Get the free transtibial measurement form

TRANSITIONAL MEASUREMENT FORM Company Name Company Contact Phone Fax Shipping Address Billing Address INNOVATIVE FABRICATIONS 3700 Brained Rd. Chattanooga, TN 37411 Phone: 423.698.7408 Toll Free:

How to fill out transtibial measurement form

How to fill out transtibial measurement form:

1. Begin by gathering the necessary information, such as the patient's personal details, including their name, date of birth, and contact information.
2. Next, record the relevant medical history of the patient, including any previous amputations or injuries, and any current medical conditions that may affect the fitting of a transtibial prosthesis.
3. Then, measure the residual limb of the patient to determine the proper size and shape of the prosthetic socket. This includes measuring the circumference at various points along the residual limb and noting any specific landmarks or bony prominences.
4. Additionally, record the length of the residual limb from specific anatomical points, such as the distal end of the tibia or the medial malleolus, to ensure proper alignment and fit of the prosthesis.
5. Finally, it is important to document any additional measurements or observations that may be relevant to the fitting of the transtibial prosthesis, such as the condition of the skin, presence of any scars, or areas of tenderness.

Who needs transtibial measurement form:

1. Individuals who have undergone a transtibial amputation and are in need of a prosthetic limb.
2. Orthotists and prosthetists who are responsible for designing and fitting the transtibial prosthesis.
3. Healthcare professionals, such as physicians or physical therapists, who are involved in the patient's care and require comprehensive information for treatment planning and monitoring progress.

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What is transtibial measurement form?

The transtibial measurement form is a document used to record specific measurements and information related to prosthetic fittings for individuals with a transtibial (below-knee) amputation.

Who is required to file transtibial measurement form?

Healthcare providers, such as prosthetists, who are involved in the fitting and management of prosthetic devices for individuals with transtibial amputations are required to file the transtibial measurement form.

How to fill out transtibial measurement form?

To fill out the transtibial measurement form, the healthcare provider should accurately measure the residual limb, including the length and circumference, and record any other relevant information such as patient's name, date of measurement, and specific requirements for the prosthesis.

What is the purpose of transtibial measurement form?

The purpose of the transtibial measurement form is to ensure that accurate and consistent measurements are documented to facilitate the proper fitting of prosthetic devices, thereby enhancing patient care and outcomes.

What information must be reported on transtibial measurement form?

The information that must be reported on the transtibial measurement form includes patient identification details, measurements of the residual limb (length and circumferences), date of measurement, and any specific clinical observations relevant to the prosthetic fitting.