in full contact with the stump, including the stump; A layer of hosiery should be put on the soft prosthesis. The sliding surface between the hosiery and the outer body can be improved by using powder. The process of putting on the prosthesis is the same as that of wearing sliding shoes or riding boots. In this process, all hosiery must be held by hand.
2. Standing balance: generally start to practice standing balance in parallel bars. First, train the standing balance of both legs, from the two hands to standing without the hands, and then train the level 3 standing balance in parallel bars, and then practice the single dish standing balance.
3. Step training: step can be practiced in parallel bars, first step forward, step back half a step, so that the healthy limb is fully loaded, then transfer the weight to the prosthesis side, and step out of the healthy limb. Take the largest stride, lift the heel of the prosthesis to load the toe, flex the prosthesis knee joint, use the body momentum to make the prosthesis move forward, practice the carbon step, so as to approach or leave the wheelchair, and practice the back.
4. Walking training: walking can be practiced with crutches outside the parallel bars. Pay attention that the stride of the healthy limbs should not be reduced, the waist should be extended, and the disabled limbs should step straight ahead. During the standing period of the prosthesis, the pelvis should be moved horizontally above the prosthesis, and the pelvis level should be maintained; the upper and lower slopes should be kept. Upper and lower slopes: crossing obstacles; standing again after falling to the ground; general lower knee amputation training 12 times 15 times; upper knee amputation training 18 times 22 times a day, 3 times a week for the elderly; upper knee amputees often need training