Which of the following is NOT recommended for transtibial amputation positioning?

• A. Elevation of residual limb for prolonged periods
• B. Avoid prolonged hip/knee flexion
• C. Limit sitting to 40 minutes of each hour
• D. Encourage periodic prone lying

Answer: (A)

Positioning after a transtibial amputation centers on preventing knee flexion contractures and preparing the limb for prosthetic fitting. Keeping the knee and hip in a flexed or dependent position for long periods tends to shorten the posterior thigh muscles and knee flexors, making full knee extension harder to achieve later. Elevating the residual limb is useful briefly to reduce swelling in the immediate postoperative period, but prolonged elevation pushes the limb into a flexed position and can promote contractures, compromising prosthetic fit and function. Once swelling settles, the limb should be kept in a neutral or extended position, with periodic prone lying to stretch the flexor muscles and maintain extension. Limiting sitting time and frequently changing positions also helps prevent contractures and supports better outcomes with a prosthesis.