Your Child’s Prosthetic Leg

Doctors must sometimes remove a leg or foot to treat cancer. This surgery is called an amputation. After surgery your child can wear an artificial leg or foot, which is also called a prosthetic limb or a prosthesis. 

Hospital care after amputation 

Your child will come out of surgery with a cast where the leg or foot was removed. A physical therapist will visit your child soon after surgery, usually the next day. The therapist will: 

• Help your child get out of bed and start using crutches 
• Teach your child how to move as safely as possible with the crutches  

A temporary prosthesis called a pylon is used to help your child start walking after surgery. 

Your care team will tell you when your child is ready to go home. 

Your Rehabilitation Services team 

The following people will work with you and your child: 

• Physical therapist (PT) - helps your child gain strength and ability to move, including walking with the prosthesis.  
• Prosthetist - measures and fits your child for their prosthetic leg. This will help your child use the prosthesis correctly.  
• Wound care specialist - helps your child heal from surgery and makes sure that your child is ready for their prosthesis.  

Family support and encouragement is important for successful use of your child’s prosthesis. 

Physical therapy 

After surgery, a physical therapist will examine your child and create a therapy plan. Physical therapy, also called PT, is important because using a prosthesis takes strength and practice. Working with the physical therapist will help your child get stronger and learn to move better.  

Your child will do exercises and activities with their therapist, including practicing how to walk with a prosthesis. The physical therapist will tell you how often your child needs therapy. 

Getting ready for the prosthesis 

As your child heals after surgery, your prosthetist will measure and fit your child for a more permanent prosthesis. This will help your child walk more naturally than the pylon (temporary prosthesis) does.  

During this process, you will hear the term residual limb. The residual limb is the part of the leg that remains after amputation surgery.  

It takes some time to get the right fit and learn to walk well with a prosthesis. The length of time this takes depends on several factors: 

• Swelling – Your child’s residual limb will swell after surgery. Your Rehabilitation Services team will give you a tight elastic sock called a shrinker or shrinker stocking to help the swelling go down. Your child will be measured for a socket. The socket is the part of the prosthesis that fits over the residual limb. It holds the prosthetic leg in place. It is normal to need several sockets after an amputation, and your child might need to be measured for new sockets several times in the first months after surgery because of swelling.  
• Wounds – Your child’s wound care nurse will give you the dressings and treatments needed for healing. Wound healing might take longer if your child has had chemotherapy. This is because chemotherapy medicines can slow down normal healing. If wound healing is a problem, your child might need to wait to use a prosthesis until healing is done.  
• Pain – Everyone has a different amount of pain after surgery. Walking with a prosthetic limb might hurt at first. Pain can affect how well your child can walk or if they use a more advanced prosthesis. Your care team will work with your child toward the goal of walking without pain. If you have questions about pain, talk to your care team. 
• Strength – Your child’s residual limb will be weak after surgery. Doing physical therapy will help your child build strength. This will make walking easier, and your child will need less help over time. It is important for your child to do all the PT exercises during appointments and at home. 

Choosing the best prosthesis 

You and your child will work with the prosthetist and physical therapy team to find the best prosthesis. The type of prosthesis depends on several factors: 

• Leg length – The type of prosthesis that works best for daily activities depends on the length of your child’s residual limb. Residual limb length can affect your child’s overall function.  
• Size – There are fewer choices in prosthetic legs for younger, smaller children. Many prosthetic knees require some strength to work properly. If your child is small, they may have to wait until they are older to use a more advanced prosthesis due to the size or length of prosthetic components.  
• Prosthetic knee – As your child gets stronger and walks better with the prosthesis, your child may get a more advanced prosthetic knee. Prosthetic knees allow your child to walk more naturally. Learning how to use the knee can take time. More advanced knees require more strength and more physical therapy and practice.  
• Activities – A prosthetic leg is designed to let your child do regular activities. The prosthetist will recommend the best option for your child. Your child can return to some activities, such as swimming, without a prosthesis. 

Long-term prosthesis care  

Your child’s residual limb and prosthesis will need long-term care. Follow your care team’s instructions for physical therapy and prosthesis maintenance. See your prosthetist for scheduled visits or if there is a problem with the device.  

With some time and effort, your child will become skilled at using a prosthesis. Talk to your care team if you have any questions or concerns.