Re: G. Boyer/ "amputee Union" / Socket fit
George Boyer
Description
Collection
Title:
Re: G. Boyer/ "amputee Union" / Socket fit
Creator:
George Boyer
Date:
9/20/1999
Text:
You are an amusing spectacle, Wade, with your foot in your mouth :-)
Since you have not been reading clearly enough let me restate, for you,
what has been the INVARIABLE thrust of my message (ask around, others
less inclined to sarcastic rhetoric will confirm this):
Socket fit AND alignment of the limb are the sine qua non of a
successful prosthesis.
If there WERE one way to make a socket THAT way would be to make it
comfortable no matter what method were chosen......amputees have been
comfortably fit by talented prosthetists using many approaches and
talented and sensitive and knowing hands are always involved. Trial and
error, without knowing what you are doing is pure ignorance.
I don't 'fancy' my approach to be anything more than an intelligent
attempt to comment on what I have experienced and encountered, with the
hope of initiating some needed improvement in the lives of amputees and
in the practice of prosthetics. Despite the haughtiness evident in his
post Mr. Bader is probably a good prosthetist....the amputees for whom
he has made limbs are the judge of that. Always making the assumption
that one's respondent (or client) is ignorant or misguided or otherwise
in the dark leaves something to be desired in any transaction.
Cheers, George Boyer.
<Email Address Redacted> wrote:
>
> I have been following some of the rhetoric the past few days on this
> listserver regarding amputee unions, socket fit... etc....
>
> I am a practitioner in Tampa Florida... I don't profess to be the best, I
> certainly hope I'm not the worst, I fancy myself a competent practitioner.
> I would like to make a comment regarding my impression of socket fit
> arguments.
>
> there is no doubt that socket fit is important in all prosthetics. However,
> It is, in my opinion, no more important than proper allignment and
> appropriate design... here is my justification:
>
> If there was one way to make a proper AK socket, why would there be so many
> socket variations... Quadrilateral, Ischial containment, modified IC,
> suction, SSS... etc.... then bottom line is that AK's are mostly soft
> tissue, and so hydraulic containment is the universal critical aspect of the
> socket. which one is the best socket Mr. Boyer? shall you or your amputee
> Union be made the authority of such decision?
>
> Prosthetists understand that alignment impacts the forces inside the socket,
> so when the patient perceives and reports a poor socket fit, it can actually
> be an alignment problem. Fine details of alignment have such a huge impact on
> outcome, yet to the patient, the main perception of a prosthesis is naturally
> the component that interface with his/her anatomy... the socket.... so often,
> alignment problems are articulated as socket fit problems by the patient. All
> competent prosthetists know this.....
>
> So when I hear this big uproar by the amputee community, (or is it just
> George Boyer), stating that if we all could just cast and modify
> appropriately, the world would be a better place for amputees... I don't
> think so... we work in a complex environment, juggling the business/cost
> containment aspects of the field, the technology of the field, the
> phsyco/social aspect of our work, and the actual evaluation, design and fit
> of the devices. So, when Mr. Boyer summarizes quality or competence to
> the taking of casts and modifying molds, I find those comments to be an
> insult to myself and this profession.
>
> Sincerely,
>
> Wade Bader, LCPO
> Tampa FL
>
Since you have not been reading clearly enough let me restate, for you,
what has been the INVARIABLE thrust of my message (ask around, others
less inclined to sarcastic rhetoric will confirm this):
Socket fit AND alignment of the limb are the sine qua non of a
successful prosthesis.
If there WERE one way to make a socket THAT way would be to make it
comfortable no matter what method were chosen......amputees have been
comfortably fit by talented prosthetists using many approaches and
talented and sensitive and knowing hands are always involved. Trial and
error, without knowing what you are doing is pure ignorance.
I don't 'fancy' my approach to be anything more than an intelligent
attempt to comment on what I have experienced and encountered, with the
hope of initiating some needed improvement in the lives of amputees and
in the practice of prosthetics. Despite the haughtiness evident in his
post Mr. Bader is probably a good prosthetist....the amputees for whom
he has made limbs are the judge of that. Always making the assumption
that one's respondent (or client) is ignorant or misguided or otherwise
in the dark leaves something to be desired in any transaction.
Cheers, George Boyer.
<Email Address Redacted> wrote:
>
> I have been following some of the rhetoric the past few days on this
> listserver regarding amputee unions, socket fit... etc....
>
> I am a practitioner in Tampa Florida... I don't profess to be the best, I
> certainly hope I'm not the worst, I fancy myself a competent practitioner.
> I would like to make a comment regarding my impression of socket fit
> arguments.
>
> there is no doubt that socket fit is important in all prosthetics. However,
> It is, in my opinion, no more important than proper allignment and
> appropriate design... here is my justification:
>
> If there was one way to make a proper AK socket, why would there be so many
> socket variations... Quadrilateral, Ischial containment, modified IC,
> suction, SSS... etc.... then bottom line is that AK's are mostly soft
> tissue, and so hydraulic containment is the universal critical aspect of the
> socket. which one is the best socket Mr. Boyer? shall you or your amputee
> Union be made the authority of such decision?
>
> Prosthetists understand that alignment impacts the forces inside the socket,
> so when the patient perceives and reports a poor socket fit, it can actually
> be an alignment problem. Fine details of alignment have such a huge impact on
> outcome, yet to the patient, the main perception of a prosthesis is naturally
> the component that interface with his/her anatomy... the socket.... so often,
> alignment problems are articulated as socket fit problems by the patient. All
> competent prosthetists know this.....
>
> So when I hear this big uproar by the amputee community, (or is it just
> George Boyer), stating that if we all could just cast and modify
> appropriately, the world would be a better place for amputees... I don't
> think so... we work in a complex environment, juggling the business/cost
> containment aspects of the field, the technology of the field, the
> phsyco/social aspect of our work, and the actual evaluation, design and fit
> of the devices. So, when Mr. Boyer summarizes quality or competence to
> the taking of casts and modifying molds, I find those comments to be an
> insult to myself and this profession.
>
> Sincerely,
>
> Wade Bader, LCPO
> Tampa FL
>
Citation
George Boyer, “Re: G. Boyer/ "amputee Union" / Socket fit,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 15, 2024, https://library.drfop.org/items/show/212931.
