Re: Difficult case - PFFD
Vikki A. Stefans
Description
Collection
Title:
Re: Difficult case - PFFD
Creator:
Vikki A. Stefans
Date:
8/27/1999
Text:
Just saw a lovely young lady, a very active grade schooler, who had a
Symes done for her PFFD at St. Louis Shriner's...without a knee
fusion...and was told by them she would never be able to use a knee joint
in her prosthesis. I did not have x-rays available, but she has a fairly
short femur, I am thinking just about 4 inches or less hip to anatomic
knee, no hip pain and good AROM.
However, a local prosthetist has fit her with a wooden prosthesis, very
simple suspension, plastic socket that is using some of the available
anatomic knee flexion to shorten the limb slightly, plus has a friction
knee with a little offset above the end of the Symes to shorten a little
more. She has a Child's Play foot and probably gets a little energy
storage fucntion out of it, but tends to keep it all abducted and stay up
on thhe toe. She is not getting all the flexion out of the system that
she could and overall it is still a significantly on the long side...but
she certainly likes it better than things she had before nevertheless.
She and her family are not all that bothered by the knee length being
different in sitting (Symes side is long) and the anatomic knee flexion
seems to be giving her a bit of compensatory lordosis she does not need,
so my suggestion is to decrease or eliminate it, and increase the offset a
little more. At least a four-bar knee would make sense, we think.
Durability and function are a lot more important to her lifestyle than
cosmesis.
It is beyond me why she did not have either a turnaround or the Symes
*with* a knee fusion, and why anyone ever thought she could not use a
prosthetic knee...any further input or ideas most welcome.
Vikki Stefans, pediatric physiatrist (rehab doc for kids) and working
Mom of Sarah T. and Michael C., aka <Email Address Redacted>
Arkansas Children's Hospital/ U of A for Medical Sciences, Little Rock
...and EVERY mom is a working mom! (OK, dads too...)
PS for Les:
Les- I THINK you subscribe to here by sending a message with a blank
subject and just subscribe OANDP-L (no quotes) in the body to
listserv@nerdc.nervm.ufl.edu...but it could have changed as our address
has changed. And please correct my description if I have erred in any
way! Thanks much, and glad you are on-line...
Symes done for her PFFD at St. Louis Shriner's...without a knee
fusion...and was told by them she would never be able to use a knee joint
in her prosthesis. I did not have x-rays available, but she has a fairly
short femur, I am thinking just about 4 inches or less hip to anatomic
knee, no hip pain and good AROM.
However, a local prosthetist has fit her with a wooden prosthesis, very
simple suspension, plastic socket that is using some of the available
anatomic knee flexion to shorten the limb slightly, plus has a friction
knee with a little offset above the end of the Symes to shorten a little
more. She has a Child's Play foot and probably gets a little energy
storage fucntion out of it, but tends to keep it all abducted and stay up
on thhe toe. She is not getting all the flexion out of the system that
she could and overall it is still a significantly on the long side...but
she certainly likes it better than things she had before nevertheless.
She and her family are not all that bothered by the knee length being
different in sitting (Symes side is long) and the anatomic knee flexion
seems to be giving her a bit of compensatory lordosis she does not need,
so my suggestion is to decrease or eliminate it, and increase the offset a
little more. At least a four-bar knee would make sense, we think.
Durability and function are a lot more important to her lifestyle than
cosmesis.
It is beyond me why she did not have either a turnaround or the Symes
*with* a knee fusion, and why anyone ever thought she could not use a
prosthetic knee...any further input or ideas most welcome.
Vikki Stefans, pediatric physiatrist (rehab doc for kids) and working
Mom of Sarah T. and Michael C., aka <Email Address Redacted>
Arkansas Children's Hospital/ U of A for Medical Sciences, Little Rock
...and EVERY mom is a working mom! (OK, dads too...)
PS for Les:
Les- I THINK you subscribe to here by sending a message with a blank
subject and just subscribe OANDP-L (no quotes) in the body to
listserv@nerdc.nervm.ufl.edu...but it could have changed as our address
has changed. And please correct my description if I have erred in any
way! Thanks much, and glad you are on-line...
Citation
Vikki A. Stefans, “Re: Difficult case - PFFD,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/212474.
