Tiêu chuẩn iso 08548 2 1993 scan

I N TE RN ATI ON AL I s0 S TAN D ARD 8548- Fi rst e d i ti o n 993-07-01 P ro sth eti cs an d d e fi ci e n ci e s P art orth oti cs Li m b - - 2: M e th o d of d e scr i bi n g l o we r l i rn b am pu tati o n stu m ps P roth kses P arti e 2: m em bres et orth eses M Bth o d e de - M al form ati o n s d escri pti o n d es d es m em bres m oi g n o n s - d ’ am pu tati o n d es i n fki eu rs R e fe re n ce I S0 n u m ber 85482: 993(E) I S0 8548=2: 993(E) Fo re wo rd I S0 (th e I n tern ati o n al fed erati on of of prepari n g tech n i cal wh i ch stan d ard s I n tern ati o n al co m m i ttees a tech n i cal represen ted an d Org an i zati o n n ati o n al on E ach (I E C) on D raft al l m atters of to Stan d ard th e n o rm al l y bo d y been wi th I S O, Stan d ard s by at for ou t i n terested in h as take wo rl d wi d e part Th e work th ro u g h a I S0 su bj ect th e o rg an i zati on s, al so a ri g h t for to be g o vern m en tal in th e E l ectrotech n i cal wo rk I S0 Co m m i ssi on stan d ard i zati o n ad opted bo d i es is bo d i es) carri ed establ i sh ed I n tern ati on al el ectrotech n i cal approval m em ber I n tern ati on al th e m em ber req u i res is h as l i so n wi th I n tern ati on al ci rcu l ated in cl o sel y S tan d ard i zati on ) (I S m em ber com m i ttee n o n -g overn m en tal , col l abo rates Stan d ard s com m i ttee th at fo r bod i es by th e vo ti n g l east 75 % tech n i cal com m i ttees P u bl i cati o n of th e as an m em ber are I n tern ati o n al bod i es casti n g a vote I n tern ati on al Stan d ard l SO/TC P ro sth eti cs I S0 68, 8548 th e ti cs - P art - P art - orth o th e - was prepared by Tech n i cal C om m i ttee orth oti cs fo l l owi n g Li m b parts, u n d er th e g en eral ti tl e d escri bi n g limb 2: M eth o d of d escri bi n g l o wer limb am pu tati on stu m ps P art 3: M eth o d of d escri bi n g u pper limb am pu tati on stu m ps - P art 4: Cau sal - P art 5: P ati en t I S0 th i s ri g h ts by an y re se rve d m e an s, in Case in No l ead i n g to presen t at bi rth am pu tati on d escri ptors of part e l e ctro n i c wri ti n g I n tern ati on al P ri n ted part d i ti o n s d efi ci en ci es I S0 8548 is for i n fo rm ati o n o n l y 993 Al l m i s si o n of P ro s- d efi ci en ci es: of A : of ti cs 8548-2 an d M eth o d An n ex si sts an d I S0 P o stal e fro m or th e Org an i zati o n 56 S wi tze rl an d l of th i s pu bl i cati o n m e ch an i cal , m ay i n cl u d i n g be reprod u ced ph otocopyi n g pu bl i sh er, for C H - ‘ I 21 Stan d ard i zati on G en eve 20 l S wi tze rl an d or an d u ti l i ze d m i cro fi l m , in an y fo rm wi th ou t or per- I S0 8548=2: 993 (E) I n tro d u cti o n M an y d i fferen t stu m ps, are bu t m an y Th e wi th d i fferen t own system s i n tern ati on al wi th wi l l system s n on e m eet system on e of wi th h eal th Th e propo sed cl i n i c cord ed I S0 in 8548 d escri bed d esi g n ed pabl e of a team way an d th at I t sh ou l d th e read y cl i n i c team s ag n st a n eed s in to Th e co m pare d i fferen t oth er ph ysi cal an d al so of co u n tri es, th ere of a th i s th ei r n eed on e care fo r an pu bl i cati on g ro u ps wh o stu m ps (especi al l y o ccu pati on al to fo r worki n g d evel op is d escri bi n g d octo rs val u e am pu tati o n reason s possi bi l i ti es, H en ce system d i sci pl i n es, is cl assi fy Th e d i fferen t o rd er an o th er stan d ard i zed system in tech n i cal d evel oped to acceptan ce in- th o se th erapi sts, an d epi d em i o l o g i sts an d o ffi ci al s d el i beratel y by d evel o ped d i fferen t reh abi l i tati on ) , a been u n i versal i n d i vi d u al d i fferen t g overn m en t system be u se Su ch th e an d to pro sth eti sts of th e th ei r pati en t an d su rg eon s cern ed of pati en ts to an o th er, h ave ach i eved m em bers appreci ate cl u d e h as be h as to to m eet en abl e can be m s easi l y at feasi bl e i n d i vi d u al ad aptati o n th e th e th e d i fferen t th e i n corpo rated in reports th i s i n sti tu ti o n ; fo r of of d efi n i n g for n eed s d escri pti on com pu ter th e minimum i n form ati o n th e to i n fo rm ati on m em bers stu m p to Th i s i n form ati o n be i n cl u d ed sh ou l d in al so be re- part of to be fo rm s be ca- an al ysi s III This page intentionally left blank I N TE RN ATI ON AL P ro s th e ti cs P art part scri bi n g of of I S0 l o wer cord i n g th e d e s cri bi n g 8548 limb Th e fo l l owi n g th i s part Li m b l o we r limb of I S0 I S0 in 8548 are appl yi n g stan d ard s i n d i cated m n tai n reg i sters of an d d e- fo r re- At th e to pro vi si o n s sti tu te ti m e Al l of ag reem en ts m ost bel o w of to M em bers are th e su bj ect based on th i s i n vesti g ate recen t cu rren tl y wh i ch , pu bl i cati on , stan d ard s en co u rag ed th e am pu tati o n D e fi n i ti o n s Fo r th e ed i ti o n s of val i d 8548-l : 989, fi ci en ci es - P rosth eti cs P art presen t at : an d M eth o d I EC I S0 8549-2 M e as u re m e n t cabu l ary - pros th eses : 989 , P art an d I d en ti fy th e I S0 G en eral extern al 8549 -2 : 89 , prosth eses - an d 2: I S0 8548, I S0 th e d efi - 8549- l an d of l o we r limb l evel s an d re fe re n ce pl an e s th e referen ce an d l evel of l evel s an d am pu tati on pl an es as rel evan t d escri bed in to l th e of an d th e I S0 d escri bi n g - Li m b limb Referen ce l evel s Cro tch wh i ch a to cen trel i n e th e - l evel ci rcu m feren ti al of th e m o st proxi m al m easu rem en t, th e th i g h , can be l evel at perpen d i cu l ar o btai n ed d e- an d term s orth o ti cs fo r - extern al Volimb ti bi a1 M ed i al pl ateau , kn ee, a o rth oses P rosth eti cs P art of 8548- , s tu m ps parti cu l ar in Term s wearers of an d rel ati n g th ese orth oti cs to - extern al pro sth eses j oi n t u n l ess wh i ch case ci rcu m feren ti al cen trel i n e cabu l ary part I S0 bi rth P rosth eti cs 7: th i s appl y R efe re n ce 8549-l of in g i ven I n tern ati on al o rth o ti cs of s tu m ps pu rpo ses n i ti o n s d efi ci en ci es I S0 - pro vi si o n s Stan d ard s I S0 d e fi ci e n ci e s am pu tati o n text, val i d parti es 8548 of stu m ps co n tai n th i s were an d possi bi l i ty m eth od i n form ati on stan d ard s of a re fere n ces i n d i cated revi si o n , part am pu tati on referen ce ed i ti o n s establ i sh es d escri pti ve N o rm ati ve th ro u g h to - o rth o ti cs S co pe Th i s of an d 8548=2: 993(E) 2: M e th o d I S0 STAN D ARD of th e line th ere th i s - th e is a l evel m easu rem en t stu m p can be l evel fi xed is th e of th e m ed i al d efo rm i ty of h i g h est wh i ch at perpen d i cu l ar to th e th e o btai n ed Volimb en d Stu m p en d l evel - th e l evel of th e stu m p I S0 48 = : 9 ( E ) ‘I ti en t G rou n d is l evel stan d i n g - th e l evel on wh i ch th e pa- Assessm en t “Fal l -away” l evel stu m ps o n l y, - th e in l evel tran s-fem oral on th e th e stu m p aspects as at it wh i ch cu rves th e in sl ope toward s of th e th e stu m p Minimum an kl e ci rcu m feren ti al d i sarti cu l ati o n minimum stu m ps ci rcu m feren ti al Fem oral l evel o n l y, ti cu l ati o n stu m ps l evel si g n i fi can t red u cti on - th e in l evel of j oi n t th e M axi m u m M easu rem en t - in kn ee d i sar- m en t an y m axi m u m d i stal ci rcu m feren ti al stu m ps o n l y, ci rcu m feren ti al as Referen ce am pu tati on s pl an es l evel th e l evel - in of th e th e pect of th e h eel - paral l el fo r pl an e wi th parti al An teri or ti bi a1 aspect of th e at th e posteri o r cen trel i n e of as- th e l eg pl an e - th e pl an e at th e th e ti bi a wi th th e cen trel i n e of S tu m p paral l el en d wi th at th e pl an e th e cabl e of Toe of th e th e red u cti o n th e an kl e j oi n t line - pl an e - th e l eg h e re Th e th e of pl an e as at th e pl an e at paral l el th e wi th ti ps th e of th e to for th e to 7) as an d record th e fo r an d th e l en g th appro pri ate l evel of m easu rem en ts tabl e (see tabl es m o- Acad em y of wh i ch al l d efi n ed m oti o n s zero starti n g power power l i kel y to affect can be bu l ky re l ati n g are or to e q u al l y as n ot o bj e cti ve l y wh i ch is m e as u re m e n ts bu t i n app l i - of p o we r i n app ro pri ate to h as m easu red ap p aratu s wh e th e r to be th e re bas e d is on s i g n i fi can t an th e s tabi l i z e s o cke t in p o we r th e th e d e m o n s trated ap pre ci - pro xi m al j oi n t pro s th e ti c wi th s tan ce wo u l d th e be stu m p in a ph as e Assessm en t an of j oi n t assessm en t of stabi l i ty th e j oi n t stabi l i ty It of is th e 8548, bon y re co g n i z e d i n te g ri ty th e th e e l e m e n ts In re co rd i n g an d /o r th at of of th e th e l i g am e n to u s s tabi l i ty of osseou s, co n te xt j oi n t a j oi n t is a fu n c- l i g am en to u s of i n stabi l i ty i m pai rm e n ts th i s re fe rs an d th e i r an d p art of sol el y co n s e - as to 7) M eth o d of in th e th e parti cu l ar d e s cri bi n g l o wer limb am pu tati o n m easu rem en ts reco rd speci fi ed th e fro m m ove- j oi n t m easu rem en ts parti cu l ar M easu re in j oi n t of q u e n ce s C i rcu m feren ti al m en ts 64 m u scl e j u d g em en t am pu tati o n 2 of s cal e s wh e th e r to Record to M eas u rem e n ts in of cen trel i n e I S0 M easu re ran g e Am eri can j oi n t an d po we r n e u ro - m u s cu l ar speci fi ed j oi n t stu m p N OTE Len g th of l eg l eg in p o we r cas e s of s u ffi ci e n t th e Th e s u bj e cti ve ti o n an y par- l eg cen trel i n e co n tral ateral an d si g n i fi can tl y po l i o m ye l i ti s toes th e th e of e xpe n s i ve we l l - fi tte d en d ran g e m easu rem en t m easu red M u s cl e re q u i re s ati o n al l el are an y re d u cti o n an teri o r of by Assessm en t Record foo t in power m easu rem en t (u sed th e m u scl e abn orm al of m eth od Su rg eo n s perform an ce pl an e re- m ove- th e o n l y) H eel of ad opted j oi n t N OTE be posi ti on s of abn orm al i ti es u si n g ti o n d i stal to j oi n t m ovem en t o n l y d i sarti cu l ati on of kn ee of of n eed ran g e stabi l i ty Orth o paed i c an kl e wh i ch of sh ape m easu rem en t d yl ar fu n cti on abn o rm al i ti es Record j oi n t i n cl u d e en d l o ss an d of si d e m en t, ch an g es fu n cti o n an d m ed i al co rd ed of j oi n t G en eral Th e tran s-ti bi a1 of barefoo t ci rcu m feren ti al appro pri ate l evel of tabl e am pu tati o n m easu re(see tabl es G e n e ral D escri be l i sted by s tu m p th e in th e th e u se stu m p appro pri ate of th e u si n g th e tabl es g u i d an ce rel evan t (see g i ven in tabl es an n ex d escri ptors to A 7) , an d I S0 U se Tran s- pel vi c th e d escri pto rs Hip th e am pu tati o n sh own in tabl e in tabl e2 u pp e r at ri g h t an g l e s th e d escri ptors ” Hip sh own d i s arti cu l ati o n ace tabu l o - fe m o ral re fe re n ce l e vel j oi n t as or re fe rs ” an to am pu tati o n d e s cri be d fo r am pu tati o n abo ve th e u s u al th e at th e N OTE m e n ts tran s - fe m o ral Th e is d escri pto rs am pu tati o n th e Th e is th e u pper sh own u pper cro tch in at ri g h t an g l e s wh i ch re fe re n ce bu t, re fe re n ce l e ve l l e ve l l eve l in fo r cas e th e ce n tre l i n e fo r of l e n g th a ci rcu m fere n ti al to Kn e e a l e n g th fl e xi o n m e n ts is be th e th e is h i g h est po s s i bl e at s tu m p wo u l d be m eas u rem e n t of in tabl e re fe re n ce u pper at ri g h t j oi n t line l e vel bu t, re fe re n ce wh i ch a an g l e s to l e ve l in fo r th e fo r sh own th e in Th e u pp e r cro tch re fe re n ce bu t, in th e l e n g th cas e l e n g th ci rcu m fe re n ti al th e m e as u re - of a fl e xi o n wo u l d be m e as u re m e n t ce n tre l i n e of th e is (S ym e’ s ) th e th e is stu m p d i sarti cu l ati o n U se th e d escri pto rs sh own in tabl e6 h i g h est po s s i bl e at N OTE m e n ts s tu m p is Th e th e th e l e ve l at u pper m e d i al u pper at ri g h t re fe re n ce j oi n t line re fe re n ce wh i ch a an g l e s to l e ve l bu t, l e vel in fo r th e fo r ci rcu m fe re n ti al th e ce n tre l i n e tabl e4 l e ve l cas e of fo r a l e n g th fl e xi o n P arti al fo o t am pu tati o n m e as u re d e fo rm i ty, U se th e d escri ptors l e n g th cas e l e n g th d i sarti cu l ati o n d escri ptors th e sh own ( be l o w- kn e e ) m e as u re d e fo rm i ty, N OTE of am pu tati o n u pp e r An kl e po s s i bl e th e wo u l d m e as u re m e n t tabl e3 l e ve l th e at h i g h est U se ce n tre l i n e m ed i al th e d e fo rm i ty, 5 l e n g th ( abo ve - kn e e ) N OTE th e d e fo rm i ty, Tran s - fe m o ral m e n ts th e d escri ptors po s s i bl e th e to Tran s- ti bi a1 h i g h est U se fo r th e pro xi m al am pu tati o n l e vel a ci rcu m fe re n ti al d i sarti cu l ati o n U se N OTE wh i ch U se re fe re n ce l e ve l 8548=2: 993 (E) sh own in tabl e7 of m e as u re a wo u l d fl e xi o n be m e as u re m e n t of th e s tu m p th e is I S0 8548-2: 993(E) Tabl e - D escri ptors for tran s-pel vi c D e s cri pto r S tate m en ts M e as u re m e n ts N ot S tu m p th e th e co n tral ate ral limb is th e s i te of an H e al e d /u n h e al e d s car S ki n G e n e ral b arri e r S e n s ati o n No i n tact/s ki n b arri e r n o rm al /s e n s ati o n ad d i ti o n al not i n tact i m pai re d s carri n g /ad d i ti o n al s carri n g C i rcu l ati o n N o n e /pre s e n t/e xce s s i ve Oe d e m a ti s s u es of th e s tu m p Am o u n t Ad e q u ate /i n ad e q u ate /e xce s s i ve C o n s i s te n cy N o rm al /fl abby/i n d u rate d S i g n i fi can t p n S po n tan e o u s p n N o /ye s Te n d e rn e s s N o /ye s P n fu l N o /ye s n e u ro m a P h an to m an n ex A) re l e van t M o bi l e /ad h e re n t P n an d re co rd e d s tu m p Am pu tati o n S o ft Abs e n t/pre s e n t re m n an t If of be (see s h ape P el vi c S ki n to am pu tati o n s afte r p n e xe rci s e N o /ye s N o /ye s ( g e n e ral i z e d ) /ye s ( l o cal i z e d ) am pu tati o n , s tate th e l eve l I S0 Tabl e - D escri pto rs fo r D e s cri p to r S tatem e n ts M e as u re m e n ts N ot Stu m p to d i sarti cu l ati o n s be (see an d an n ex A) re co rd e d re l e van t s h ap e U pper fe m o ral re m n an t Abs e n t/pre s e n t If S ki n hip 8548=2: 993(E) of th e th e bu t co n tral ate ral not limb pro m i n e n t/pre s e n t is th e si te of an an d pro m i n e n t am pu tati o n , s tate th e l e ve l s tu m p Am pu tati o n H e al e d /u n h e al e d s car M o bi l e /ad h e re n t S ki n G e n e ral barri e r S e n s ati o n No i n tact/s ki n b arri e r n o rm al /s e n s ati o n ad d i ti o n al n ot i n tact i m pai re d s carri n g /ad d i ti o n al s carri n g C i rcu l ati o n N o n e /pre s e n t/e xce s s i ve Oed em a S o ft ti s s u e s of th e s tu m p Am o u n t Ad e q u ate /i n ad e q u ate /e xce s s i ve C o n s i s te n cy N o rm al /fl abby/i n d u rate d S i g n i fi can t pai n S p o n tan e o u s pai n N o /ye s Te n d e rn e s s N o /ye s P n fu l N o /ye s n e u ro m a P h an to m P n afte r pai n e xe rci s e ( g e n e ral i z e d ) /ye s ( l o cal i z e d ) N o /ye s N o /ye s I S0 48 - : 9 ( E ) Tabl e - D escri ptors fo r tran s-fem o ral tran sco n d yl ar (above- kn ee) am pu tati on s) am pu tati on s (see be fi g u re (i n cl u d i n g an d an n ex D e s cri pto r S tatem en ts M e as u re m e n ts R e co rd th e - th e l e n g th fro m th e cro tch - th e l e n g th fro m th e “fal l - away” - th e l e n g th of th e co n tral ate ral limb fro m th e th e l e n g th of th e co n tral ate ral limb fro m th e - to 4, su pracon d yl ar re co rd e d fo l l o wi n g m e as u re m e n ts ? ) to th e s tu m p to th e en d , s tu m p I, en d, cro tch m ed i al Z2 to th e j oi n t g ro u n d , line to - th e ci rcu m fe re n ce at th e cro tch , - th e ci rcu m fe re n ce at th e “fal l - away”, S tu m p Ski n co n tral ate ral limb is th e si te C, of an C2 am pu tati o n , s tate th e l e ve l s h ap e C yl i n d ri cal /co n i cal /bu l bo u s G e n e ral End th e of of N ot fe m u r th e pro m i n e n t/pro m i n e n t s tu m p Am pu tati o n H e al e d /u n h e al e d s car M o bi l e /ad h e re n t S ki n G e n e ral barri e r S e n s ati o n No i n tact/s ki n b arri e r n o rm al /s e n s ati o n ad d i ti o n al n ot i n tact i m pai re d s carri n g /ad d i ti o n al s carri n g Ci rcu l ati o n Col ou r of N o rm al /cyan o ti c/o th e r ski n Te m pe ratu re ( to th e e xam i n i n g h an d ) So ft d i s co l o rati o n Warm /co l d N o n e /pre s e n t/e xce s s i ve Oed em a ti s s u e s of th e s tu m p Am o u n t Ad e q u ate /i n ad e q u ate /e xce s s i ve C o n s i s te n cy N o rm al /fl abby/i n d u rate d Si g n i fi can t pai n S po n tan e o u s N o /ye s pai n Te n d e rn e s s N o /ye s P n fu l N o /ye s n e u ro m a P h an to m P n J oi n t ( l o cal i z e d ) N o /ye s pai n afte r ( g e n e ral i z e d ) /ye s N o /ye s e xe rci s e fu n cti o n Hip R an g e M u scl e ) of N o rm al /abn o rm al m o vem e n ts No p o we r s i g n i fi can t S tabi l i ty N o rm al /i m pai re d P n N o /ye s If th e s tu m p was m e as u re d wi th th e p ati e n t in an y ( S pe ci fy: fl e xi o n /e xte n s i o n re d u cti o n /s i g n i fi can t po s i ti o n o th e r th an or ab d u cti o n /ad d u cti o n ) re d u cti o n s tan d i n g , s tate th e p ati e n t’ s Z3 th e If an d A) p o s tu re g ro u n d , I S0 Cro tch Fal l - away S tu m p en d l e ve l 8548=2: 993 (E) - LeveL l e ve l - M e d i al j oi n t line , - Fi g u re - Referen ce l evel s an d m easu rem en ts fo r tran s- fem o ral G rou n d Level am pu tati o n s l e ve l I S0 48 - : Tabl e 993(E) - D escri pto rs fo r kn ee d i sarti cu l ati on s am pu tati o n s) (see (n o t 5, D e s cri pto r S tate m e n ts to M eas u re m en ts R e co rd th e - th e l e n g th fro m - th e l e n g th of - th e l e n g th an d su praco n d yl ar A) of cro tch to th e co n tral ate ral th e s tu m p limb co n tral ate ral fro m limb en d , th e I, cro tch fro m th e to th e m ed i al g ro u n d , j oi n t Zd ci rcu m fe re n ce - th e minimum - th e ci rcu m fe re n ce at th e cro tch , ci rcu m fe re n ce co n tral ate ral of limb th e is C, of th e fe m o ral th e s i te of s tu m p, co n d yl e s , an C4 C T3 am pu tati o n , s tate th e l e vel s h ape C yl i n d ri cal /bu l bo u s /co n i cal G e n e ral Ski n th e th e th e tran sco n d yl ar an n ex m e as u re m e n ts : l ) th e - If an d re co rd e d fo l l o wi n g g ro u n d , Stu m p be i n cl u d i n g fi g u re2 of th e stu m p Am pu tati o n H e al e d /u n h e al e d s car M o bi l e /ad h e re n t S ki n G e n e ral b arri e r S e n s ati o n No i n tact/s ki n barri e r n o rm al /s e n s ati o n ad d i ti o n al n ot i n tact i m pai re d s carri n g /ad d i ti o n al s carri n g C i rcu l ati o n Col ou r of N o rm al /cyan o ti c/o th e r s ki n Te m pe ratu re ( to th e e xam i n i n g h an d ) N o n e /pre s e n t/e xce s s i ve Oe d e m a S o ft d i s co l o rati o n Warm /co l d ti s s u es of th e s tu m p Am o u n t Ad e q u ate /i n ad e q u ate /e xce s s i ve C o n s i s te n cy N o rm al /fl abby/i n d u rate d S i g n i fi can t p n S po n tan e o u s N o /ye s pai n Te n d e rn e s s N o /ye s P n fu l N o /ye s n e u ro m a P h an to m P n J oi n t ( l o cal i z e d ) N o /ye s pai n afte r ( g e n e ral i z e d ) /ye s N o /ye s e xe rci s e fu n cti o n Hip R an g e M u s cl e ) of N o rm al /abn o rm al m o ve m en ts No p o we r s i g n i fi can t S tabi l i ty N o rm al /i m pai red P n N o /ye s If th e stu m p was m e as u re d wi th th e pati e n t in an y ( S peci fy: fl e xi o n /e xte n s i o n re d u cti o n /s i g n i fi can t po s i ti o n o th e r th an or abd u cti o n /ad d u cti o n ) re d u cti o n s tan d i n g , s tate th e pati e n t’ s po s tu re line to th e I S0 Crotch M i n i m u m ci rcu m fe re n ce Fe m o ral co n d yl ar Stu m p en d l e ve l 8548-2: - l e ve l l e ve l - l e vel M e d i al j o i n t M U - Fi g u re 993(E) - Referen ce l evel s an d m easu rem en ts for kn ee G rou n d d i sarti cu l ati o n s l e ve l line l e ve l I S0 8548-2: 993(E ) Tabl e - D escri ptors fo r tran s-ti bi a1 (bel o w-kn ee) to D e s cri pto r S tate m en ts M e as u re m e n ts R e co rd th e - th e l e n g th fro m th e cro tch - th e l e n g th fro m th e m ed i al - th e l e n g th fro m th e “fal l - away” - th e l e n g th of - th e l e n g th th e of to th e j oi n t to po i n t co n tral ate ral th e m e d i al line limb co n tral ate ral j oi n t th e to fro m limb fi g u re3 an d an n ex l i n e, stu m p I, th e s tu m p en d , th e cro tch to fro m th e l2 th e m e d i al g ro u n d , j oi n t th e ci rcu m fe re n ce at th e l e ve l th e ci rcu m fe re n ce at th e “fal l - away”, co n tral ate ral limb is th e of s i te of th e an m ed i al j oi n t l i n e, C, C2 am pu tati o n , s tate th e l eve l s h ap e C yl i n d ri cal /co n i cal /bu l bo u s G e n e ral En d of ti bi a N ot pro m i n e n t/pro m i n e n t En d of fi bu l a N ot pro m i n e n t/pro m i n e n t of th e s tu m p Am pu tati o n H e al e d /u n h e al e d s car M o bi l e /ad h e re n t S ki n G e n e ral barri e r S e n s ati o n No i n tact/s ki n b arri e r n o rm al /s e n s ati o n ad d i ti o n al not i n tact i m pai re d s carri n g /ad d i ti o n al s carri n g C i rcu l ati o n Col ou r of N o rm al /cyan o ti c/o th e r s ki n Te m pe ratu re ( to th e e xam i n i n g h an d ) S o ft d i s co l o rati o n Warm /co l d N o n e /p re s e n t/e xce s s i ve Oe d e m a ti ss u e s of th e s tu m p Am o u n t Ad e q u ate /i n ad e q u ate /e xce s s i ve C o n s i s te n cy N o rm al /fl abby/i n d u rate d S i g n i fi can t pai n S po n tan e o u s N o /ye s pai n Te n d e rn e s s N o /ye s P n fu l N o /ye s n e u ro m a P h an to m P n J oi n t ( g e n e ral i z e d ) /ye s ( l o cal i z e d ) N o /ye s pai n afte r N o /ye s e xe rci s e fu n cti o n Hip R an g e M u scl e of N o rm al /abn o rm al m o ve m en ts No po we r s i g n i fi can t ( S pe ci fy: fl e xi o n /e xte n s i o n re d u cti o n /s i g n i fi can t or ab d u cti o n /ad d u cti o n ) re d u cti o n N o rm al /i m pai re d S tabi l i ty Kn e e R an g e M u scl e of m o ve m en ts N o rm al /abn o rm al po we r No S tabi l i ty P n ) in I f th e s i g n i fi can t ( S pe ci fy: fl e xi o n /e xte n s i o n ) re d u cti o n /s i g n i fi can t re d u cti o n N o rm al /i m pai re d pro xi m al stu m p j o i n ts was m easu red N o /ye s wi th th e pati e n t in an y A) Z5 en d , Z4 - th e 6, m e as u re m e n ts ? ) - If S ki n (see re co rd e d fo l l o wi n g g ro u n d , S tu m p be am pu tati o n s po s i ti o n o th e r th an s tan d i n g , s tate th e pati e n t’ s p o s tu re Z3 line to th e I S0 48 - : 9 ( E ) C ro tch - M e d i al j o i n t line l e ve l Fal l - away S tu m p e n d - G ro u n d l e ve l Fi g u re - Referen ce l evel s an d m easu rem en ts for tran s- ti bi a1 am pu tati on s 1 I S0 48 = : 9 ( E ) Tabl e - D escri ptors for an kl e (Sym e’ s) to d i sarti cu l ati on s I e s cri pto r S tatem e n ts Vl e as u re m e n ts R e co rd th e - th e l e n g th fro m th e cro tch - th e l e n g th fro m th e m ed i al - th e l e n g th of - th e l e n g th of fi g u re4 an d an n ex A) to th e j oi n t co n tral ate ral th e m ed i al line limb co n tral ate ral to j oi n t th e fro m th e limb l i n e, s tu m p cro tch fro m Z5 en d , th e to Z6 th e m e d i al g ro u n d , j oi n t Z4 th e ci rcu m fe re n ce th e minimum - th e m axi m u m at th e m ed i al ci rcu m fe re n ce d i stal co n tral ate ral limb of j oi n t th e ci rcu m fe re n ce is th e si te of l i n e, of an C, stu m p, th e C4 s tu m p, am pu tati o n , Cs s tate th e l e ve l s h ap e G e n e ral C yl i n d ri cal /bu l bo u s Bon e N ot Ski n th e - th e 7, m e as u re m e n ts ? ) - If (see re co rd e d fo l l o wi n g g ro u n d , Stu m p be of th e pro m i n e n t/pro m i n e n t s tu m p Am pu tati o n H e al e d /u n h e al e d s car M o bi l e /ad h e re n t S ki n G e n e ral barri e r S e n s ati o n No i n tact/s ki n b arri e r n o rm al /s e n s ati o n ad d i ti o n al n ot i n tact i m pai re d s carri n g /ad d i ti o n al s carri n g Ci rcu l ati o n Col ou r of N o rm al /cyan o ti c/o th e r s ki n Te m pe ratu re ( to th e e xam i n i n g h an d ) N o n e /pre s e n t/e xce s s i ve Oed em a So ft d i s co l o rati o n Warm /co l d ti s s u e s of th e s tu m p Am o u n t Ad e q u ate /i n ad e q u ate /e xce s s i ve C o n s i s te n cy N o rm al /fl abby/i n d u rate d Si g n i fi can t pai n S po n tan e o u s N o /ye s pai n Te n d e rn e s s N o /ye s P n fu l N o /ye s n e u ro m a P h an to m P n J oi n t ( l o cal i z e d ) N o /ye s pai n afte r ( g e n e ral i z e d ) /ye s N o /ye s e xe rci s e fu n cti o n Hip R an g e M u scl e of N o rm al /abn o rm al m o ve m e n ts No po we r s i g n i fi can t ( S pe ci fy: fl e xi o n /e xte n s i o n re d u cti o n /s i g n i fi can t or ab d u cti o n /ad d u cti o n ) re d u cti o n N o rm al /i m pai re d S tabi l i ty Kn e e R an g e M u scl e of N o rm al /abn o rm al m o vem e n ts No p o we r ) If in th e ( S pe ci fy: fl e xi o n /e xte n s i o n ) re d u cti o n /s i g n i fi can t re d u cti o n N o rm al /i m pai re d S tabi l i ty P n s i g n i fi can t pro xi m al stu m p N o /ye s j o i n ts was m e as u re d wi th th e p ati e n t in an y po s i ti o n o th e r th an s tan d i n g , s tate th e pati e n t’ s po s tu re Z3 line to th e Cl i Cro tch l e ve l I / - - - - M e d i al M n i m u m ci rcu m fe re n ce M axi m u m d i s tal l e vel en d - l e vel - G rou n d Fi g u re i n e l e ve l l e ve l - ci rcu m fe re n ce Stu m p j oi n t - Referen ce l evel s an d m easu rem en ts for an kl e l e ve l d i sarti cu l ati o n s I S0 8548-2: 993(E) Tabl e - D escri pto rs fo r parti al U l e as u re m e n ts R e co rd th e - th e l e n g th fro m th e h eel - th e l e n g th fro m th e an te ri o r - th e l e n g th of S tu m p fo l l o wi n g an y (see fi g u re 5) re co rd e d m e as u re m e n ts: th e pl an e co n tral ate ral s i g n i fi can t an d co n tral ate ral N ot pro m i n e n t/pro m i n e n t l e n g th to ti bi a1 th e s tu m p p l an e fo o t fro m d i s cre p an cy to en d th e th e h eel b e twe e n pl an e , stu m p pl an e th e Z8 en d to pl an e , th e s e g m e n ts l i m bs s h ap e Bon es S ki n be am pu tati on s l e s cri pto r R e co rd to fo ot S tatem e n ts of th e s tu m p Am pu tati o n H e al e d /u n h e al e d s car M o bi l e /ad h e re n t S ki n G e n e ral barri e r S e n s ati o n No i n tact/s ki n b arri e r n o rm al /s e n s ati o n ad d i ti o n al n ot i n tact i m pai re d s carri n g /ad d i ti o n al s carri n g Zi rcu l ati o n Col ou r of N o rm al /cyan o ti c/o th e r s ki n Te m pe ratu re ( to th e e xam i n i n g d i s co l o rati o n Warm /co l d N o n e /p re s e n t/e xce s s i ve Oed em a S o ft h an d ) ti s s u e s of th e s tu m p Am o u n t Ad e q u ate /i n ad e q u ate /e xce s s i ve C o n s i s te n cy N o rm al /fl abby/i n d u rate d S i g n i fi can t pai n S po n tan e o u s pai n N o /ye s Te n d e rn e s s N o /ye s P n fu l N o /ye s n e u ro m a P h an to m P n J oi n t ( l o cal i z e d ) N o /ye s pai n afte r ( g e n e ral i z e d ) /ye s e xe rci s e N o /ye s fu n cti o n Hip R an g e of M u scl e m o ve m en ts N o rm al /abn o rm al No po we r s i g n i fi can t ( S pe ci fy: fl e xi o n /e xte n s i o n re d u cti o n /s i g n i fi can t re d u cti o n N o rm al /i m pai re d S tabi l i ty Kn e e R an g e of M u scl e m o ve m en ts N o rm al /abn o rm al No po we r s i g n i fi can t ( S pe ci fy: fl e xi o n /e xte n s i o n ) re d u cti o n /s i g n i fi can t re d u cti o n N o rm al /i m pai re d S tabi l i ty An kl e R an g e of M u scl e m o ve m en ts S tabi l i ty P n Fo o t in N o rm al /abn o rm al N o s i g n i fi can t po we r ( S pe ci fy: fl e xi o n /e xte n s i o n ) re d u cti o n /s i g n i fi can t re d u cti o n N o rm al /i m pai red pro xi m al j o i n ts N o /ye s re m n an t G e n e ral Oth e rwi s e P l an ti g rad e N o /ye s O th e r N ot d e fo rm i ti e s n o rm al /abn o rm al s i g n i fi can t/s i g n i fi can t ( s pe ci fy) ( s pe ci fy) or ab d u cti o n /ad d u cti o n ) Z, to e of pl an e , th e Z9 affe cte d I S0 -H eel 48 = : 9 ( E ) p l an e - An ter i or ti bi a1 pl an e - Stu m p en d pl an e - -, - - To e pl an e / I I I ‘ \A / -z - -c- (N on - am pu tated foot) - - Fi g u re - Referen ce pl an es an d m easu rem en ts fo r parti al foo t am pu tati o n s I S0 48 = : 9 ( E ) An n e x A (i n fo rm ati ve) E xpl an ato ry Am1 Th e n o tes for d escri pto rs A G en eral m n u se d el em en ts in an y d escri pti o n sh ou l d facto rs reco rd ed a) stu m p m easu rem en ts; b) stu m p sh ape; d th e a) tabl e s to C i rcu l ati o n M an y i n cl u d e: in cern i n g bu t wh eth er it is th e th e en o u g h ski n is ci rcu l ati on to might wel l be state: n o rm al , cyan o ti c or o th erwi se d i scol ou red ; co n d i ti o n of th e ski n of th e b) stu m p; wh eth er it is warm to th e exam i n i n g h an d or n ot; an d d) th e co n d i ti o n of th e ci rcu l ati on e) th e co n d i ti o n of th e soft f1 pai n I in th e stu m p; c) ti ssu es of th e wh eth er o ed em a E xcessi ve force pro xi m al 9) j oi n t fu n cti o n , to i n cl u d e is presen t stu m p; ran g e of m o ve- th e d ay or wi th a oed em a pati en t su ch th at is to seen take on e o ff to be th e wou l d th at wh i ch pro sth esi s h esi tate to wou l d d u ri n g fi t th e th e pati en t prosth esi s m en t; rel evan t h) d i m en si o n s of th e co n tral ateral Am l i m b Th e A M e as u re m e n ts Th e no m easu rem en ts speci al m em ber m en ts of th e u sed ad eq u ate ch osen is cl i n i c no are an d m ore of Th e th an th e n o n -i n vasi ve, can team d escri pti o n soft term s eq u i pm en t, is be of n ecessary stu m p an d i ts ti ssu es of th e by an y to g i ve an proporti on s Am bu l bo u s of an d provi d ed th e i n terpreted In ad d i ti o n is unduly th e cyl i n d ri cal word s too it sh ape is are restri cted Bu l bo u s is “cyl i n d ri cal ” l i teral l y, th ey i m po rtan t to or are to record i cal , sel f- evi d en t “con i cal ” eq u al l y P n as an an d , are en ti ty of ever so u rce, pai n an d fro m th e wi th th e req u i rem en t d etai l h eal ed bu t th e it ski n of th e g en eral th e ski n to an d ad d i ti o n al th e wh eth er wh eth er on l y in si g n i fi can t to after pai n fu l exerci se is ph an tom d escri be Th e spo n tan eo u s ten d ern ess, pai n d i ffi cu l t m easu rem en t pai n fro m n eu rom a, to be sen sati on s an d is presen ce or wh at- ph an to m d i sti n g u i sh ed an d is to be record ed n ot wh eth er an y bon e Am J oi n t fu n cti o n prom i n en t d escri bi n g n ote d escri bed d escri pti ve S ki n si m pl y are co n si sten cy al ways of co m m on j oi n t m en t, po wer is be to si tu ati o n ski n h as barri er n o rm al d escri be sh o u l d be m obi l e, scarri n g stu m p, th e is sh o u l d is sen sati on n o ted is co n cern ed su ffi ci en t or n o t, Th ere i n ci si o n wh eth er oth erwi se be It i n tact operati on reco rd ed or on e Th e th e fu n cti o n an d or in term s stabi l i ty, n oted tractu res) In is i n capabl e P ro xi m al A stu m p an d P n l arg el y S h ape D escri pti on s th e m easu re- absen ce A of am ou n t req u i re m ad e n u m ber ti s s u e s So ft an d Abn o rm al i ti es excessi ve of ran g e th e of m o ve- presen ce of of m ovem en t m o vem en t pai n (e g is al so stu m p can to be record ed to an d is in no scar presen ce Am C o n tral ate ral limb an y is of In o rd er l ated to th at th e n eed s som e l en g th from th e d escri pti on pati en t m i n i m al th e as of a wh ol e, d i m en si o n al cro tch to th e th e th e d escri pti on , g rou n d be co n tral ateral e g re- limb th e This page intentionally left blank This page intentionally left blank This page intentionally left blank I S0 8548- 2: U DC 61 6- 28 471 73 D escri ptors: P ri ce 93 (E ) based m e d i ci n e , on pag es pro sth eti c d e vi ce s, l o wer l i m bs, d efects, d e scri pti on