How do non-mechanical prosthetic legs work

For every human being, an amputation is a significant encroachment on the physical integrity. A leg amputation, regardless of the height, leads to unwanted immobility, which should be remedied as quickly as possible in order to enable an independent and as symptom-free life as possible.

A leg prosthesis helps to restore your mobility and your external appearance and to actively participate in everyday life. You gain significantly more quality of life and independence. Our goal is to find an individual solution for you that meets your requirements and problems. Both the functional and the cosmetic design of your leg prosthesis are extremely important to us!

CONTACT LEG PROSTHETICS

If you have any questions about prosthetics, please contact our employee directly:

Christa Becker
Master orthopedic technician

0201 82050-458

Assumption of costs

As a rule, all costs of your leg prosthesis are covered by your sponsor. We will handle the application for you! After approval of the assumption of costs, we will endeavor to produce your lower limb prosthesis as soon as possible. Your prosthesis is also subject to mechanical wear! You should therefore have them checked regularly. Any deficiencies can then be corrected quickly without great effort and free of charge for you.

budgeting
of prostheses

A distinction must be made between drugs and remedies on the one hand and aids on the other
There is no budgeting for aids.
According to Section 33 (1) of the Social Code Book V, those insured by statutory health insurance are "entitled to receive [...] orthopedic and other aids that are required in individual cases

to ensure the success of patient treatment,
to prevent an impending disability or
to compensate for a disability.

Statutory additional payment by the insured

According to the stipulation in Section 33 (8) SGB V, insured persons who have reached the age of 18 pay an additional payment for every aid that is provided at the expense of the statutory health insurance.
The amount of the additional payment is based on Section 61 of Book V of the Social Code and amounts to 10% of the sales price, but at least 5 euros and at most 10 euros; however, in each case no more than the cost of the agent.
However, the additional payments are only to be made until the limit is reached.
The collection of the statutory additional payment must be carried out by the service provider in accordance with Section 43b SGB V. The collected payment is to be offset against the compensation claim of the service provider from the health insurance company.

This means that the service provider's entitlement to reimbursement for the aids supplied to the health insurance company is reduced accordingly by the additional payment amount.


Amputation heights

The term amputation height describes the point at which a part of the body is amputated. In addition to other factors, the amputation level also decides on the appropriate prosthesis. The amount of amputation is determined by the doctor before the operation and depends on the reason for the amputation. The following amputation levels are usually performed.

Actions after an amputation

Preparation for the prosthesis begins immediately after the leg amputation. The following measures serve to improve the residual limb and help us to manufacture the prosthesis promptly.

You too should contribute to promoting your progress in order to regain your accustomed mobility and independence as soon as possible. However, you should always discuss all measures with your treating doctor!

Stump formation

The tissue of the stump is usually very swollen after the operation. For this reason, the stump should be provided with a compression bandage, a post-op liner or a compression stump (day and night if possible). The compression displaces the tissue water and the volume of the residual limb decreases. This process is important for the fitting of the prosthesis. The residual limb volume and thus the fit of the prosthesis is retained for much longer with constant compression.

Basics about the leg prosthesis

As soon as the residual limb conditions allow, the leg prosthesis is provided. A leg prosthesis essentially consists of a shaft for receiving the stump and the prosthesis components (modular components): a knee joint, a connection unit and the foot component. Foam cosmetics are individually adapted to the shape of the leg and give the prosthesis a largely natural appearance. As a first aid, you will receive a so-called "interim prosthesis" (temporary prosthesis). Since the stump changes in the early phase and for several months after the amputation, the prosthesis has to be readjusted more frequently during this time. As soon as the residual limb volume remains stable, a "definitive prosthesis" is made.

The prosthetic components


Various criteria, such as amputation height, residual limb conditions, physical performance capabilities and the patient's individual functional requirements, are decisive for the selection of the prosthesis components. "Modular construction" prostheses can be corrected statically well, as all joints and adapters are connected to one another and to the prosthesis socket. The possibility of adapting the components to your personal performance or exchanging them is a great advantage of the modular design, which is used today for modern prosthetics for this reason.

We use components from the following manufacturers:
Otto Bock, Össur, Medi, Uniprox, Teufel, Freedom Innovations, Endolite, Streifeneder, Ortho-Reha-Neuhof

Silicone liner and soft-walled inner socket


The silicone liner is rolled directly onto the stump. The individual adjustment offers optimal adhesion between skin and liner, which prevents skin irritation due to friction. The prosthesis socket is fixed over the liner either with a locking pin or a cable pull. In the case of a prosthesis with a soft-walled inner socket, it encloses the residual limb exactly and offers the right level of comfort for all residual limb conditions. The prosthesis is fixed using the knee-clasping prosthesis shaft.

We use components from the following manufacturers:
Otto Bock, Össur, Medi, Uniprox, Teufel, Freedom Innovations, Endolite, Streifeneder, Ortho-Reha-Neuhof

The prosthesis socket


The prosthesis shaft is essential for the quality of the prosthesis, as it establishes the connection between the patient's body and the lower section of the prosthesis. The socket and the residual limb bedding are individually made to measure for each type of prosthesis and thus offer an optimal fit. This is the basic requirement for the guidance of the prosthesis and a comfortable, safe gait. In the most common cases of restoration, the stump is embedded in the socket using a so-called silicone liner or soft-walled inner socket. Active negative pressure systems (e.g. the Harmony® System from Otto Bock) are mostly used in the area of ​​lower leg care.

We use components from the following manufacturers:
Otto Bock, Össur, Medi, Uniprox, Teufel, Freedom Innovations, Endolite, Streifeneder, Ortho-Reha-Neuhof

The prosthetic knee joint


The function of mechanical prosthetic knee joints is of particular importance for the supply. Which knee joint is suitable for you depends on your individual requirements and your degree of mobility. The technical possibilities for securing the stance and gait range from the so-called "locked prosthetic joint" to load-dependent brake joints and electronically controlled prosthetic joints. In order to minimize the risk of falling, knee safety when standing and walking always has priority! In order to get used to standing and walking with a prosthetic leg, a "locked" knee joint is used in most cases! As a next step, a movable knee joint can be built into the prosthesis. The advantage here is the freedom of movement. As with normal walking, the prosthesis can now simply be swung forward.

We use components from the following manufacturers:
Otto Bock, Össur, Medi, Uniprox, Teufel, Freedom Innovations, Endolite, Streifeneder, Ortho-Reha-Neuhof

The prosthetic foot


With all the technology of the rest of the leg prosthesis, the prosthetic foot is of central importance. The correct selection of the prosthetic foot is decisive for safety and stability as well as wearing comfort. Various performance characteristics are required of a prosthetic foot. The foot should have functionality and mobility on different surfaces and at the same time keep the energy expenditure when running as low as possible. In modern lower limb prosthetics, there are many different foot models that are selected for the respective runner according to his degree of mobility and individual requirements. There is the possibility of using energy-storing, jointless prosthetic feet and those with ankle joints.

We use components from the following manufacturers:
Otto Bock, Össur, Medi, Uniprox, Teufel, Freedom Innovations, Endolite, Streifeneder, Ortho-Reha-Neuhof

Amputation heights and their prosthetic fitting

In general, the prosthesis supply depends on the amputation level. The following is a detailed presentation of the most common types of amputation with associated prosthesis fitting:

The forefoot amputation prosthesis

This prosthesis is used for restoration after amputations in the foot area. Due to the length of the stump, fitting parts can only be used to a limited extent. The prosthesis gives you better stability when standing and enables you to roll naturally while walking. The silicone and soft-walled inner sockets are used as socket systems.

The lower leg prosthesis

This prosthesis is used for the treatment of lower leg stumps of different amputation heights. The prosthetic socket with residual limb bedding and the prosthetic foot are connected to one another using adapters of various types. The socket systems used are silicone and soft-walled inner sockets with or without active negative pressure systems (e.g. the Harmony® system from Otto Bock).

The knee disarticulation prosthesis

This prosthesis is used for restoration after knee disarticulation. The end of the stump can be loaded directly, which contributes to increased wearing comfort. The prosthesis shaft with residual limb bedding, the knee joint and the prosthetic foot are connected to one another using adapters of various types. The socket systems used are silicone and soft-walled inner sockets with an outer socket made of carbon fiber.

The thigh prosthesis

This prosthesis is used for the treatment of thigh stumps of different amputation heights. The prosthesis shaft with residual limb bedding, the knee joint and the prosthetic foot are connected to one another using adapters of various types. The silicone liner and the adhesive contact shaft are used as shaft systems. Shank shapes such as transverse oval, longitudinal oval or MAS shank are used here. The outer socket is often made in a so-called frame construction.

The hip disarticulation prosthesis

This prosthesis is used for treatment after hip disarticulations and hemipelvectomies. The individually made pelvic cage serves as a stump bedding. The hip joint, knee joint and the prosthetic foot are connected to one another and to the pelvic cage using adapters of different designs. The pelvic cage, the silicone inner shank and the pelvic cage contact shank are used as shaft systems.

Classification of the degree of activity / mobility classes

With this classification, the orthopedic technician can orientate himself towards the component part as well as the needs of the respective prosthesis wearer when building a prosthesis. When dividing the mobility classes, we take into account many different factors such as:

  • Your general condition
  • Individual stump peculiarities
  • Possible concomitant illnesses
  • Pain

Always keep in mind that only the current status of your mobility can be assessed.

Mobility class 1:
"Indoor
goer "

You have the ability or the potential to use your prosthetic leg on level floors and especially in the home environment at low speed. Based on your general condition, you can walk short distances in one go.

The prosthesis as therapy: You should be able to stand securely with your prosthesis and be able to cover short distances with the prosthesis indoors.

Mobility class 2:
"Restricted outdoor walker"

You have the ability or the potential to walk at a slow speed with your prosthesis. You can master smaller obstacles such as curbs, individual steps or uneven floors. Walking time and walking distance are limited due to your condition.

The prosthesis as therapy: You can safely cover shorter distances of short duration both indoors and outdoors.

Mobility class 3:
"Unrestricted outdoor area walker"

You have the ability or potential to walk at a medium to high speed with your prosthesis. You can also vary the speed. Most of the environmental obstacles are not a problem for you. You can also move around easily in open terrain, such as in nature. The load on the prosthesis remains average. Walking distances and walking times hardly differ from those of a non-amputee.

The prosthesis as therapy: your mobility differs only slightly from that of a non-amputee both outside and inside.

Mobility class 4:
"Unrestricted outdoor walker with particularly high demands"

You can do everything that is described under mobility class 3. In addition, you have high demands on your prosthesis, as it is often exposed to high impact loads. You can get around with no restriction on distance or duration.

The prosthesis as therapy: the restoration of unlimited walking ability both indoors and outdoors.

Stump care


Your therapist will show you how to properly care for your residual limb. Wash the stump in the evening and morning with warm water and a mild soap. Then dry the skin well or pat it dry carefully.

If skin folds or indented scars have formed on the stump, these must be cared for particularly intensively in order to prevent infections. Also, watch out for skin injuries, pressure points and blisters during stump care. A mirror can help you see the back of your stump as well.
Care products (medi)

Stump hardening


The hardening of the residual limb is important in order to get used to the sensitivity of your skin to pressure and touch. Running with a prosthesis is initially a change for the skin and muscles. It is therefore important to prepare the stump for this in order to avoid possible pressure pain and sensitivity of the skin. Make sure that you only start hardening the residual limb when there are no more signs of inflammation such as reddening, swelling, pain and warmth and the scar is well closed. Ask your doctor to be on the safe side. Use different materials to irritate the die skin.

Phantom feeling / phantom pain


The term phantom feeling is a limb deception. The missing limb is perceived as still there. Especially in the early phase after the amputation, a change in body awareness has not yet taken place, which can have unforeseeable consequences in careless situations. For example, going to the toilet at night can easily lead to a fall! Phantom pain does not always appear, but often occurs with residual limb pain. Causes for this can be wound healing disorders as well as irritations of the nervous system! The pain is alleviated, among other things, by consistently wrapping the residual limb, but also by frequently wearing the prosthesis. A hardening of the residual limb through ice rubbing, etc., can help reduce the phantom feeling and pain.

Cleaning the prosthesis


Proper care is essential for optimal use of your prosthetic leg. Inadequate care of the prosthesis and the residual limb can lead to skin irritation, allergies and premature wear of the device. As with your clothing, the prosthesis also needs to be cleaned regularly. This also prevents unpleasant odors. You can wipe the prosthesis socket, regardless of the plastic material, with a mild, preferably pH-neutral (5.5) cleaning agent and a damp cloth! You can of course also obtain cleaning agents and all stump care products directly from us.

Exercise after a leg amputation


Nothing stands in the way of exercise even after an amputation! Nordic walking, for example, offers a good introduction to sport! Here you have walking sticks in your hands, which can initially give you the necessary security in open terrain.

The bicyling


There are hardly any problems with a lower leg prosthesis.In the case of a thigh amputation and knee ex-amputations, a return spring and a stationary pedal are often required. By converting the saddle, you can also enable a patient with a movable knee joint to cycle! You have the opportunity to join a disabled sports club. Sports are practiced here taking your disability into account and you are guaranteed to train under professional guidance. You can get addresses from us on request.

Driving a car after a leg amputation


Please note the following: If you already have a driver's license, the disability must be reported to the driving license authority. This decides whether a specialist medical report is required. On the basis of the specialist medical report, an expert from TÜV prepares a suitability report. This shows whether any modifications to the vehicle are necessary and, if necessary, a driving test must take place. As far as financial aid, support and grants are concerned, these must be applied for in advance. If something is done in advance, there will usually be no reimbursement.

Support groups


Amputations are hard blows of fate. It's good that there are people who stand up for the concerns of those affected. These help, advise and inform those affected and their relatives before and after an amputation. Here you will receive support in asserting your claims and offer you a forum for exchanging experiences.

Federal Association of Self-Help for the Physically Disabled (BSK)
www.bsk-ev.org

Information about life with a prosthetic leg:
www.myhandicap.de
www.leben-mit-beinprothese.de

Self-help groups throughout Germany:
www.stolperstein.com

Contact

Luttermann GmbH
Hindenburgstrasse 51-55
45127 Essen

Business hours
Mon-Fri 9:00 a.m. - 6:00 p.m.