Learn to care for your residual limb after surgery with tips on post-op limb positioning for above and below-knee amputation.

How to position your residual limb after surgery | Össur South Africa

How to position your residual limb after surgery

Proper care and attention to your residual limb are key to achieving comfort, preventing irritation, and ensuring a secure fit with your prosthesis. Here are some foundational practices:

After a leg amputation, it is very important to keep your residual limb positioned correctly to prevent complications such as muscle contracture. Proper positioning can also help you maintain a full range of motion in your remaining joints, and promote good blood circulation.

Whenever possible, avoid putting your residual limb in a flexed (bent) position. For example, do not support your limb on the handle of a crutch, hang it over the side of a bed or keep the knee joint flexed when sitting on a bed. Keeping the knee or hip joint flexed for long periods may disturb blood circulation and cause muscle contracture.

For below-knee amputations, keep your residual limb supported and the knee straight when seated. In a wheelchair, you can use an “amputee board,” and on a regular chair you may use a second chair of the same height to support your residual limb.

For both below-knee and above-knee amputees, lying flat on your stomach stretches the muscles at the front of your hips, which prevents contractures from developing after being seated for too long. You may want to spend 15 to 20 minutes in this position several times per day, to help prevent contracture complications from developing.

Resting your residual limb in an elevated position can reduce pain and swelling. You may want to strive to keep your limb straight, especially when resting it on something like a cushion where it may inadvertently bend. A piece of foam cut to size and in the right shape can work well to elevate and support the residual limb while keeping it straight.

Positioning your residual limb while relaxing

After amputation, the skin on your residual limb will be sensitive to the touch, and eventually, when the prosthesis is fitted and you are starting to walk, it will be subjected to forces it was never intended to cope with. To develop a tolerance for these forces you may need to desensitise your residual limb. Please note that for some people, desensitisation techniques like those suggested here may also decrease phantom pain. Talk with your prosthetist or other members of your medical team for suggestions on how to perform desensitising exercises on your residual limb. 

Sometimes as your body heals, scar tissue adheres to the soft tissues and bone beneath it. This can cause skin problems and pain when you are wearing a prosthesis. Scar tissue can limit movement and cause discomfort. Lightly massaging the scar area in circular motions can help keep the tissue flexible and improve skin comfort when wearing a prosthetic liner. Ask your medical or rehabilitation team for suggestions about at-home scar mobilisation techniques that may be helpful to you.

Other skin problems can make using a prosthesis uncomfortable or, in some cases, even impossible. Regularly inspecting your residual limb can help you identify skin problems early, before they become severe.

Use a mirror to check your residual limb from every angle.

In the beginning, check your residual limb whenever you change your dressing or take off your prosthesis.

Later, one daily inspection after washing your residual limb should be enough.

NOTE: if you lost a limb due to vascular disease such as diabetes, proper care of your residual limb, including regular inspections, is even more important, as skin breakdown could lead to another amputation.

You will want to clean your socket daily, ideally with a cleaning solution recommended by your prosthetist.

Your residual limb must fit snugly but comfortably in the socket. If the socket becomes loose, or if there are pressure areas, your skin might get damaged and your gait will be affected. Talk to your prosthetist if you experience changes in how your socket is fitting.

During rehabilitation and beyond, it is important to eat as healthily as possible and keep your weight stable. Maintaining a consistent, healthy weight is important for everybody, but for people who have prosthetic limbs it is even more important for the following reasons:

To maintain the proper fit of the prosthetic socket attached to your residual limb,

To reduce the energy required to use your prosthesis,

To prevent or reduce secondary conditions, such as back pain, and

To manage the risk of medical conditions such as diabetes and high blood pressure

The importance of controlling your weight

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How to position your residual limb after surgery

Positioning your residual limb while relaxing

Desensitising the residual limb

Scar mobilisation

Inspection of the residual limb

Inspection of the socket-liner interface

The importance of controlling your weight