The hip-disarticulation and short above-knee immediate postsurgical adjustable pylon prosthesis.

The fitting of short above-knee stumps with an immediate postsurgical prosthesis in our experience originally required the use of a balsa wood or styrofoam extension block between the distal cast-socket and the socket attachment plate. This was necessary in order to place the effective prosthetic knee center in a more functional anatomical position corresponding to that of the sound side. Location of the extension block in proper alignment attitude of flexion and adduction including anterior-posterior and medio-lateral placement was considered critical and demanded skill and experience on the part of the prosthetist. With the patient anesthetized and supine, application was under less than ideal conditions. Satisfactory results were nevertheless routinely possible when the prosthetist complied with the recommended Prosthetics Research Study procedure developed for this technique. Failure to follow the prescribed instructions could require complete removal of the socket attachment straps and plate including the extension block from the cast-socket (rigid dressing) to achieve a more desirable and functional relocation. Of course, inconvenience, time consuming delays, and undue pain to the patient would result if this procedure was necessary in the early postsurgical period. It was also difficult if not impossible to determine the proper length of the extension block preoperatively and therefore required either bringing several extension blocks of varying sizes or carrying a small portable handsaw to the operating room to shorten the extension to its