Modify A BK
Use this page to communicate to us how you would like your BK prosthesis modified.
General Information
Contact Name:
Company Name:
Depth of PTB
Length from MPT to distal end
Distal tibia buildup
Anterior View
Posterior View
Medial View
Lateral View
Fibular head buildup
Patient Name:
Age:
Height:
Weight:
Activity level:
Casted over a liner?:
Cast Modification Information
Tibial crest buildup
Posterior Shelf Choice:
Special Instructions
Level of shelf:
Depth of shelf:
PML
Special Instructions
