To prevent contractures in a transfemoral amputation, emphasis should be placed on designing a positioning program that maintains ROM in the hip:

To prevent contractures in a transfemoral amputation, emphasis should be placed on designing a positioning program that maintains ROM in the hip:

• A. flexion and abduction
• B. extension and adduction
• C. adduction and lateral rotation
• D. flexion and medial rotation

Answer: (B)

Focusing on hip extension and adduction helps prevent the two most common contractures after a transfemoral amputation: hip flexion and hip abduction. Keeping the hip near extension lengthens the hip flexor muscles (like the iliopsoas) and reduces the tendency to develop a flexion contracture, which would pull the thigh into a bent position and complicate prosthesis fitting. Placing the hip in adduction counters the natural tendency toward an abducted position, helping prevent an abduction contracture that can tilt the pelvis and misalign the residual limb in the socket. In short, extending and bringing the hip toward the midline maintains more neutral hip mechanics, supporting better prosthetic outcomes. Positions that promote flexion and abduction would foster those contractures, making extension with adduction the best approach.

Focusing on hip extension and adduction helps prevent the two most common contractures after a transfemoral amputation: hip flexion and hip abduction. Keeping the hip near extension lengthens the hip flexor muscles (like the iliopsoas) and reduces the tendency to develop a flexion contracture, which would pull the thigh into a bent position and complicate prosthesis fitting. Placing the hip in adduction counters the natural tendency toward an abducted position, helping prevent an abduction contracture that can tilt the pelvis and misalign the residual limb in the socket. In short, extending and bringing the hip toward the midline maintains more neutral hip mechanics, supporting better prosthetic outcomes. Positions that promote flexion and abduction would foster those contractures, making extension with adduction the best approach.