The Anatomy of a Prosthetic Leg

Legs are all individual, with each component being picked to suit the owner – the activity level, what you want to do with the foot, any sore areas, personal taste etc.

I currrently have a carbon fibre foot called the Esprit, made by Endolite. There are a huge variety of feet for different activities and for different activity levels.

This is my current foot:

http://www.endolite.co.uk/products/esprit

It’s put into a foot shell, which means it fits nicely into shoes and is the same size as my left foot. Having the same sized feet is a luxury that I’ve never experience before and makes buying and wearing shoes far easier than it has ever been! The leg is set up to a pair of shoes of my choice (trainers) and then I use foam wedges inside other shoes to keep the angles roughly correct. I can wear more or less any flatish shoes at the moment and you can get ankles that move by pressing a button, enabling you to wear different shoes with different heel heights. Wearing shoes with a difference in heel height of more than a few mm to what it is set up to would throw me off balance and affect my gait.

Please excuse the chipped nails!

Please excuse the chipped nails!

The crucial and hardest part to get right is the socket. You can have the most expensive, high tech foot in the world, but if the socket isn’t right, that amazing foot will be of no use to you at all. It’s the interface between my remaining bit of leg and the prosthetic leg, so it’s where I weight bear and is where the majority of problems arise. These problems can range from small blisters, to open wounds and skin infections.

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It is made by taking a plaster cast mould of my residual limb, then a transparent check socket is made to check the fit, then if everything is fine, the final leg is made. My current leg is made of a carbon fibre outer shell and a plastic inner.

The inside of my current socket

The inside of my current socket

To put it on, I first put on a gel liner which is thick and squidgy.

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Then, as I’ve mentioned in earlier posts, my leg is constantly changing shape and getting smaller, or swelling occasionally. To compensate for those changes the fit is controlled by socks. They are normal tube socks that are either thick or thin. Cutting the toe section off makes them into half socks, so when the top half changes but the bottom remains the same, that can still be managed by padding the top half out, stopping the leg from “bottoming out” – where weight goes through the bottom of the socket.

Socks!

Socks! (Normally plain white but I made them colourful…)

I push my leg into the socket, expelling the air as I do so through the top and through the valve. Then I roll up a sleeve creating a seal. I’ve had trouble with sleeves getting holes in after a couple of days and have had no end of problems with the valve leaking, not being fixed properly or having dirt in it. This is the cause of most of my frustrations and when it’s not working air leaks out and my leg isn’t held securely, so it can move a bit on weight bearing causing problems.

One way valve

One way valve

However, now I’ve got a sleeve with a gaiter that covers the top of the socket and my knee area to try and reduce holes or tears from the edges of the socket.

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Leg with sleeve rolled up

Leg with sleeve rolled up

Leg and sleeve on

Leg and sleeve on

It worked brilliantly for about three weeks, then this happened when I knelt down and it cut right through the gaiter and the sleeve. Luckily, the gaiter can be twisted so combined with the sleeve, it still creates a seal.

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Obviously mine doesn’t look very leg like at the moment. You can get foam covers with stockings on to make it leg shaped, and you can get silicone ones that look a bit more realistic but take longer to make. I have a constant dilemma about whether or not I want it covered and looking leg like, and change my mind about it on a day to day basis. I’d like it to look leg shaped under trousers and it would be very handy for riding, skiing etc. when boots are made to fit a real leg, rather than a pole (I currently wrap lots of thick socks around it to pad it out and give boots something to grip onto). However, I’m not keen on the stocking covered look, I think it’s a bit strange and would rather it look obviously fake than weird. At the moment, I am getting through new sockets so quickly that by the time I’d waited a few weeks for a leg to be covered in silicone, it wouldn’t be fitting well, so there isn’t a lot of point. For now, I’m going for function over appearance, but in time I think I’d like to have a decently covered leg. Maybe…

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