What might cause a patient with a TF prosthesis to feel a ramus pressure during ambulation?

A patient with a transfemoral (TF) prosthesis feeling pressure against the ramus, which is part of the pelvic bone, is typically due to the socket being too tight. When the socket is overly constrictive, it can lead to excessive force being applied to specific areas of the residual limb during weight-bearing activities, such as walking. This pressure can cause discomfort and potential skin issues due to the compromised blood flow and tissue adherence to the socket.

The proper fit of the socket is crucial for optimal alignment and distribution of forces throughout the prosthesis. An appropriately fitted socket ensures that weight is evenly distributed, preventing localized pressure points that can detract from comfort and efficiency of ambulation. Therefore, addressing the tightness of the socket would be essential to alleviate the ramus pressure the patient is experiencing.

While factors like the length of the prosthesis or insufficient knee extension can cause other forms of discomfort or gait deviations, they are less likely to directly result in localized ramus pressure issues compared to the socket's tightness. Similarly, weak hip flexors might affect gait mechanics but do not typically cause pressure directly against the ramus in the context of a TF prosthesis.