Use of temporary plaster of plastic pylons preparatory to fitting a permanent above-knee or below-knee prosthesis.

Temporary or preparatory prostheses for use by lower-extremity amputees have been mentioned frequently and used occasionally for many years (1, 2, 3, 4, 5), but they have not been adopted readily in the United States. Many reasons have been given why preliminary fitting has not been done and these have included: 1. stump damage because of malfitting plaster or other temporary socket, 2. rapid shrinkage resulting in discomfort and stump damage because of change in contour of the stump, 3. development of persistent undesirable gait habits because of the absence of a knee joint, 4. a satisfactory preparatory prosthesis is almost as expensive as a finished limb, 5. it is cosmetically an inadequate device, 6. prosthetists do not have the time or desire to learn to use this mechanism, 7. if the principle of preparatory prostheses were good, it would be accepted readily and this has not been the case (6) . Preparatory lower-extremity prostheses have been used in the Orthopaedic Amputee Clinic at Duke University Medical Center since 1955 (7) and the Durham Veterans Administration Hospital since 1957. Originally, these were plaster sockets with wooden crutch extensions and were used primarily to assist with stump shrinkage in the aboveknee amputee and early ambulation of this same group for physical and psychological reasons. These primary uses were then supplemented by an additional activity directed toward assessing an increasing number of geriatric amputees with vascular disease whose potential for successful use of a prosthesis was doubtful and whose limited public and