Air Pocket Sockets
John T. Brinkmann, CPO
Description
Collection
Title:
Air Pocket Sockets
Creator:
John T. Brinkmann, CPO
Date:
9/14/1999
Text:
I am currently seeing a pleasant, responsible, and compliant gentleman
who has bilat TT (BK) amputations. (Rt: '85; Lt: '91) He is diabetic
and has very little soft tissue on either residual limb. The distal
ends of the RLs are very sharp - worse on left side. He has had
problems with distal end ulceration on both RLs, but the right is
currently resolved. He had a revision on the rt. side due to bone
infection - after prolonged ulceration of the distal tibia. I am the
third prosthetist in several years to work with him.
Many different liners have been tried - pelite and gel, non-locking and
locking. I have him in an Alpha Locking liner (6mm, medium, contoured).
There are several other options I want to try with him, but would like
to get your perspective before proceeding any further.
1. Is it possible that the distal tibia is so sharp that the ulceration
will occur regardless of what material the distal RL contacts in the
socket? Is this suggestion simply a cop-out?
2. What are the merits of inflatable pockets in the socket in
addressing this situation? I have always considered them more
applicable for larger RLs with greater variations in volume. Any
experience with the Otto Bock inflatable liner?
3. I have had good success with the TEC liner for an extremely brittle
diabetic. Is the sharp distal end a contra-indication for use of the
TEC liner?
Thank you for your consideration of these questions.
Sincerely:
John T. Brinkmann, CPO
who has bilat TT (BK) amputations. (Rt: '85; Lt: '91) He is diabetic
and has very little soft tissue on either residual limb. The distal
ends of the RLs are very sharp - worse on left side. He has had
problems with distal end ulceration on both RLs, but the right is
currently resolved. He had a revision on the rt. side due to bone
infection - after prolonged ulceration of the distal tibia. I am the
third prosthetist in several years to work with him.
Many different liners have been tried - pelite and gel, non-locking and
locking. I have him in an Alpha Locking liner (6mm, medium, contoured).
There are several other options I want to try with him, but would like
to get your perspective before proceeding any further.
1. Is it possible that the distal tibia is so sharp that the ulceration
will occur regardless of what material the distal RL contacts in the
socket? Is this suggestion simply a cop-out?
2. What are the merits of inflatable pockets in the socket in
addressing this situation? I have always considered them more
applicable for larger RLs with greater variations in volume. Any
experience with the Otto Bock inflatable liner?
3. I have had good success with the TEC liner for an extremely brittle
diabetic. Is the sharp distal end a contra-indication for use of the
TEC liner?
Thank you for your consideration of these questions.
Sincerely:
John T. Brinkmann, CPO
Citation
John T. Brinkmann, CPO, “Air Pocket Sockets,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/212839.
