A comfortable socket and a balanced foot are the twin objectives of all partial-foot prostheses. The design choice will depend on the level of amputation, the condition of the remaining soft tissues, and the ankle status.
The use of above-ankle designs should be limited to patients who require assisted ankle function, who experience difficulties with suspension, or who cannot tolerate full plantar weight bearing.
New materials and fabrication techniques have permitted the development of both cosmetically and functionally improved designs that may make partial-foot amputation a practical alternative to higher amputation where pathology allows.
Prosthetic, Orthotic, and Footwear Interventions
FINGER AMPUTATION/TOE AMPUTATION
SILICON FINGER
Partial foot
Toe fillers are used alone or attached to an insole
Toe fillers and insoles are designed to be worn with footwear. Because toe fillers and insoles do not encompass the residuum, they rely on the shoe to maintain their position with respect to the residuum. Extra-depth shoes or low-top boots often are used to accommodate the orthosis and provide adequate suspension.
SILICON PROSTHESIS – A silicone cosmetic prosthesis can provide a cosmetically acceptable restoration of a partially amputated foot, usually when the amputation is at or distal to the midfoot. It is possible to match the skin color, shape, and alignment of the toes and nails to those of the contralateral limb, prescribed usually for office going, ladies and for those who are looking for a cosmetically acceptable solution.
CARBON FIBRE PLATE – The socket material is a laminated glass-fiber composite. A prosthetic foot has been bonded to the socket to replace the lost forefoot. The bivalve socket allows donning, given the bulbous distal end of the residual limb.commonly prescribed for high activity users.
ANKLE FOOT ORTHOSIS WITH FILLER
An ankle-foot orthosis is often provided after a transmetatarsal or tarsometatarsal (Lisfranc) amputation (Figures 2 and 6). Variations in materials, footplate lengths, trim lines, and articulation at the ankle mean that ankle-foot orthoses with a similar appearance can serve quite different mechanical functions and treatment goals. An ankle-foot orthosis is often used in conjunction with other interventions to achieve complex treatment goals. For example, an insole that distributes pressure away from the sensitive distal end of the residuum can be used in combination with an anterior-shell ankle-foot orthosis to control the progression of the leg over the stance foot