Stump Coning

This is a technique of reducing oedema and obtaining the correct shape of the stump in order to fit prosthesis. Following the amputation, the stump is very swollen and a lot of fluid accumulates in the stump, therefore coning should commence as early as possible following the removal of staples and once the wound has healed sufficiently. Coning is vital to achieve the correct stump shape in the early stages of an amputee as this creates the foundation on which to fit the prosthesis.

Other advantages of coning include earlier fit of the prosthesis, assistance in supporting the surgical wound, reduction of contractures and protection of the stump.

New amputees will need to cone in order to reduce the size of their stump, but experienced amputees also need to use the compression bandages when not wearing their prosthesis for periods of time to minimize oedema and maintain stump shape.

The compression bandage should be applied at two thirds of its stretch with more tension around the lower end of the stump. Be careful not to pull too tightly in the mid section of the stump, creating a bulge at the bottom. The stump is to be bandaged at all times, but re-applied 3 to 4 times a day. Massage the stump for about 10 minutes between re-application.

A shrinker sock may also be used instead of the bandage, but needs to be specially measured to be effective on each individual stump. It is made of elasticized material and helps improve circulation. More frequently used by above knee amputees than below knee. Check with your prosthetist for details.

 

TECHNIQUES

 

Above the knee

 

Below the knee

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