ISO 8548-2:2020 pdf free.Prosthetics and orthotics – Limb deficiencies -Method of describing lower limb amputation stumps.
4 Stump description
4.1 General
Specify the amputation side and describe the stump using the relevant descriptors listed in the appropriate tables (Tables 1 to 7.) and the guidance given in 42 to 4.6.
4.2 Stump characteristics
The shape of the stump should be described as either conical, bulbous or cylindrical. In this context, the meanings of these terms are self-evident.
The soft tissues of the stump should be described by reference to their amount and consistency. The amount should be described as sufficient, insufficient or excessive and the consistency described as normal, flabby or indurated. If the heel pad is retained, its position should be recorded as correctly positioned, displaced or mobile.
It is important to record whether the stump musculature is attached, detached or displaced.
Relevant bony features such as prominences, remnants, length or position should be described. The presence of any prominent foreign bodies, for example grafts, implants or shrapnel, should be noted.Where appropriate, the end-bearing status of the stump should be recorded.
For partial foot amputations, record the level of amputation specified in Iso 8549-4. The complete
description requires the identification of the amputated bones and their levels of amputation.
4.3 Skin
Record whether the skin barrier is intact or not, and whether the skin has normal sensation.
The position/orientation of the incisional scar and whether it is healed or not and mobile or adherent should be recorded. Additionally, the presence and condition of other scarring or skin grafting should be noted.
Any history of skin pathology, for example contact dermatitis, skin allergy and/or hyperhidrosis, should be noted.
4.4 Circulation
The factors which should be described concerning the circulation are colour, temperature and oedema.
The skin should be described as either normal in colour, cyanotic or otherwise discoloured, and as warm to examination or not.
The presence of excessive oedema should be noted. Excessive oedema is considered as that which would adversely affect stump healing or prosthetic fitting and use.
4.5 Pain
Significant pain is regarded as that which is greater than expected at the stage of treatment.
The presence of significant pain or tenderness from whatever source (e.g. painful neuroma, pain after
exercise or from prosthetic use) should be recorded using an appropriate pain scale.
4.6 Phantom sensation and phantom pain
Phantom sensation and phantom pain are sensation and pain felt as if in the amputated part of the limb. Phantom sensation is common after amputation and does not normally require treatment. Phantom pain varies in intensity and should be recorded using an appropriate pain scale.
4.7 Joint function
4.7.1 Measurement of abnormal range of joint movement
Abnormalities of the range of joint movement in the proximal joint(s) of the amputated limb should be recorded using the neutral zero method in which zero is the anatomical position.
4.7.2 Assessment of stump muscle strength
Reduced strength of the muscle groups responsible for producing movements at the proximal joint(s) of the amputated limb should be recorded using the manual muscle testing 0—5 scale.
4.7.3 Assessment of joint stability
Instability of the proximal joint[S) of the amputated limb, which is a consequence of bony or ligamentous impairments, should be recorded.ISO 8548-2 pdf download.