Choice of Prosthetic Components
Many young traumatic amputees are adamant about obtaining the highest tech prosthetic components for their prosthesis. The prosthesis becomes a part of their body and their desire for the finest is understandable. However, many of the high tech components are not optimal for the first year of amputee care. Some of the highest-end foot and ankle components are actually too stiff for the first 6 to 12 months of ambulating. Other less technologically deluxe components actually make adapting to the prosthetic device easier. A new prosthetic prescription should only be generated after the amputee has established a steady symmetric gait, can engage in impact activities and is ready to advance to a higher level of activity. He should be able to maneuver barriers, manage stairs and negotiate inclines and ramps. This typically does not happen until between months 9 and 18. Only at this point is a new, higher-tech prosthesis useful. The old prosthesis can be refurbished to become a spare limb or a water limb.

Conclusion
It is essential that the thoughtful amputation surgeon understand the entire course of the amputation process, from the initial emergency room visit to the final selection of the perfect prosthesis. As devastating as it is for the patient, amputation will always be a difficult and a complex process for the surgeon as well. It asks the surgeon to successfully balance exacting surgical technique and knowledge, his intimate familiarity with the entire course of amputee care and his human understanding of each of his unique patients. Remembering the young woman’s vision at the start of this chapter, we think not of artificial limbs, but instead of replacement limbs. The surgeon capable of making an amputation successful, can indeed help make the patient whole.

Acknowledgement:
Much of this material was updated from Ernest M. Burgess (deceased September 2000), Atlas of Limb Prosthetics - Surgical and Prosthetic Principles, Edition 1, 1981.

References:

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