Otto Bock 3R95, Инструкция по эксплуатации

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4 Handling
4.1 Alignment recommendations and assembly
The three-dimensional arrangement of the prosthetic socket and the modular components affects
the static and dynamic functions of the prosthesis. Function of the joint is influenced by the posi-
tion of the axes.
The advantages of the 3R95 und 3R95=1 can only be made optimal use of in case of a correct
alignment. The optimal residual limb position must be anticipated when positioning the socket
connector.
Plumb lines in the frontal and sagittal planes (drawn from the hip joint’s centre of rota-
tion and marked during plaster cast taking and trial fitting of the test socket) will facilitate correct
positioning of the lamination anchor or socket adapter.
To align the prosthesis please proceed in two steps:
1. First make the bench alignment using an alignment tool such as 743L200 L.A.S.A.R. Assembly.
2. For subsequent optimisation of the static alignment, please use 743L100 L.A.S.A.R. Posture.
4.1.1 Bench Alignment with Alignment Tool
(Fig. 6)
1
Position the middle of the foot approx. 30 mm anterior to the alignment reference line.
2
Add 5 mm to the required heel height of the foot. Set correct outward rotation of the foot.
3
Clamp the 3R95 knee joint using the appropriate adapter inserts. For bench alignment, place the
rotation axis of the knee joint (alignment reference point) 15 mm posterior to the alignment
reference line.
At that point the pyramid base should be horizontal. Pay attention to the knee-ground
distance and outward rotation of the knee (adapter inserts provide for a rotation of approx. 5°)!
Recommended positioning of the alignment reference point: 20 mm above the medial tibial plateau.
4
Connect the foot to the modular knee joint using a tube adapter.
5
Mark the centre of the socket proximally and distally on the lateral side. Draw a line through
both marks from socket brim to the distal end of the socket.
6
Position the socket such that the alignment reference line passes through the proximal centre
mark of the socket. Set the socket flexion to somewhere between 3° and 5°; however, the
individual situation (e.g. hip joint contractures) must be taken into account and, if necessary,
more flexion should be provided. Also pay attention to the ischial tuberosity to ground distance!
Attention!
If the residual limb flexion is not taken into account, the joint will be positioned too far
to the front. This will lead to malfunction and premature wear. If necessary, use the
4R118 Adapter Plate to optimise the alignment corrections.
7
Connect the socket and modular knee joint using a corresponding adapter (e.g. 4R111, 4R41,
4R55, 4R51 Socket Adapter).
4.1.2 Static Alignment Optimisation ONLY using 743L100 L.A.S.A.R. Posture
(Fig. 7)
The bench alignment can be substantially improved using L.A.S.A.R. Posture. In order to ensure
appropriate stability combined with easy swing phase initiation, please proceed as follows:
1
To make the load line visible, the transfemoral amputee stands on the L.A.S.A.R. Posture with
the prosthetic side on the force plate and with the other leg on the height compensation panel.
The prosthesis side should be sufficiently loaded (> 35 % of the body weight).
2
Now adapt the alignment by only adjusting the plantar flexion of the foot. The load line (laser
line) should be approx. 45 mm anterior to the knee axis (alignment reference point).
3
After step 2, dynamic optimisation can take place between parallel bars.