Diagram with prothese and orthoses in detailed

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Now I have enough material to deliver a comprehensive, well-illustrated reference. Let me compile it all.

Prostheses & Orthoses — Detailed Illustrated Reference

PART 1 — DEFINITIONS

Term	Definition
Prosthesis	An artificial device that replaces a missing body part (limb, joint, organ)
Orthosis	An external device that supports, corrects, or augments a body segment that is still present

PART 2 — ORTHOSES

Core Principle

"The primary function of an orthosis is control of the motion of certain body segments. Orthoses are named according to the joints they control, the function they provide, and the method used to obtain or maintain that control." — Miller's Review of Orthopaedics, 9th Ed.

Orthoses may be static (no movement allowed), static-progressive (gradually adjustable), or dynamic (spring/hinge-assisted motion).

2A — LOWER LIMB ORTHOSES

Foot Orthoses (FO)

Type	Material	Function
Rigid	Hard plastic	Limits joint motion, stabilizes flexible deformities
Semirigid	Semi-flexible	Support + shock absorption
Soft	Foam/viscoelastic	Shock absorption; accommodates fixed/neuropathic deformities

Ankle-Foot Orthosis (AFO) — Most common lower limb orthosis

Transtibial prosthesis components (a) vs. solid AFO (b)

Panel (a) = transtibial prosthesis anatomy; Panel (b) = solid posterior-shell AFO. Key contrast: prosthesis replaces the limb; AFO supports it.

Indications: Foot drop, plantar spasticity, spinal cord injury, post-hindfoot fusion Trimlines: Posterior → intermediate → full/anterior (increasing mediolateral control) Materials: Metal bars attached to shoe OR thermoplastic elastomer (TPE)

Knee-Ankle-Foot Orthosis (KAFO)

Controls knee + ankle
Indications: Quadriceps paralysis, knee instability, post-polio, genu valgum/varum

Hip-Knee-Ankle-Foot Orthosis (HKAFO)

Controls hip + knee + ankle
Indications: High-level paraplegia (T12–L2), spina bifida
Heavy; functional ambulation limited

Pediatric — Pavlik Harness

Mainstay for early treatment of developmental dislocation of the hip (DDH)
Dynamic; allows hip motion without total immobilization

2B — UPPER LIMB ORTHOSES

Elbow Orthoses

Type	Use
Hinged-elbow	Ligament instability (minimal stability)
Dynamic spring-loaded	Flexion/extension contractures
Elbow strap	Lateral epicondylitis
Long-arm splint (45° flexion)	Cubital tunnel syndrome

Wrist-Hand Orthoses (WHO)

Type	Use
Static/static-progressive/dynamic	Post-operative after injury or reconstructive surgery
Opponens splint	Thumb prepositioning (impairs tactile sensation)
Wrist-driven hand orthosis	Lower cervical quadriplegia; body-powered by tenodesis

2C — SPINE ORTHOSES

Cervical Orthoses

Effective immobilization ranges from soft collars → rigid collars → posted orthoses (shoulder/chin purchase) → halo vest (greatest stability; pins fixed to skull)

Thoracolumbar Orthoses (for Scoliosis)

Spinal braces: A = Milwaukee (CTLSO), B = Boston brace (TLSO), C = OMC brace (TLSO variant)

A = Milwaukee brace (CTLSO) for high thoracic curves (apex above T7); B = Boston brace (TLSO) for thoracolumbar curves; C = Osaka Medical College (OMC) asymmetric TLSO.

Orthosis	Coverage	Key Feature
CTLSO (Milwaukee)	Cervical → sacral	Pelvic mold + metal bars + neck ring; longitudinal distraction
TLSO (Boston)	Below axilla → pelvis	Rigid symmetric plastic shell; under-arm trim line
LSO	Lumbar → sacral	Three-point pressure mechanism; reduces back pain

2D — FRACTURE BRACES

Remain valuable for isolated tibia/fibula fractures
Prefabricated versions for ankle sprains, simple foot/hand fractures

PART 3 — PROSTHESES

3A — LOWER LIMB PROSTHESES

Levels of Amputation → Prosthesis Type

Amputation Level	Prosthesis
Toe/partial foot	Toe fillers, foot orthosis
Transtibial (below-knee)	BK prosthesis
Knee disarticulation	Through-knee prosthesis
Transfemoral (above-knee)	AK prosthesis with prosthetic knee
Hip disarticulation	Hip disarticulation prosthesis

Transtibial Prosthesis Components

(as seen in the diagram above, panel a)

Residual limb (stump)
Liner — soft silicone/urethane interface; reduces shear
Socket — rigid custom-molded; transfers body weight distally
Shank — exoskeletal (hard outer shell) or endoskeletal (pylon)
Prosthetic foot — SACH (Solid Ankle Cushion Heel), energy-storing carbon fiber, or multiaxial

Transfemoral Prosthesis — Additional Components

Prosthetic knee joint: mechanical (single-axis, polycentric) or microprocessor-controlled
Suspension systems: suction socket, pin-lock, lanyard

Pediatric — Combined Prosthetic + Orthotic Use

This clinical photo illustrates integration in a child with congenital limb deficiencies: a transfemoral prosthesis on one side and a KAFO/AFO supporting a shortened limb on the other — a common rehabilitation strategy.

3B — UPPER LIMB PROSTHESES

Levels of Amputation → Prosthesis Type

Level	Prosthesis
Partial hand	Finger/partial-hand prosthesis
Wrist disarticulation	Below-elbow (transradial) variant
Transradial (below-elbow)	TR prosthesis
Elbow disarticulation	Through-elbow prosthesis
Transhumeral (above-elbow)	TH prosthesis with powered elbow
Shoulder disarticulation	Shoulder prosthesis

Types by Control Mechanism

Type	Mechanism	Components
Body-powered	Harness + cable system	Hook or mechanical hand terminal device
Myoelectric (EMG-controlled)	Surface EMG signals from residual muscles	Motorized hand, wrist rotator
Hybrid	Combination of body-powered + myoelectric
Bionic/Multi-articulating	Myoelectric + microprocessor, individual finger control	i-Limb, Bebionic

Transhumeral Prosthesis — Labeled Components

Transhumeral prosthesis: (1) Modified Hosmer motorized elbow, (2) Raspberry Pi 3 controller, (3) Ottobock electronic wrist rotator, (4) i-Limb Ultra prosthetic hand

Advanced 2-DoF transhumeral prosthesis showing modular integration of powered elbow, forearm processor, wrist rotator, and myoelectric hand.

PART 4 — QUICK COMPARISON TABLE

Feature	Orthosis	Prosthesis
Limb present?	✅ Yes	❌ No (replaces it)
Purpose	Support / correct / protect	Replace / substitute
Named by	Joints controlled (e.g., AFO, KAFO)	Level of amputation (e.g., transtibial)
Examples	AFO, TLSO, Pavlik harness, elbow strap	BK prosthesis, myoelectric hand, SACH foot
Fixation	External straps, shells, uprights	Socket + suspension system

PART 5 — NAMING CONVENTIONS

Orthoses use acronyms based on anatomical coverage:

FO = Foot Orthosis
AFO = Ankle-Foot Orthosis
KAFO = Knee-Ankle-Foot Orthosis
HKAFO = Hip-Knee-Ankle-Foot Orthosis
WHO = Wrist-Hand Orthosis
EWHO = Elbow-Wrist-Hand Orthosis
SO = Shoulder Orthosis
LSO = Lumbar-Sacral Orthosis
TLSO = Thoracic-Lumbar-Sacral Orthosis
CTLSO = Cervical-Thoracic-Lumbar-Sacral Orthosis

Prostheses are named by amputation level and side (e.g., right transtibial prosthesis, left transhumeral myoelectric prosthesis).

Sources: Miller's Review of Orthopaedics 9th Ed.; Rockwood and Green's Fractures in Adults 10th Ed. 2025

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