Pylon Prosthesis

• Pylon is a rigid, usually tubular structure between the socket (or knee unit) and the foot that provides a weight bearing shock-absorbing support shaft for the prosthesis.

• It can be used after above knee or below knee amputations.
• Rigid plaster dressing with a simple pylon can be used to allow early walking.

1. At the completion of the amputation, a gauze dressing is covered with a single layer of web roll and a stockinet bandage.
2. A rigid plaster dressing is then applied, extending to upper mid-thigh level.
3. The pt is allowed up in a chair, walker or with crutches depending on physical capability.
4. If there are no complications, the original plaster is removed one week later for wound inspection and a change of dressing.
5. A new well-moulded cast is then applied and a copper-tube pylon is added.
6. The patient is then allowed to take partial or full weight as is tolerated, and is encouraged to continue to walk throughout his hospital stay. 

Advantages

1. The plaster-pylon technique offers most of the advantages of an immediate fit prosthesis, an inflatable splint device or a removable rigid dressing, and has the added benefit that it does not require the services of a prosthetist for application.
   
2. Early postoperative ambulation with full weight bearing is possible in most cases at one week.
   
3. The full length of the cast prevents knee flexion contracture.
   
4. In addition, the fitting of a pylon, even if the patient cannot yet stand, is important in maintaining morale and encouraging efforts to walk.
   
5. The pylon also allows easier transfer of patients from bed to chair and facilitates nursing care, particularly of older patients.
   
6. Amputees can learn to balance and begin to walk long before an artificial leg is available.
   
7. Early outpatient management frees expensive hospital beds.
   
8. Stump healing and rehabilitation time appear to be improved with this method.
   
9. The amputee who receives a temporary pylon is able to ambulate and accept a final prosthesis much sooner.
10. Medical complications such as contractures and circulatory difficulties are minimized when an amputee can begin weight bearing as soon as the condition of the stump will allow following amputation.
11. The materials used for plaster-pylon application are cheap, readily available in any hospital, and can be used by paramedical staff without specialised training. 

The Difficulties With This Technique

• The cast loosens as soon as the edema subsides and the subsequent pistoning action can cause tissue breakdown.
• The cast must either be continually replaced or be removable so that additional socks or fillers can be used to maintain compression.
• Other difficulties involve the heaviness of the cast, which prevents movement of the contained joints, impedes walking, and leads to muscle atrophy.
• The cast must be removed to monitor wound healing, frequently needs to be reapplied to contain compression, and is not cosmetic.
• Auxiliary suspension may be required.