Your Child’s Prosthetic Leg

What is a prosthetic leg? 

A prosthetic leg (also called a prosthesis) is an artificial leg or foot that your child can wear after a leg or foot amputation. An amputation is a surgery to remove a part of a leg, foot, or other body part. This surgery may be needed to treat cancer or another serious health condition. With time, practice, and physical therapy, many children learn to walk and return to daily activities with a prosthetic leg. 

What to expect after surgery

After surgery, your child may have a cast or bandage 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 an immediate post-op prosthesis may be used to help your child start walking after surgery.  

Your care team will tell you when your child is ready to go home. They will give you instructions for care at home.  

Your child’s rehabilitation team 

A team of health care providers will work together to support your child’s recovery and help your child learn to move safely and adjust to their prosthetic leg.   

• Physical therapist: Helps your child build strength and improve movement, including learning to walk with the prosthetic leg.   
• Prosthetist: Measures and fits your child for their prosthetic leg and makes sure it works properly.   
• Wound care specialist: Helps your child heal after surgery and makes sure that your child’s limb is ready for a prosthesis.   

Other care team members may include child life specialists, psychologists, social workers, spiritual care providers, school specialists, and others who can help your child cope and adjust. 

How physical therapy helps

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 muscle 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.  

Healing and getting ready for a prosthesis 

As your child heals after surgery, your child’s prosthetist will fit your child for a more permanent prosthesis. This will help your child walk more naturally than the temporary prosthesis does.   

Residual limb

During this process, you will hear the term residual limb. The residual limb is the part of the leg that remains after amputation surgery. The type of prosthesis your child needs will depend on the residual limb.  

It takes some time to get the right fit and learn to walk well with a prosthesis. The length of time it takes to adjust will depend on your child’s swelling, wound, pain, and strength. 

Swelling

Your child’s residual limb will swell after surgery. Your child’s rehabilitation 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. Your child might need to be measured for new sockets several times in the first months after surgery because of swelling.   

Wound healing

Your child’s wound care nurse will give you the dressings and treatments needed for healing. Your child might have delayed wound healing if they have had chemotherapy. This is because chemotherapy medicines can slow down healing.  

Your child might need to wait to use a prosthesis until their residual limb is fully healed. Call your care team if your child has redness, swelling, drainage, or pain that does not improve.   

Pain 

Pain can affect when your child is ready for a prosthetic leg and how well they are able to walk with it. Your child may only be able to wear their prosthesis for a short amount of time at first. Pain can also affect whether they might use an advanced prosthesis (a prosthesis that uses technology to move more naturally). Some prostheses fit more closely to the limb and need more muscle control to use them.  

Your care team will work with your child to help manage pain and make wearing the prosthetic leg more comfortable. If you have questions or concerns about your child’s pain, talk to your care team.  

Phantom limb pain

After an amputation, your child might still feel like they are having pain in the limb that was removed. This is known as phantom limb pain. This type of pain is common after amputation and comes from how the nerves and brain respond after surgery. Phantom limb pain may affect how your child adjusts to the prosthesis.  

Physical therapy, acupoint therapy, or mirror therapy may help with your child’s phantom limb pain. Mirror therapy is a rehabilitation technique that uses a mirror so it looks like a missing limb is still there. This visual feedback can help retrain the brain and may reduce pain for some people.  

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. Your child will be able to do more on their own over time. It is important for your child to do all their PT exercises during appointments and at home.  

Choosing the right prosthesis for your child  

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.   
• Age and size: There are fewer choices in prosthetic legs for younger, smaller children. Many prosthetic knees require some muscle 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 muscle strength, 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. Some advanced prostheses are specially designed for certain activities or sports. Your care team will let you know what activities your child can do with their prosthetic leg. 

Caring for the prosthetic leg

Your child’s residual limb and prosthetic leg 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.  

Call your prosthetist if: 

• Your child’s prosthetic leg does not fit correctly 
• Your child is limping or falling 
• Your child has changes in posture or alignment 
• The prosthesis has broken parts, cracks, or makes strange noises 

Call your care team if: 

• Your child has redness, sores, blisters, or skin breakdown on the residual limb 
• Your child has fever, swelling, or pain that gets worse or does not improve  

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

Questions to ask your care team

• When can my child get a prosthetic leg after surgery? 
• What type of prosthesis will my child need? 
• Will insurance cover my child’s prosthetic leg? 
• How should the prosthetic leg fit, and how can I tell if something is wrong or uncomfortable?  
• How often will my child need a new prosthetic leg or adjustments as they grow?  
• What daily care or cleaning does the prosthetic leg and skin need?  
• What activities can my child safely do, and are there any limits?  
• What signs should I watch for that mean we need to call the care team (like pain, redness, or sores)?  
• Who do we contact if the prosthetic leg breaks or stops working properly? 

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