A hip disarticulation (HD) or trans-pelvic (TP) prosthesis typically consists of a custom-made, flexible inner socket with a rigid outer frame, a hip joint, rotator, knee unit, pylon, and foot. HD and TP sockets cover the amputated side and also wrap around the person’s sound buttock and torso, with secure straps fastening the two sides together.
- The challenges of learning to use a HD or TP prosthesis call for an extra measure of perseverance from the patient, the prosthetist and the physical therapist. It usually takes several months of physical therapy and daily use for the user to feel independent and confident.
A Hemipelvectomy amputation involves removal of the entire lower extremity and half of the pelvis, separation generally being effected at the sacroiliac and symphysis pubis joints. Whenever possible the gluteus maximus and oblique abdominal muscles are preserved and usually are sutured together along the lower anterior aspect of the abdominal cavity. Because of disease or trauma, it is often necessary to remove the gluteus maximus, in which case the “stump” consists simply of a skin-covered abdominal cavity.
- However, it has been found that it is entirely feasible for the “stump” to carry the loads if the socket is designed so that the semisolid abdominal mass of the stump is upward and medially toward the somewhat firmer area of the lower rib cage. Sometimes it is possible to utilize the sacrum for some support but relief for the coccyx must be provided because pressure on this sensitive bone almost always results in pain. Some additional support can often be achieved by utilizing the area of the gluteus maximus on the unaffected side.
- Patient treatment video