A 62-year-old man underwent a right transfemoral amputation five days ago. The ward nurse notes that he keeps a pillow under the residual limb for comfort and spends most of the day reclined in bed with the stump supported on pillows. What is the single most important instruction regarding positioning to prevent a future prosthetic-walking problem?

• A Keep the residual limb elevated on pillows continuously for six weeks
• B Lie prone on a firm mattress for 15 to 30 minutes several times daily ✓
• C Sit upright with hips flexed beyond 90 degrees to stretch the hamstrings
• D Place a sandbag against the lateral thigh to prevent abduction

Explanation

After transfemoral amputation, sustained hip flexion from pillows or prolonged sitting produces a flexion-adduction contracture of the hip, which makes prosthetic gait difficult and energy-costly because the pelvis cannot extend over the prosthetic limb. Prone lying stretches the hip flexors and is the standard preventive measure taught in stump care. Continuous elevation promotes flexion rather than preventing it, and lateral support addresses adduction, not the dominant flexion problem.

Reference: Maheshwari's Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.