Get the free Trans-Femoral Measurement Form

POPPET Transferal Measurement Format: PROSTHETIC: PO NUMBER: Use the following sizing information for selecting POPPET sockets for your patient. Each of these sockets is a one piece, polyethylene,

How to fill out trans-femoral measurement form

How to fill out trans-femoral measurement form

1. To fill out the trans-femoral measurement form, follow these steps:
2. Start by filling out the patient's personal information, including their name, date of birth, and contact details.
3. Next, record the patient's medical history and any relevant conditions or medications they are taking.
4. Moving on to the measurement section, begin by measuring the overall length of the residual limb from the most prominent point of the ischium to the distal end.
5. Measure the circumference of the residual limb at specified intervals, typically at 10cm, 15cm, and 20cm from the ischium.
6. Note down the anterior-posterior dimension of the residual limb, which is the distance between the front and back of the limb at the level of the ischium.
7. Measure the mediolateral dimension, which is the width of the residual limb at the level of the ischium.
8. Finally, document any other relevant measurements or observations, such as scar tissue, skin condition, or muscle strength.
9. Review the completed form for accuracy and completeness before submitting it.

Who needs trans-femoral measurement form?

1. Trans-femoral measurement forms are needed by prosthetists, orthotists, and healthcare professionals who specialize in designing and fitting prosthetic limbs for individuals with above-knee amputations.
2. These forms provide vital information about the patient's residual limb measurements and other physical characteristics, which are necessary for creating a well-fitting and comfortable prosthetic limb.
3. The forms help ensure that the prosthetic limb is properly aligned, supports the patient's weight, and allows for optimal mobility and functionality.
4. By accurately filling out the trans-femoral measurement form, healthcare professionals can tailor the prosthetic limb to meet the specific needs and requirements of each individual patient.

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What is trans-femoral measurement form?

The trans-femoral measurement form is a document used to collect specific measurements for individuals who have undergone a trans-femoral amputation, to aid in the proper fitting of prosthetic limbs.

Who is required to file trans-femoral measurement form?

Healthcare providers and prosthetic specialists involved in the fitting of prosthetics for individuals with trans-femoral amputations are required to file the trans-femoral measurement form.

How to fill out trans-femoral measurement form?

To fill out the trans-femoral measurement form, a healthcare provider must accurately record the patient's measurements, including limb length, circumference, and any other relevant anatomical data, along with patient identification details and clinical notes.

What is the purpose of trans-femoral measurement form?

The purpose of the trans-femoral measurement form is to ensure that prosthetic devices are customized and appropriately fitted for individuals who have undergone trans-femoral amputation, thereby enhancing mobility and comfort.

What information must be reported on trans-femoral measurement form?

The form must report patient demographics, specific anatomical measurements, any clinical observations, and the healthcare provider's credentials and signatures.