Amputation

 

All the parts of the prosthesis fit together for comfort and function.

Once your wound has healed, you may be ready for a prosthesis (artificial leg). A prosthesis can help you regain the ability to walk. You'll start by working with a prosthetist. This is an expert who makes and fits the prosthesis. At first, you'll be fitted with a preparatory (temporary) prosthesis. Later, you'll get your definitive (permanent) prosthesis. Your activity level and goals help decide the type of definitive prosthesis that will be best for you.

 

The Parts of the Temporary Prosthesis

The temporary prosthesis is fairly basic in design. It has a socket, which fits around your residual limb. The socket is attached to a pylon (pipe) that supports your limb. Or, the socket may lead to a knee-like joint, if needed. The pylon then extends down to a solid foot piece. The foot piece has a cover that makes it look more like a natural foot.

Fitting the Prosthesis

The prosthetist will work with you to craft a socket that fits your residual limb. A model of your limb will be made to customize the socket fit. By the first fitting, you'll have been wearing a shrinker sock daily. This will have helped shape your residual limb. Your limb will continue to change in volume (size) as you work with the temporary prosthesis. As volume changes, the socket must still fit securely. To make sure the socket always fits, you'll be taught to add sock ply(thickness) using special prosthetic socks. This is the basis of good socket fit. Work with your prosthetist to learn how to adjust sock ply at home. You'll likely be told to maintain a stable body weight. This is because even small weight changes can affect the fit of your prosthesis. The prosthetist will teach you to slowly increase the amount of time you wear your prosthesis each day. Follow this "wearing schedule" as directed.

Learning to Walk

You may work with both your prosthetist and physical therapist to practice gait training. This means learning to walk with your prosthesis. You'll likely begin by learning to stand using parallel bars. The bars help you get used to putting weight on your prosthesis. Then you'll progress to slow walking, using the bars for support. When you're ready, you'll practice walking with an aid, such as a walker or cane.

Getting Your Permanent Prosthesis

 

The type of permanent prosthesis you use depends on your specific needs.

You'll get a permanent prosthesis when your residual limb volume is stable. It may take 6-12 months until you are ready. Even with a permanent prosthesis, you will still need to adjust sock ply as needed. The type of prosthesis you get will depend on your health and special needs. Your permanent prosthesis may have:

  • A more advanced knee or foot design.

  • A more "natural" look.

  • Features for special tasks or higher activity levels.

Prosthesis Care and Maintenance

The socket of your prosthesis may need to be replaced every 2-8 years. And parts of the prosthesis can be changed if they are not meeting your needs. Wear clean prosthetic socks every day to help prevent skin problems. Wash your socks and socket liner (depending on type) as directed by the manufacturer.

Watch for Signs of Poor Fit

Proper fit of your prosthesis is crucial for comfort and good function. Watch for signs that your prosthesis needs adjusting. Contact your prosthetist if you notice:

  • Your prosthesis feels heavy or hard to move. This may mean it is too loose.

  • Blisters or open sores on your residual limb. The prosthesis may be too loose or too tight in certain places. If this happens, stop wearing the prosthesis until you see the prosthetist. You may also need to see your doctor to treat wounds or skin problems.

  • Your residual limb moves up and down within the socket as you walk (pistoning). Your limb should fit snugly into the socket of the prosthesis. Pistoning means that the prosthesis is too loose.

Back to Top


Learning to walk with your prosthesis takes practice. To prevent falls, you may need a cane for balance and support. Work with your physical therapist and prosthetist (an expert who makes and fits your prosthesis). They'll teach you how to use the cane properly. Follow all instructions from the physical therapist and prosthetist closely.

 

Walking with a Cane

  • Hold the cane on the side of your intact limb (unless told otherwise by your healthcare team).

  • Put your weight on your intact limb and find your balance.

  • Move the cane and the prosthetic limb forward at the same time.

  • Support your weight on both the cane and your prosthesis.

  • Step through with your intact limb.

  • Put your weight on your intact limb and take the next step, using the cane and your prosthesis. When climbing stairs, always lead with your intact limb.

Using Steps

  • If there is a railing, hold on to it with your free hand.

  • Step up with your intact limb first.

  • Then move the cane and prosthetic limb together to the same step as your intact limb.

  • To walk down steps, hold the railing with your free hand.

  • Step down with your prosthetic limb and the cane first.

  • Then follow with your intact limb to the same step.

Note: Consult with your physical therapist and prosthetist to learn how to handle steps without railings.

Home Safety Tips

Making a few changes at home can reduce hazards and help prevent falls. Ask a family member or friend to make these changes before you go home.

 

  • Remove objects that could cause you to trip, such as area rugs.
  • Store supplies between waist and shoulder level. This will help you maintain balance as you reach for things.

  • Make sure all rooms are well lit.

  • Move all electrical cords out of the way or tape them securely to the floor.

  • Pick up clutter. Keep floors clear at all times.

  • Reduce stair use by making the most of each trip (do more than one task per trip).

Back to Top


As you become mobile again after amputation surgery, you'll need to use a walking aid to get around. Walking aids help prevent falls, which can seriously damage your wound. At first, you'll likely use a wheelchair. Once your wound has healed, you may begin using a walker. A physical therapist will teach you how to use the walker safely. Follow all instructions from the physical therapist closely.

Moving Forward

For safety, keep your hands on the handgrips at all times while using a walker.

  • Stand in the center of the walker frame with your hands on both handgrips. Balance your weight between your intact limb and your hands.

  • Shift your weight slightly back, onto your intact limb. Lift or roll the walker forward about 12 inches.

  • Shift your weight onto your hands, pushing down on the handgrips. Move your foot forward, to the center of the walker frame. Make sure your toe does not go past the front of the walker.

  • Repeat to take your next step.

Note: Don't step too far inside the walker. Always aim for the center of the frame.

 

Sitting Down

  • Position yourself in front of the chair, keeping your residual limb slightly forward.

  • Be sure the chair is braced so it can't slide out from under you as you sit.

  • Bend forward at the hip, reaching behind you with one hand.

  • Grasp the armrest or side of the chair.

  • Do the same with the other hand.

  • Lower yourself onto the center of the chair, then slide back.

  • To get up, reverse the steps above.

Note: This method can also be used to get into and out of a car.

Moving Through Doorways

  • To push open a closed door, stand facing the doorway with the walker close to the door. Use one hand to turn the knob and push the door so it swings open. Then move the walker into the doorway to keep it from closing. Walk through the doorway, using the walker to hold the door open as you pass through.

  • To pull open a closed door, stand to the side opposite the direction the door will open. Use one hand to turn the knob and pull the door so it swings open. Move the walker into the doorway and keep the walker firmly planted to keep the door from closing. Walk through the doorway. The walker will keep it from closing until you are through.

Note: For safety, never remove both hands from the walker at the same time. Avoid revolving doors when using a walker.

Curbs and Steps

Your walker may be used to climb a single step, such as a curb. Before climbing a curb, look for "curb cuts." These are places where curbs are cut down to street level. Use curb cuts whenever you can. To step onto a curb, position the walker as close as possible to the curb. Step into the center of the frame. Lift the walker onto the curb. Step up and into the frame with your intact leg, pushing down onto the handgrips with your hands. To descend a curb or step, position the walker as close to the edge as you safely can. Place your foot close to the edge of the curb. Lower the walker to the street. (Brace the frame against the curb to keep the walker steady.) Holding the handgrips securely, lower your foot down into the center of the frame.

Note: For a person with an amputation, walkers may not be safe for use on stairs. If you can't avoid taking stairs, ask your physical therapist for special instructions.

Home Safety Tips

Making a few changes at home can reduce hazards and help prevent falls. Ask a family member or friend to make these changes before you arrive home.

 

  • Remove objects that could cause you to trip, such as area rugs.
  • Store supplies between waist and shoulder level. This will help you maintain balance as you reach for things.

  • Make sure all rooms are well lit.

  • Move all electrical cords out of the way or tape them securely to the floor.

  • Pick up clutter. Keep floors clear at all times.

  • Prepare a bedroom or sleeping area on the main level if you normally sleep upstairs.

Back to Top


As you become mobile again after amputation surgery, you'll need to use a walking aid to get around. Walking aids help prevent falls, which can seriously damage your wound. At first, you'll likely use a wheelchair. Once your wound heals, you may begin using crutches. A physical therapist will teach you how to use crutches safely. Follow all instructions from the physical therapist closely.

Walking with Crutches

There are two types of crutches: forearm and underarm. You and your physical therapist will decide which type will work best for you.

Caption: For safety, hold the handgrips securely when using forearm crutches.

  • As you're standing, start with the crutches about 12 inches in front of your body.
  • Press down on the handgrips. Support your weight on your hands, no matter which type of crutches you're using.

  • If using underarm crutches, position the pads of crutches against the sides of your chest. (Don't press the pads into your underarms.)

  • Lift your intact limb and gently swing your foot forward.

  • Land your foot in between the crutches, keeping your knee slightly bent.

  • Transfer your weight back to your foot.

  • Reach forward with the crutches to take the next step.

Moving Through Doorways

  • To push a door open, stand sideways. Push the door open with your body. Plant the tip of the nearest crutch inside the doorway to act as a doorstop. Keep the crutch in place to hold the door open as you pass through.

  • To pull a door open, stand to the side. Get your balance and pull the door fully open with one hand. Plant the tip of the nearest crutch inside the door to act as a doorstop. Keep the crutch close to the door to hold it open as you pass through.

Note: Avoid revolving doors while using crutches.

Sitting Down

  • Position yourself in front of the chair, keeping your residual limb slightly forward.

  • Hold both crutches in one hand, on the side of your residual limb.

  • Grasp the armrest or side of the chair with your free hand.

  • Lower yourself onto the front of the chair, then slide back.

  • To get up, reverse the steps above.

Note: Look for sturdy chairs with solid arms. If you use a chair that swivels or has wheels, back it against something stable before sitting.

Crutches and Steps

Climbing and descending steps or stairs with crutches after leg amputation requires special care. Consult your physical therapist for instructions and safety tips.

Home Safety Tips

Making a few changes at home can reduce hazards and help prevent falls. Ask a family member or friend to make these changes before you arrive home.

  • Remove objects that could cause you to trip, such as area rugs.
  • Store supplies between waist and shoulder level. This will help you maintain balance as you reach for things.

  • Make sure all rooms are well lit.

  • Move all electrical cords out of the way or tape them securely to the floor.

  • Pick up clutter. Keep floors clear at all times.

  • Prepare a bedroom or sleeping area on the main level if you normally sleep upstairs.