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Lower Limb Cosmetic Covers 


A prosthetic cosmetic cover is a cover applied over the endoskeletal structure of a prosthesis.  The term ‘cosmetic cover’ is misleading, as a cover can provide a very functional role:  protecting the inner prosthetic components from exposure to harmful elements.


In an exoskeletal prosthesis, the socket, components, and alignment are combined in a solid, rigid structure.   Exoskeletal prosthetic designs may seem rare and outdated today; however, this was the first real attempt at mimicing the shape of a human leg. 


Exoskeletal Finish Pros         


·          Durable

·          Inexpensive


Exoskeletal Finish Cons


·          Heavy

·          Limited adjustement ability

·          Rigid

·          Limited color options

·          For above knee prostheses, components exposed at the knee


In an endoskeletal prosthesis, the socket and other joint components form an internal structure, like the human skeleton.


Unlike exoskeletal prostheses, these endoskeletal designs lack protection from harmful elements, such as moisture. 


Endoskeletal Design Pros


·          Lightweight

·          Better adjustment capabilities

·          More component options



Endoskeletal Design Cons

·          Less durable


To protect the inner components, and to provide a more realistic appearance, foam covers can be applied to the outside of the prosthesis.  These foam covers can be custom shaped, based on measurements from the client’s sound limb.  The foam cover can be finished in one of three ways:


·          Cosmetic stocking

·          Off-the-shelf skin

·          Custom skin



Cosmetic Stocking

Cosmetic stockings, which are similar to everday knee high or thigh high hosery, can be pulled over the foam cover.  Various layers and colors of stockings can be utilized to achieve various skin shades.  These stockings are widely available and ordinary hosery, not designed for use with prosthetics, may suffice.  This is a very economical option for amputees; however, stockings require frequent replacement and do not protect the foam cover from moisture.  Eventually, the unprotected foam cover will suffer premature wear and will require replacement.


Pre-fabricated Skin


For superior moisture resistance and realism, a rubber-like skin can be utilized in lieu of hose.  Off-the-shelf protective skins come in a variety of materials, colors, and shades.  These skins are large rubber-like socks that are pulled over the foam cover and adhered to the top of the prosthetic socket.  These skins can be pulled down to allow for adjustments, but usually cannot be repaired when torn.


Custom Skin 


Custom protective skins can also be painted or sprayed onto the foam cover.  These skins provide the ultimate in realism and can even include birth marks and hair.  As these skins are custom painted, they can often be repaired and the color adjusted after the initial fabrication.  However, the cannot be easily removed in the event of a major component repair.    


Many amputees decide again covering exposed prosthetic components.  Athletes often do not cosmetically finish lower limb prostheses in order to keep the prosthesis as lightweight as possible.  Some individuals simply prefer the appearance of their prosthetic components without cosmetic finishing.


The majority of insurance companies, including any insurance company that follows Medicare guidelines, cover cosmetic finishing for a definitive prosthesis.  This coverage determination is based on the fact that this finishing does provide a very functional role and preserves the life of the prosthesis.

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