Two weeks after a transtibial amputation, a surgeon plans casting for the definitive prosthesis. Which finding best indicates that the residual limb is ready for definitive socket fitting?

• A Sutures removed and wound dry
• B Patient can stand unaided on the sound limb
• C Stump volume remains unchanged between successive measurements taken days apart ✓
• D Radiographs show complete tibial cut-end remodelling

Explanation

Definitive casting waits until the stump is mature: the volume must be stable on serial circumference measurements, with oedema resolved and soft tissue supple. A socket made into a shrinking stump soon becomes loose, causing pistoning and skin problems. Wound healing alone, option A, does not guarantee volumetric maturity, and radiological remodelling is irrelevant to socket fit. Temporary or preparatory prostheses bridge the interval until then.

Reference: Apley and Solomon's System of Orthopaedics and Trauma, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.