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Limb Loss and Limb Differences: Terms You Need to Know

Limb Loss and Limb Differences: Terms You Need to Know

by | Apr 19, 2023 | Prosthetics & Orthotics

There are many different words that are used to describe limb loss and limb differences. These medical terms allow patients and their families to effectively communicate with their health care provider. This glossary of words and phrases will help you learn some of the terms used to describe limb differences and limb loss. 

Acquired amputation: The surgical removal of a limb(s) due to complications associated with disease or trauma.

Alignment: The position of the prosthetic socket in relation to the foot and knee.

Amputation: The surgical removal of all or part of a limb due to disease or injury.

Atrophy: A wasting away of a body part, or the decrease in size of a normally developed extremity or organ, due to a decrease in function and/or use.  After amputation, for example, some of the muscles in the remaining (residual) limb often atrophy over time since they are not being used as actively as before. 

Bilateral: Occurring on both sides, as in loss of both arms or both legs.

Check or test socket: A temporary socket, often transparent, made over the plaster model to aid in obtaining proper fit and function of the prosthesis.

Congenital limb deficiency: An absent, shortened or abnormal limb present at birth.

Custom fit: Fitting an individual with a device that is made from a scan or cast of the individual’s unique anatomy and fabricated according to the needs of that individual.

Extremity: A limb of the body, as in upper or lower extremity.

Gait: Referring to the manner or style of walking.

Gait training: Part of ambulatory rehabilitation, or learning how to walk, with your prosthesis or prostheses.

Lower extremity (LE): Relating to the leg.

Nylon sheath: A shear nylon interface worn close to the skin on the residual limb to reduce friction and to help wick away perspiration from the surface of the skin.

Orthosis: A external device that is used to protect, support or improve function of parts of the body that move, i.e., braces, splints, slings, etc. It can include anything from an arch support to a spinal orthosis. Orthoses is plural.  

Orthotics: The profession of providing devices to support and straighten the body (orthoses).

Orthotist: A skilled professional who designs, fabricates, fits and maintains orthotic devices that are prescribed by a physician, generally as a collaboration regarding the biomechanical goals of the orthosis and the patient’s needs.

Proximal Femoral Focal Deficiency (PFFD): Proximal Femoral Focal Deficiency is a complex congenital difference in which the femur (thigh bone) is short or even mostly absent, making that leg significantly shorter than normal. PFFD includes a wide range of severity and multiple treatment options based on how big the length difference is, the child’s age and development and whether other parts of the limb or other extremities are involved.

Prosthesis/prosthetic device: An artificial limb, usually an arm or a leg, that provides a replacement for the amputated or missing limb. Prostheses is plural. Generally, the word prosthetic should be used as an adjective. If referring to an individual’s replacement artificial limb, it should be called a prosthesis not just a prosthetic.

Prosthetics: The profession of providing those with limb loss or with a limb difference (congenital anomaly) a functional and/or cosmetic restoration of missing or underdeveloped human parts.

Prosthetist: A person involved in the science and art of prosthetics; one who designs and fits artificial limbs.

Pylon: A structural part, usually a metal alloy or composite tube, that provides a relatively light weight support structure between other components of the prosthesis such as between the socket or knee unit and the foot.

Residual limb: The portion of the arm or leg remaining after an amputation, sometimes referred to as a stump or residuum.

Revision: Surgical modification of the residual limb.

Socket: Part of the prosthesis that fits around the residual limb.

Symes: a type of surgery for amputation through the ankle joint, generally retaining the heel pad so that the residual limb can tolerate more loading through that area.

Upper extremity (UE): Relating to the arm.

Van Nes (Rotationplasty): Rotationplasty is a surgical reconstruction occasionally indicated for bone tumors near the knee or for PFFD.  There are many variations of this surgery, but in general the limb is shortened, and the anatomical ankle and foot are moved up to about knee level and rotated around so the heel faces forward.  Once healed the person with a rotationplasty can eventually be fitted with a “below knee” prosthetic leg where the foot rests inside a custom socket and the rotated ankle is protected with metal joints and a thigh cuff.   The ankle then controls the prosthesis much like a knee but with slightly less overall range of motion.  

Share Your Story: Parker and the Superhero Leg

Share Your Story: Parker and the Superhero Leg

by | Jan 16, 2019 | Clubfoot & Foot Disorders

Meet Parker, a patient who is treated in our Prosthetics and Orthotics department. Learn more about his journey below.

Blog written by Parker’s father, James, of Flower Mound. 

In August 2012, our family traveled to Nanchang, China to adopt our two youngest sons, Parker and Xander. Overnight, our family of four expanded to six and we were fortunate to be blessed with two of the sweetest, most resilient boys you will ever meet. As you can imagine, it was a life-changing event that we will never forget.

Prior to our journey to China, we were connected with Texas Scottish Rite Hospital for Children as we prepared for Parker and Xander’s arrival here in the U.S. Both boys were born with limb differences and we knew that we would need to find a health care provider that could handle their special needs. In Parker’s case, we were particularly curious to learn what options were available for him, since he was born without his right femur and tibia. He was unable to walk in the traditional sense.

From our very first consultation onwards, the Scottish Rite Hospital staff could not have been more accommodating – from walking us through how the care process would work to answering our questions about artificial limbs. Over the years, we had heard many glowing stories from friends and acquaintances describing what the hospital meant to them and their families, but none of this really hit home until we got to experience all this for ourselves.

Once we arrived back home to the U.S., Parker was pretty overwhelmed with all the changes. At only 20 months, he had already been whisked away from the only home he knew, an orphanage in Nanchang. Everything and everyone he had ever known was gone and he was then inserted into a crazy family, which consisted of a new Mom and Dad, two older siblings and a younger sibling that was going through a similar adjustment period. Add into the mix a couple of large Great Danes and you basically have a recipe for constant chaos around the Wood house.

Although he was (and still is) amazingly resilient, it was a huge adjustment. While in China, he began to learn a few words in Mandarin and now he was challenged with learning a new language. Communication was difficult and further exasperated by all the complex emotions he was feeling. He was very shy, uneasy in public and struggled a lot with separation anxiety.

During this period, Parker had his first visits to our local pediatrician and, while she is fantastic, he was absolutely terrified – you could literally feel the heat waves coming off his body. We feared the worst when the time came to start our visits at Scottish Rite Hospital. Since he had been born with a partial foot, the process was difficult and would not be as easy as just fitting him for a prosthesis. In order to make things work, he would need to have his partial foot removed or work around it. This was not an easy decision for us since he used that partial foot to pseudo-walk on his knee.

When the time came for the surgery, we really didn’t know what to expect. Parker’s visits to the hospital were successful and he had already taken pretty well to Dr. Herring and “Dr. Kara.” Surgery and overnight visits were something we honestly weren’t sure he was prepared for emotionally

What actually transpired was beyond any of our expectations.

From the moment he arrived, we were greeted with countless friendly faces in his room. For a kid who normally hated large crowds, he really ate it all up. It’s hard to imagine having a fun time during major surgery, but I daresay he did – at least as much as you can when having your foot amputated. Probably the best thing we can say about Scottish Rite Hospital is that they took a really scary event in his young life and turned it into a positive memory. After the surgery, he was made to feel like a celebrity, and he left a different kid in so many ways.

patient being diagnosed
patient with a robot behind him

The entire experience was truly remarkable.

In the years that have followed, Scottish Rite Hospital has become a routine part of Parker’s life. I’ve never met a kid that’s more excited to go to the doctor and he loves to point out the hospital when we drive by. Seeing him walk for the first time was miraculous and we’ll never forget the smile on his face when he discovered how to walk on his own. He’s been the talk of the playground at school – but in a good way. We hear kids all the time telling their parents that they “wish they could have a cool leg like that” or “Mom! Look! That kid has a Transformer leg!” That’s not to say that it’s all been sunshine and roses of course, but it helps. Getting to meet other kids with similar limb differences and being able to see firsthand how others have been able to use their prosthetic legs to run and dance has made it so much easier for him to just be a kid and have a normal life. 

Parker is a confident kid who now has the ability to get out there and try activities that his siblings have enjoyed. He has tried gymnastics, soccer, t-ball and is about to give basketball a whirl. He may not always have the speed that other kids have, but he is able to get out there, compete and surprise kids with his craftiness. It’s pretty incredible to watch.

As parents, we’re eternally grateful for all the wonderful work that Scottish Rite Hospital has done, not only for our own children, but also for countless children throughout the U.S. and beyond. It’s a truly magical place.

Parker’s Superhero Leg from Scottish Rite for Children on Vimeo.

DO YOU HAVE A STORY? WE WANT TO HEAR IT! SHARE YOUR STORY WITH US.