ISO 8548-2:2020 pdf download – Prosthetics and orthotics — Limbdeficiencies — Part 2: Method of describing lower limb amputation stumps.
Where appropriate, the end-bearing status of the stump should be recorded.
For partial foot amputations, record the Level of amputation specified in ISO 8549-4. The complete
description requires the Identification of the amputated bones and their levels of amputation.
4,3 Skin
Record whether the skin harrier is intact or not, and whether the skin has normal sensation.
The position/orientation of the incisional scar and whether it is healed or not and mobile or adherent should he recorded Additionally, the presence and condition of other scarring or skin grafting should be noted.
Any history of skin pathology, for example contact dermatitis, skin allergy and/or hyperhidrosis, should be noted.
4.4 Circulation
The factors which should be described concerning the circulation are colour, temperature and oedema.
The skin should be described as either normal in colour, cyanotic or otherwise discoloured, and as warm to examination or not.
The presence of excessive oedema should be noted. Excessive oedema is considered as that which would adversely affect stump healing or prosthetic fitting and use.
43 Pain
Significant pain is regarded as that which is greater than expected at the stage of treatment.
The presence of significant pain or tenderness from whatever source (e.g. painful neuroma. pain after exercise or from prosthetic use) should be recorded using an appropriate pain scale.
4.6 Phantom sensation and phantom pain Phantom sensation and phantom pain are sensation and pain felt as If In the amputated part of the limb. Phantom sensation is common after amputation and does not normally require treatment. Phantom pain varies in intensity and should be recorded using an appropriate pain scale.
4.7 JoInt function
4.7.1 Measurement of abnormal range of joint movement
Abnormalities of the range of joint movement in the proximal joint(s) of the amputated limb should be recorded using the neutral zero method in which zero is the anatomical position.
4.7.2 Assessment of stump muscle strength
Reduced strength of the muscle groups responsible for producing movements at the proximal joint(s) of the amputated limb should be recorded using the manual muscle testing 0—5 scale.
4.7.3 Assessment of joint stability
Instability of the proximal joint(s) of the amputated limb, which is a consequence of bony or ligamentous impairments, should he recorded.
4.7.4 Joint pain
Pain in the proximal joint[s) should be recorded.
5Measurement of lower limb amputation stumps5.1Reference levels and reference planes
5.1.1 General
ldentify the reference levels and planes relevant to the particular level of amputation as described in5.1.2 and 5.1.3.
5.1.2 Reference levels5.1.2.1Waist
The level midway between the costal margin and the iliac crest. lliac crest
The level defined by a line joining the highest point on the crest of each ilium. Proximal
The most proximal level at which a circumferential measurement, perpendicular to the mid-line of thethigh,can be obtained. Minimum circumferential
ln knee and ankle disarticulation stumps only, the level of the minimum circumference. Femoral condylar
ln knee disarticulation and transcondylar amputation stumps only, the level of the maximum condylarcircumference.
ln transfemoral and transtibial stumps only, the level on the stump at which the slope of the stumpshape changes as it curves in towards the end. end
The level of the stump end. Medial joint line
The level of the medial tibial plateau,unless there is a fixed deformity of the knee, in which case thislevel is the highest at which a circumferential measurement perpendicular to the mid-line of the stumpcan be obtained. Mid-patellar tendon
The level mid-way between the origin and insertion of the patellar tendon.