Three weeks after receiving his first transfemoral prosthesis, a 45-year-old amputee is noted to swing the prosthesis outward in a semicircle during every swing phase. The most likely prosthetic cause of this circumducted gait is:

• A Prosthesis is too long ✓
• B Socket is too loose proximally
• C Knee unit friction is set too high
• D Prosthetic foot is set in excessive dorsiflexion

Explanation

Circumduction, swinging the prosthesis laterally in an arc, is the classic gait deviation caused by a prosthesis that is too long: the toe catches at mid-stance transition, so the patient abducts and swings the limb around it. Excessive knee friction delays knee flexion and produces vaulting or lateral leaning instead. A loose socket causes pistoning, and excessive dorsiflexion causes an abrupt knee-buckling moment, neither of which produces circumduction.

Reference: Campbell's Operative Orthopaedics, 14th ed.

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Written and medically reviewed by the StethoPrep medical team.