After a transfemoral or transtibial amputation, which practice helps prevent contractures?

• A. Elevate the residual limb continuously in supine
• B. Sit for several hours without a break
• C. Avoid prolonged hip and knee flexion
• D. Keep the residual limb tucked under the body during sleep

Answer: (C)

Prolonged hip and knee flexion leads to shortening of the soft tissues around those joints, creating contractures that can prevent full ROM and complicate prosthetic fitting after amputation. The best way to reduce this risk is to avoid staying in a flexed position for extended periods, keeping the joints nearer to neutral or extended when possible. In practice, this means encouraging positions that lengthen and stretch the hip flexors and knee flexors—such as prone lying to help stretch the hip flexors and avoiding long periods of sitting or positions that tuck the residual limb under the body. Elevating the residual limb in the early post-op period may help with edema but should not be relied on to prevent contractures, and it does not counteract flexion when the limb is kept flexed in any position. Keeping the limb tucked under the body during sleep or maintaining a flexed position over long periods promotes contracture development, so that choice is not beneficial for preventing contractures.