Distal Stump Pain

Distal Stump Pain

3/30/1999

One fine day Dave Fenton asked:

DF> Patient is a 77 years old male, bilateral BK (level 3+). Tried 3S
    sockets. Patient expressed sharp pain when leg is lifted, no pain
    while standing in legs. I assumed that distraction of the pin cause
    by the weight of the prosthesis was the source of the pain but we
    were unable to replicate discomfort by manually manipulating the
    pin. Any thoughts on this phenomenon.

I am R-BK since 1969. Trauma due to motorcycle accident. Chuck Dillard,
CPO, has made rigs for me since about 1980. Fact, I see him at 9am
tomorrow.

When the 3-S system first hit the scene he suggested it for me, since I
was much younger than your patient and was then speedwalking up to
10K/day.

We tried it. The distal pain was, uhhhh, serious. Exactly what your
patient is describing to you. Just lifting the leg caused serious
annoyance on the distal portion of my stump, which I can assure you was
severe enough to capture my complete attention.

Chuck, being a very conscientious prosthetist, had forewarned me that
yes, there would be some discomfort at first, but after a week or so it
would dissipate and I would eventually be a happy camper. He was also
aware that my stump was, even after many years, quite sensitive. It
still is.

Now I am no stranger to pain. We are old friends. I can and will
tolerate short-term pain for perceived long-term gain. I realize life is
a series of little trade-offs. But, in the final analysis, I was too
much of a woos and sissy to tolerate the discomfort. For me, it did not
work.

Manually manipulating the pin is one tact. Another might be to manually
manipulate your patient's stump...put both hands around the distal end
and pull downward. If the resulting pressure causes him pain, well,
maybe your patient is similar to me. Tho slightly older.

Amazing, ain't it, how as I celebrate 30 years of having a stump (this
November 1) it is still quite sensitive. Happy birthday to me. And my
stump.



Wayne Renardson