A prosthetic device for use in rehabilitating a patient after a limb reduction surgery, allows the patient to begin learning to walk with a bendable knee joint that is typically used with a more permanent, later provided prosthetic. The inventive prosthetic device includes an adjustable first portion that is secured about a portion of the amputated limb and a second portion that provides axial and radial clearance between the terminal end of the amputated limb and the interior of the prosthetic sleeve. The second portion of the prosthetic sleeve also includes a radially defined opening that assists a patient or medical personnel in observing the terminal end of the amputated limb during the post-operative healing process.

BACKGROUND OF THE INVENTION 
This invention relates generally to prosthetic devices and, more 
specifically, to a prosthetic device for use immediately after a limb 
reduction surgery until the patient is fitted with a more permanent 
prosthesis. 
Medical and technological inventions have provided significantly enhanced 
prosthetic devices for patients that have had limb reduction surgery. 
There is still a need, however, for a more effective immediate 
post-operative prosthesis that can be used by patients that have had an 
above-the-knee amputation surgery. Typically, after an above-the-knee 
amputation surgery, the patient is fitted with an immediate post-operative 
prosthesis that the patient uses to begin to learn to walk with the newly 
amputated limb. 
A significant disadvantage associated with conventional immediate 
post-operative prosthetic devices is that they are functionally different 
from the more permanent prosthesis later provided to the patient. 
Conventional immediate post-operative prosthetic devices for 
above-the-knee amputation patients do not have a bendable knee joint, 
whereas permanent prosthetics have bendable knee joints. Therefore, 
shortly after surgery the patient begins to learn to walk with the reduced 
limb using a prosthetic device that is not the same as the patient will be 
provided on a more permanent basis at a later time. This presents certain 
difficulties including a tendency for the patient to develop an unnatural 
walking pattern or gait that can cause undue strain on the patient's hip 
joint. Further, the patient typically has to "re-learn" to walk with 
later-provided prosthetic devices, which include a temporary and 
definitive prosthetic that have a bendable knee joint. 
Prior to this invention only the temporary and definitive prosthetics were 
provided with bendable knee joints. A more permanent prosthetic cannot be 
used in a post-operative setting because design criteria are different. 
For example, permanent prosthetics ideally provide total contact between 
the reduced limb and the prosthetic. Conversely, an immediate 
post-operative prosthetic preferably avoids contact between the end of the 
reduced limb and the prosthetic. Shortly after surgery, Edema is 
presented, the point of amputation is extremely sensitive and any contact 
with a prosthetic while walking would cause the patient to experience 
discomfort and could interfere with the healing process. Additionally, 
such contact could cause the suture line to separate causing undesirable 
drainage, which lengthens the healing process. 
Accordingly, it is desirable to provide an immediate post-operative 
prosthetic device that is adaptable to be used with a bendable knee joint. 
This provides significant advantages in that the patient learns to walk 
with a more normal gait during rehabilitation immediately after the 
surgery, which avoids the patient developing bad gait patterns such as hip 
hiking, vaulting, or circumducting of the hip joint or prothesis. 
Accordingly, the risk of the patient developing a walking pattern that 
causes undue strain on the hip joint is reduced. 
SUMMARY OF THE INVENTION 
In general terms, this invention is a prosthetic device for use after limb 
reduction surgery that includes a generally cylindrical sleeve having an 
axial opening at a first end for receiving an amputated limb. The 
generally cylindrical sleeve is closed at a second axial end, which is 
adapted to be connected to a bendable knee joint. The cylindrical sleeve 
has a first portion extending from the first end toward a longitudinal 
midsection of the sleeve. The first portion has a first inner surface 
circumference. The sleeve also has a second portion extending between the 
first portion and the second end. The second portion has a second inner 
surface circumference that is greater than the first inner surface 
circumference so that the amputated limb contacts only the first inner 
surface and the terminal end of the amputated limb does not contact the 
second inner surface of the second portion. 
In another embodiment, the first portion includes a longitudinal split 
extending along the length of the first portion. An adjustment member is 
provided for adjusting the spacing defined by the longitudinal split such 
that the first inner surface circumference of the first portion is 
adjustable. The second portion of the sleeve also includes a radially 
defined opening for viewing at least the terminal end on the amputated 
limb without removing the limb from the sleeve. 
In the most preferred embodiment, the longitudinal split on the first 
portion extends between the axial opening at the first end of the sleeve 
and the radially defined opening in the second portion of the sleeve. 
These and other features and advantages of a prosthetic device designed 
according to this invention will become apparent to those skilled in the 
art from the following detailed description of a preferred embodiment. The 
drawings that accompany the detailed description can be briefly described 
as follows. 
BRIEF DESCRIPTION OF THE DRAWINGS 
FIG. 1 is a perspective view of a post-operative prosthetic device for use 
by an above-the-knee amputee designed according to this invention. 
FIG. 2 is a top elevational view of the embodiment of FIG. 1. 
FIG. 3 is a top elevational view of the embodiment of FIG. 2 in an adjusted 
position. 
FIG. 4 is a cross-sectional view taken along the lines 4--4 of FIG. 3.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
FIG. 1 is a perspective illustration of an immediate post-operative 
prosthetic device 20 for use with an amputated limb 22. The illustrated 
device is particularly adapted for a patient that has undergone a limb 
reduction surgery resulting in an above-the-knee amputation. The 
prosthetic device 20 includes a sleeve 24 that is at least partially 
received about the limb 22. The sleeve 24 is preferably made of a 
copolymer plastic, plastic polypropylene or a polyester resin. In one 
preferred embodiment, the sleeve 24 is vacuum formed. It is also possible 
to use a conventional thermoforming process by heating the plastic 
material and forming it over a mold. 
The sleeve 24 includes a first portion 26 and a second portion 28. An axial 
opening 30 allows the sleeve 24 to be received about a portion of the limb 
22. The axial end of the sleeve 24 that is opposite from the axial opening 
30 is closed at 32. The end 32 is adapted to be connected to a 
conventional, bendable knee joint (partially illustrated diagrammatically 
at 33). Prior to this invention, it was not possible to provide a patient 
with an immediate post-operative prosthetic that includes a bendable knee 
joint that is the same (or essentially the same) as a knee joint that 
later will be included in a more permanent prosthetic. 
The second portion 28 of the sleeve 24 includes a radially defined opening 
34. The radially defined opening 34 provides the significant advantage of 
allowing the patient or medical personnel to observe the terminal end of 
the limb 22, which would include the suture point at the point of limb 
reduction. This enables the patient or medical personnel to determine 
whether drainage has occurred and the dressing on the reduced limb 22 need 
be changed, for example, without removing the limb 22 from the sleeve 24. 
The opening 34 also allows one to visually observe any undesirable contact 
between the limb and sleeve which can cause undue pressure on the suture 
line. 
As best illustrated in FIGS. 1 and 4, the interior volume of the second 
portion 28 is great enough such that an axial and radial clearance exists 
between the terminal end of the limb 22 and the inner surface of the 
second portion 28. It is important to maintain clearance between the end 
of the amputated limb 22 and the prosthetic device because the end of the 
limb is typically sore, edemous and not healed sufficiently shortly after 
surgery. Moreover, contact between the end of the limb 22 and the interior 
of a prosthetic device while the patient is learning to walk shortly after 
surgery can cause complications in the healing process. 
The first portion 26 preferably includes a longitudinal slit 36. The 
longitudinal slit 36 preferably extends along the length of the first 
portion 26 between the axial opening 30 and the radially defined opening 
34. The longitudinal slit 36 enables an inner surface circumference of the 
first portion 26 to be adjusted. Therefore, the sleeve 24 can be 
comfortably and securely adjusted about a portion of the amputated limb 
22. The adjustability permits weight bearing on the ischial tuberosity and 
circumferentially around the middle to upper portion of the amputated 
limb. 
The first portion of the sleeve 24 is preferably generally flexible in a 
radial direction such that the circumference of the first portion 26 can 
be adjusted by flexing the first portion 26 in order to adjust the length 
of an arcuate gap defined by the longitudinal slit 36. The first portion 
26 should also be substantially rigid in an axial direction because the 
prosthetic device 20 assists in supporting the patient as the patient 
learns to walk with the reduced limb 22. The second portion 28 of the 
sleeve 24 is preferably substantially rigid in an axial and radial 
direction to provide stable support and to avoid contact between the end 
of the reduced limb and the second portion 28. Therefore, the sleeve 24 
can be described as self-supporting. 
After the limb 22 is inserted through the axial opening 30, the size of the 
gap 36 is adjusted using adjustment members 38. Adjustment members 38 are 
preferably straps mounted onto the sleeve 24 by conventional hinges or 
clasps 40 that allow the effective length of the straps 38 to be adjusted. 
In the most preferred embodiment, the straps 38 include the adjustable 
hook and loop fabric weave known as Velcro.TM. so that the effective 
length of the straps 38 can be infinitely adjusted within a given range. A 
foam pad or flap 44 is provided that extends across the slit 36 in order 
to enhance patient comfort and to avoid the gathering of the patient's 
skin within the split 36. FIGS. 2 and 3 illustrate that straps 38 are used 
to adjust the arcuate length of a gap 50 defined by the split 36. FIG. 2, 
for example, illustrates a gap 50 when the sleeve 24 is first placed about 
the limb 22. FIG. 3 illustrates the first portion 26 of the sleeve 24 
secured about the limb 22 so that the patient can walk with the help of 
the prosthetic device 20. FIG. 3 illustrates the reduced arcuate length of 
the gap 50 after the straps 38 were used to tighten the first portion 26 
about the limb 22. 
Once the limb 22 is properly received within the sleeve 24 and the straps 
38 are appropriately adjusted so that a secure fit is achieved between the 
first portion 26 and a portion of the limb 22, a conventional waste belt 
or silesian belt is used to fully secure the prosthetic 20 to the patient. 
The patient then is able to walk using the prosthetic device 20. 
The prosthetic device 20 includes an ischial shelf or seat 48. The ischial 
seat 48 is preferably formed near the upper medial and posterior edge of 
the sleeve 24. The seat 48 bears against the ischial tuberosity as the 
patient stands or walks while wearing the prosthetic device 20. 
The foregoing description is exemplary rather than limiting in nature. 
Variations and modifications of the described embodiment are possible that 
do not depart from the purview and spirit of this invention. For example, 
the radially defined opening 34 and the split 36 are illustrated on the 
anterior side of the sleeve 24. It is also possible to have the opening 34 
and the split 36 on a medial or lateral side of the sleeve 24. 
Accordingly, the scope of this invention is to be limited only by the 
appended claims.