Otto Bock Harmony P3 Technical Information page 26

Tips and tricks
Topic: Residual limb
Problem
Red welt on the skin
at top of the liner
Blisters on the skin
Skin in distal region
white and thickened
Pressure in the distal
region
Pressure in the prox­
imal area
26 | Ottobock
Cause
User wears liner with textile
cover.
The textile cover prevents the
seal between the liner and seal­
ing sleeve. This causes the vacu­
um to extend up to the thigh,
forming welts on the skin.
Residual limb sock reaches at
least to the upper edge of the
liner.
This has the same effect as
wearing a liner with a textile cov­
er.
Liner not put on correctly.
The air between the liner and the
residual limb was not removed
when it was put on. This is the
most frequent cause of blisters.
Liner or sealing sleeve is too
loose on the thigh.
Air gets under the liner.
Insufficient end contact of the
residual limb in the prosthetic
socket.
This generates pressure that is
too low in the distal region.
Volume loss in the distal
region.
The volume loss creates an area
without load. The vacuum pulls
the liner and the residual limb
into a gap and creates a feeling
of pressure in the user. This feel­
ing is frequently misinterpreted
as contact in the prosthetic sock­
et.
Volume loss on the entire
residual limb.
The volume loss has caused the
residual limb to slip deeper into
the socket, and the end of the
residual limb now bears the
majority of the body weight.
Volume loss in the distal
region.
The volume loss creates an area
without load. The residual limb
hangs proximally in the prosthet­
ic socket, which causes the
Solution
• Only use liners without textile or with partial textile
cover.
• Instruct the user to pull the residual limb sock up to
only about 5 cm below the edge of the liner. This
allows the seal between the liner and sealing sleeve.
• Explain to the user how to properly remove all air
from the liner when putting it on.
When using a PU standard liner: Ensure that the
•
liner is seated correctly along the entire residual
limb and the thigh.
• Use a PU custom liner to ensure a correct fit.
• Compensate for the lack of residual limb contact
with one or more distal spots or a half residual limb
sock.
• If the skin has thinned again after a few weeks and
returned to a normal colour: Check whether a new
prosthetic socket needs to be made.
• If the medial and lateral markings on the liner have
slipped into the prosthetic socket, the residual limb
has lost volume.
• Ensure that the vacuum is generated and main­
tained. Without vacuum, the user loses residual limb
volume every day.
If there is vacuum: Compensate for the volume
•
loss with a distal spot/half residual limb sock until
the marks on the liner are located at the height of
the socket brim again.
If the distal fillers increase the feeling of pres­
•
sure: The residual limb has probably lost overall
volume; see next table row.
• Remove the distal fillers again.
• Pull a long residual limb sock under the thin residual
limb sock.
If the markings on the liner become visible and
•
the pressure abates: Put on another distal
spot/half residual limb sock to prevent the long
residual limb sock from hanging and creating an
area without load.
• If more than three fillers are used, a new prosthetic
socket should be made.
• Ensure that the vacuum is generated and main­
tained. Without vacuum, the user loses residual limb
volume every day.
If there is vacuum: Compensate for the volume
•
loss with a distal spot/half residual limb sock before
putting on the thin residual limb sock.
Harmony System