Bulbous limb, pistoning
Lane Ferrin
Description
Collection
Title:
Bulbous limb, pistoning
Creator:
Lane Ferrin
Date:
12/15/2018
Text:
Dear friends,
I'm looking for suggestions to resolve distal end pressure and provide
max suspension on a very soft bulbous limb. Patient is 23 yrs, female,
5'4, 200 lbs, carried mostly in her legs. Amputation is longer than
average TT, traumatic, has been successfully wearing a sock fit socket
with sleeve and suction valve, hinged posterior brim to allow donning.
Pistoning was minimal initially, (July of this year), but rapidly
progressed as her limb softened and is now about 3/4-1.
Limb is 36cm circ distally, 32cm at MTP. Tissue is extremely mobile,
moving vertically in relation to the tibia about 1.5. I am attempting
to use a locking liner to keep pistoning to a minimum by pulling the
soft tissue distally. An original Alpha liner allows extreme vertical
motion, 1 of pistoning even with aggressive distal traction with a
lanyard. An Otto Bock 6Y75 stops the pistoning but impinges on the
anterior distal tibia under load, causing pain. The tibia is very
prominent, just under the skin over its whole length and the distal
tissue can be pushed posteriorly and vertically to the point where one
can palpate the posterior distal tibia a little.
Perhaps a very small diameter umbrella would work, so soft liner
material is not directly under the tibia. A custom umbrella might
work, but I am not aware if anyone has ever made one.
Suggestions?
Lane Ferrin CP
This encrypted email is in compliance with the Breach Notification
Requirements under Section 13402 of Title X111 (Health Information
Technology for Economic and Clinical Health Act) of the American
Recovery and Reinvestment Act of 2009.
CONFIDENTIALITY NOTICE: This e-mail message and any attachments are for
the sole use of the intended recipient(s) and may contain proprietary,
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responsible for delivering this message to an intended recipient,
please contact the sender by reply e-mail and destroy all copies of the
original message.
--
Lane Ferrin
<Email Address Redacted>
I'm looking for suggestions to resolve distal end pressure and provide
max suspension on a very soft bulbous limb. Patient is 23 yrs, female,
5'4, 200 lbs, carried mostly in her legs. Amputation is longer than
average TT, traumatic, has been successfully wearing a sock fit socket
with sleeve and suction valve, hinged posterior brim to allow donning.
Pistoning was minimal initially, (July of this year), but rapidly
progressed as her limb softened and is now about 3/4-1.
Limb is 36cm circ distally, 32cm at MTP. Tissue is extremely mobile,
moving vertically in relation to the tibia about 1.5. I am attempting
to use a locking liner to keep pistoning to a minimum by pulling the
soft tissue distally. An original Alpha liner allows extreme vertical
motion, 1 of pistoning even with aggressive distal traction with a
lanyard. An Otto Bock 6Y75 stops the pistoning but impinges on the
anterior distal tibia under load, causing pain. The tibia is very
prominent, just under the skin over its whole length and the distal
tissue can be pushed posteriorly and vertically to the point where one
can palpate the posterior distal tibia a little.
Perhaps a very small diameter umbrella would work, so soft liner
material is not directly under the tibia. A custom umbrella might
work, but I am not aware if anyone has ever made one.
Suggestions?
Lane Ferrin CP
This encrypted email is in compliance with the Breach Notification
Requirements under Section 13402 of Title X111 (Health Information
Technology for Economic and Clinical Health Act) of the American
Recovery and Reinvestment Act of 2009.
CONFIDENTIALITY NOTICE: This e-mail message and any attachments are for
the sole use of the intended recipient(s) and may contain proprietary,
confidential, trade secret or privileged information. Any unauthorized
review, use, disclosure or distribution is prohibited and may be a
violation of law. If you are not the intended recipient or a person
responsible for delivering this message to an intended recipient,
please contact the sender by reply e-mail and destroy all copies of the
original message.
--
Lane Ferrin
<Email Address Redacted>
Citation
Lane Ferrin, “Bulbous limb, pistoning,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/209260.
