There are many levels of lower extremity amputations, and with each one comes a different method of rehabilitation as well as a different type of prosthesis. At the Lower Extremity Clinic at the University of Michigan, we offer complete, compassionate care, taking you from the amputation process to getting you back to daily living by listening to your needs, providing you a thorough education and utilizing the most current therapy and prostheses available.
In addition to amputation, our Lower Extremity Clinic cares for and treats patients with conditions such as leg and foot wounds, leg and foot deformities, peripheral vascular disease, foot pain and diabetic foot care. We coordinate care among our physiatrists (a physician who specializes in physical medicine and rehabilitation), prosthetists (certified to design, fabricate and fit prostheses) and therapists in order to fully address mobility, pain and function issues.
Levels of lower extremity amputations include:
- Foot – including toes or partial foot
- At the ankle (ankle disarticulation)
- Below the knee (transtibial)
- At the knee (knee disarticulation)
- Above the knee (transfemoral)
- At the hip (hip disarticulation)
In the U.S., more than 60% of all lower-leg amputations that are not related to an accident are performed because of diabetes.
Before you can get fitted for a prosthesis (a replacement for a lost limb or a limb deficiency), you must first go through physical therapy to gain strength and range of motion, and occupational therapy to learn how to adapt to daily living tasks without a prosthesis. This also gives your wound time to heal, and for the swelling to go down so your prosthesis fits properly. Wearing a shrinker sock (a tight, elastic covering worn over the limb) is key to reducing swelling and molding the limb for a more comfortably fitting prosthesis. An at home exercise program will be created to prevent contracture (a permanent shortening of a joint due to inactivity).
Healthy trauma patients are fitted for customized, lower extremity prostheses within 4 to 6 weeks, while the diabetic population takes longer for healing, typically 6-8 weeks.
Your first prosthesis is called a provisional prosthesis. Your limb will still be healing and changing at this point and you won’t get your definitive (final) prosthesis until the limb is stabilized. Think of it as getting used to a one-speed bike before taking off on a 27-speed mountain bike. You may need therapy to learn how to use your prosthesis. There are a variety of prosthesis options, which your team will discuss with you, based on your age, lifestyle, needs and insurance.
Our Orthotics & Prosthetics Center has been awarded a three-year accreditation by the American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc., and is among the few University based facilities in the country that offer comprehensive orthotic and prosthetic services. We custom design orthotics and prosthetics to fit each patient’s individual needs, and utilize CAD/CAM (computer-aided design/computer-aided manufacturing) to quickly and efficiently design and fabricate the devices, using 3-D imaging.
Our outpatient center is conveniently located in Ann Arbor, minutes from I-94 and US-23. Free parking and easy access to the facility is available. Call ahead and we can provide wheelchair support. We require prescriptions for most of our orthotics and prosthetics services. Some walk-in services are available. Please call ahead.