What to Expect

Use the following information to learn more about the fitting process, and how our technology can work for you. Yanke Bionics has the latest in computer-aided design and manufacturing to maximize the fit and function of your prosthesis. Accept No Limitations!

General prosthetic information

General information on the cause and predominance of amputations.

Causes of Amputations

There are four major causes of lower-limb amputation: vascular disease, trauma, tumors and congenital birth defects. The majority of amputations result from vascular disease.

Vascular diseases, with or without diabetes, produce the largest group of amputations. Data from the National Commission on Orthotic and Prosthetic Education reveals that 54,000 major lower-limb amputations were performed on patients with diabetes in the United States in 1990. Patients with diabetes who are 65 years of age and older account for 61% of all diabetic-related lower-extremity amputations.
Trauma (such as accidents) is the second major cause of amputations. For the most part, amputees who have lost a limb due to trauma are young and healthy and progress with rehabilitation very quickly without complications.
Tumors most often occur in the long bones and soft tissue of young people between the ages of 11-20, although tumors may occur at any age. Prompt and proper diagnosis is very important to take full advantage of the treatments available to retard further growth of the tumor. Once identified and after treatment has begun, prosthetic rehabilitation can begin. Although many amputees may receive other therapies, including radiation and chemotherapy, prosthetic rehabilitation can occur simultaneously.
Congenital limb deficiency results from the failure of all or part of a limb to form. Children born with congenital limb deficiencies may undergo surgical revision in order to provide a residual limb (amputated limb) that is easier to fit with a prosthesis. In some cases, congenital limbs do not require surgical revision and are fitted with nonstandard prostheses instead. Children with congenital limb deficiencies usually adapt and function well with a prosthesis. They often need regular visits to the prosthetist to alter the size and length of the prosthesis as growth occurs. In general, they also benefit from “high-tech” prostheses designed to meet the demands of an active, energetic child.

Your prosthetist's role

Read how Yanke Bionic's skilled professionals can meet your prosthetic needs.

Either prior to or just following your amputation, you will be introduced to a prosthetist who will provide you with your new prosthesis. A prosthetist is a healthcare professional skilled in the design, fabrication, and fitting of prostheses. You should see a prosthetist who has received special training and has successfully completed a rigorous examination to become certified by the American Board for Certification in Orthotics and Prosthetics, Inc. (ABC, http://www.abcop.org). This certification allows him/her to use the credentials "CP" (certified prosthetist) or "CPO" (certified prosthetist and orthotist). If your prosthetist is a "CPO" he/she is also skilled in the design, fabrication, and fitting of orthoses (braces). Your ABC-certified prosthetist actively participates in professional continuing education to maintain and further enhance his/her skills. The state of Ohio also requires prosthetists and orthotists to become licensed. All of Yanke Bionic’s clinicians are licensed and adhere to the high standards of Ohio law. More information on Ohio’s licensure laws is available at www.ohio.gov\bopp.

Your prosthetist may visit you prior to your surgery to answer questions that you have about wearing a prosthesis. By assessing how you walk prior to your surgery he/she can gather information that will be very useful in the early days following your surgery and prior to your prosthetic fitting. It is important for your prosthetist to know about your lifestyle and the activities that you enjoyed prior to your amputation so that he/she can design a prosthesis to best suit your individual needs.

Either prior to or immediately following your amputation your prosthetist may assess the strength and range of motion of both hips and knees as well as evaluate your sound side limb (non-amputated limb).

Your physician will determine when you are ready to be fitted for your prosthesis. Your prosthetist will help the physician decide which type of prosthesis will be best for you. The prosthetist will then design, fabricate, and fit a prosthesis custom made to meet your particular needs. He/she will work closely with the other members of your treatment team, your physician and physical therapist (PT), to ensure that you receive the maximum benefits from your prosthetic care. You will continue to see your prosthetist over your lifetime for adjustments, repairs, and replacement of your prosthesis.

Your prosthetist will encourage you to be an active participant in the development of your prosthesis. Ask questions and use the many resources available to you on our website. Together your prosthetist and the other members of your treatment team will strive to provide you with the most functional prosthesis and best care for your needs.

Commonly asked questions about phantom limb sensations

What is phantom limb sensation? When people have an amputation, they usually have feelings in the limb that is missing. There may be tingling, a prickly sensation, or a numb feeling. The missing limb may feel hot or cold. It may feel like the toes or fingers are moving, that the limb is in a funny position, or there may be a feeling that the limb is still there. These feelings are called 'phantom limb sensations.' The sensations are very real; 'phantom' refers to the fact that the limb is missing. The important thing to know is that phantom limb sensations are perfectly normal, and almost all people with amputations experience them to some degree.
How long does phantom limb sensation last? How long phantom limb sensation lasts is different for everyone. In some people, the phantom limb sensations go away in a few months. For most people with amputation, the sensation decreases in how often it happens and how strong the sensation is during the first few months, but never goes away fully-even after 10 or 20 years some people still feel like their limb is still there. People with amputations become used to their phantom limb sensations and many grow to like their phantom limb sensations. Phantom limb sensations can go away in many different patterns. For most people with amputations, the sensations simply become weaker and happen less often. Sometimes the upper part of the limb will fade away and the foot or hand sensation will remain. Sometimes it feels like the limb is getting shorter--this is called 'telescoping.'
What about phantom limb pain? All people have some pain in their residual limb right after the amputation. This is surgical pain and it is unavoidable. Fortunately, this pain goes away in a few days or weeks, just like any other surgical pain. Pain in the missing part of the limb is called 'phantom limb pain.' Many amputees feel some phantom limb pain. It is usually described as a sharp or shooting pain. Sometimes it is an achy pain or burning. The pain is usually worst just after amputation and decreases rapidly in the first few weeks after surgery. In many amputees, phantom limb pain may persist as an infrequent, short spell of pain lasting a few seconds or a few minutes. Only a small number of patients have ongoing, severe phantom limb pain.
Is phantom limb pain treatable? Yes! There are several ways to treat phantom limb pain. One of the easiest and best treatments is massage. Massaging the residual limb helps to lower phantom limb pain and can control the problem. Other simple treatments include tapping, friction rub, and compression socks. Phantom limb pain is often linked to stress. Many people find that if they can relax and lower their stress level, the phantom pain subsides. Therefore stress reduction techniques can help treat phantom limb pain. If the phantom limb pain is bad enough that it is interfering with sleep or a person's ability to do things, then there are a number of medicines that can help with the treatment of phantom limb pain. Your doctor will be happy to discuss these with you.

For patients with an arm amputation

Information for the upper extremity amputee

Losing a limb will present many new challenges in your life. Fortunately, you will not be facing these challenges alone. Yanke Bionics is just one member of the skilled healthcare team helping you overcome these new challenges. Remember, except no limitations! Your team of experts may include occupational therapists, physical therapists, case managers, and social workers as well as your physician and prosthetist (people trained to fit artificial limbs or prostheses).

Healing: The first stage of rehabilitation for an arm amputation is healing. As your arm begins the healing process, you will want to keep any open areas clean and dry. Your physician will recommend the appropriate dressings to your arm and any other special considerations you may need to follow. Things to notify your doctor about are any discoloration to the incision, sudden onset of high fever, or excessive draining. These can be signs of infection which need to be treated immediately.

Shrinker: One technique to help speed healing and to reduce edema, is the use a shrinker. A shrinker is an elastic stocking that provides graded (tighter at the bottom and less compression the higher you go on the sock) compression to your residual limb. This compression helps control edema (swelling) which helps “shape” your limb, helps decrease nerve sensitivities and improves circulation to healing tissues. Since a shrinker is a tight stocking, you may need someone else to help assist donning initially. Your prosthetist at Yanke Bionics will size you for the appropriate shrinker and explain how to care for this garment.

Phantom Sensation and Pain: Although most amputees experience some form of phantom sensation at some point during their lives, there are tricks to help reduce and minimize its effect. Please note that there is a big difference between phantom pain and phantom sensation. Phantom pain is a physical discomfort and the feeling like the missing appendage is in a painful position or severely injured (Perhaps it feels like the finger is bent back and broken). However, the phantom sensation is simply the sensation that the missing appendage is still there without physical discomfort. (“It feels like my hand is still there”)Your occupational and/or physical therapist can do things to help reduce phantom pain and sensation. The tips they will provide, work at desensitizing nerve endings in your residuum. A shrinker provided by Yanke Bionics will also help reduce phantom sensation/pain. Read more about phantom sensations.

The First Prosthesis: After your limb is healed, your physician will prescribe a prosthesis. A Yanke Bionics prosthetist will use this prescription to fabricate the appropriate prosthesis for your needs. It is important to tell your prosthetist what kind of activities you would like to return to. For example, make a list of activities you find enjoyable so you can discuss these activities with your prosthetist. Your prosthetist will work with you at designing a prosthesis best-suited for your lifestyle. The level of amputation greatly changes the design of prosthesis, as will your likes and interests.

Limb changes: Your residual limb will rapidly decrease in size during the first few months following amputation due to the decrease in swelling and because of muscle atrophy. Be aware that this is a necessary part of the healing process. Also be aware that this will require adjustments by the prosthetist to accommodate for this decrease in limb size. Over the first year, the limb will gradually taper off to a point where a decrease in size is much slower.

The Second Prosthesis: Many times it will be necessary to replace the socket, components, or both by the first 12 to 24 months due to the loss of limb size. This may be called a definitive prosthesis but by no means is it the last prosthesis you will received. As your age, limb, and/or interests change, so will the prosthesis.

For patients with a trans-tibial amputation

Information for the trans-tibial (below the knee, BK amputee)

Immediately after surgery

During the days following your amputation, it is normal to feel a range of emotions because of the loss of your leg and to wonder how you will be able to get on with your life. You can be sure that all new amputees share these feelings of loss and sadness. However, these feelings of sadness or depression are usually followed by the need to resume your normal activity and developing the will to do so.

Your first prosthesis

Preparatory Prosthesis

Once your residual limb begins to heal, your physician is likely to prescribe a preparatory (temporary) prosthesis. The early fitting of an below knee prosthesis can offer you a positive alternative to crutch walking or using a walker or wheelchair as your residual limb heals. To allow the limb to heal fully and to reduce most of the swelling, a preparatory prosthesis is usually worn for 3 to 6 months. During this time you will learn how to evaluate and adjust the fit of your prosthesis.

K levels

NOTE: This information is relevant only to Medicare patients. Your physician, in consultation with your prosthetist, will decide on the type of prosthetic components (socket design, foot type, etc.) to be used in your prosthesis. During this process they will try to predict the activity (functional) level you're most likely to achieve in order to choose the most appropriate components for your prosthesis.

Your definitive prosthesis

There are two primary types of design for a definitive prosthesis:

Exoskeletal

Exoskeletal designs include a hard shell often made of acrylic plastic. This shell or "skin" is rigid and durable. This type of prosthesis is not readily adjustable after it has been finished. The primary advantage of an exoskeletal design is durability and its ability to transfer the weight from the socket to the foot. The acrylic lamination often used for the prosthetic shell allows a high impact surface with excellent load bearing capabilities. When an amputee requires great durability in a prosthesis, such as that needed for farming, or other element involving or heavy-duty occupations, an exoskeletal design may be a good choice.

Endoskeletal/Modular

Endoskeletal/Modular designs include an anatomically shaped, soft foam cover designed to look and feel like skin. This soft material covers the internal structure of the prosthesis and is removable to allow the prosthetist to make adjustments and changes to the prosthetic system when necessary. Connectors with an aluminum, titanium, or carbon pylon (tube) connect the socket with the foot. The soft covering on an endoskeletal prosthesis is somewhat fragile and requires careful attention to prevent damage. The primary advantages of this design are that it is adjustable and lightweight.

Accessories

For patients with a trans-femoral amputation

Information for the trans-femoral (above the knee, AK) amputee

Immediately following surgery

Your first prosthesis

Preparatory Prosthesis

Once your residual limb begins to heal, your physician is likely to prescribe a preparatory (temporary) prosthesis. The early fitting of an above-knee prosthesis can offer you a positive alternative to crutch walking or using a walker or wheelchair as your residual limb heals.

K levels

NOTE: This information is relevant only to Medicare patients. Your physician, in consultation with your prosthetist, will decide on the type of prosthetic components (socket design, suspension, knee, foot type, etc.) to be used in your prosthesis. During this process they will try to predict the activity (functional) level you're most likely to achieve in order to choose the most appropriate components for your prosthesis.