Standard of Practice Tarsus Prosthetic Impressions

GATHER DOCUMENTS AND IMPRESSION MATERIALS:

⦁ Patient Information Document (included in kit or can be found on website)

⦁ Measurement form

⦁ Glad Press’n Seal plastic wrap (must use this for greatest success)

⦁ Cut strip (can substitute ¼” surgical tubing or drip line)

⦁ Hook blade (available at local hardware store)

⦁ Tape

⦁ Bandage scissors

⦁ Fabric measuring tape

⦁ Permanent marker

⦁ Gloves

⦁ Bowl of cold water

⦁ Fiberglass non-flexible casting tape:

⦁ Recommend 2” for Labrador size; 1.5” for smaller breeds.

⦁ Do not use larger than 2” except for equine size animals.

STEP-BY-STEP INSTRUCTIONS:

1) Positioning:

a. Patient is lateral/on their side.

b. Align limb in desired position/angle.

c. Ok to align limb for standing position or in a therapeutic alignment.

2) Waterproof barrier – use Glad Press’n Seal wrap (in place of stockingette).  Wrap the entire length of limb needed for impression.  When in doubt a longer impression is better.

3) Cut strip – Position cut strip with groove facing out on the cranial aspect of the leg. Continue the cut strip upwards on the cranial/front of the tarsus joint (if present), ending lateral and proximal to stifle (not to obscure boney landmarks of the stifle).

4) Prep fiberglass casting material – use cold water.  Don’t open casting material pouch until you’re ready to use it.

5) Apply fiberglass:

a. Start with a double wrap at center of the knee.

b. Spiral wrap down towards the bottom of the limb, overlapping only ½ of the previous layer.

c. End by including bottom of stump (need to see entire bottom aspect of residual limb segment).

d. Do NOT wrap back up the limb.  We need a thin impression of the limb (unlike a cast).

e. Cut off excess fiberglass material while it is wet.

6) Setting the impression:

a. Hold tarsus joint in alignment you want device to support your patient.

b. Position paw into normal standing alignment.

c. Massage the fiberglass material with your hands to achieve the following results:

i. Ensure the tape layers bond.

ii. Expose the contours and landmarks/anatomy of the limb.

1. Medial and lateral malleoli.

2. Calcaneus.

3. Calcaneal tendon.

4. Distal tip and plantar surface of stump.

7) Mark the impression – Use a permanent marker to identify landmarks once the impression has hardened:

a. Distal end of stump.

b. Malleoli/ankle bones (if present).

c. Fibular head.

d. Tibial crest (attachment site for patella tendon).

e. Patient name and ‘Left’ or ‘Right’.

8) Remove impression – starting at the top/proximal edge, use bandage scissors to cut down to cut strip, then use hook blade utility knife and follow the cut strip groove.  Remove Press’n Seal.

9) Tape impression back together – Immediately tape the cast back together using any tape available.

10) Ship impression to OrthoPets – Use sturdy box appropriately sized to fit impression without too little or excess space. Light padding material can be used.