TF/IPOP Responses

TF/IPOP Responses

RE: Transfemoral Immediate Post-Op Prosthesis (IPOP)
POSTED: October 26, 1999

The following are the responses I received to the above subject. The orginal
post is also included following the response.

Thanks to those who who took the time to responded! Some questions were
raiased by the respondents which might lead to further responses on this
subject.

RESPONSES:
Date: 10/26/99 12:09:17 PM Eastern Daylight Time
From: <Email Address Redacted> (zach harvey)
Have you considered using a silesian belt on the IPOP for rotation ctrl and
suspension? Incorporate into the plaster: one strap with a buckle, a second
strap to go around the waist (with attached ring), and a third strap to feed
through the ring and back through the buckle. The second strap can be
adjusted by embedding an attachment plate on the lateral side. Positioning
of the first and second straps affects rotation control. We learned this
method at UT-Southwestern. I hope this helps.
Zach Harvey, O&P Student
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Date: 10/26/99 2:12:55 PM Eastern Daylight Time
From: <Email Address Redacted> (John W. Michael)
Your comments and observations coincide with mine.

My fundamental question is: why do an AK IPOP? In my experience, aggressive
early fitting with an endoskeletal definitive offers the same long term
result as an AK IPOP with a lot less aggravation for everyone involved, most
particularly the patient. Particularly with a frame system, socket changes
as necessary are straightforward and cost little or no more than an IPOP and
prep would.

For what it's worth, the various pneumatic bag devices that have come and
gone over the years are adequate for mobilizing patients in the week or two
before they can be fitted with a prosthesis. I have rarely felt that was
necessary either, however.

Hi level IPOPs seem to me more driven by one's philosophy than by any
documentable need. Or, do you see it differently?
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Date: 10/26/99 2:41:41 PM Eastern Daylight Time
From: <Email Address Redacted> (Don Cummings)
In some cases on smaller patients, a TES pre-fabricated neoprene belt may
work, with same concerns of compliance, necessary understanding of
importance of suspension and rotational control. Also, because of the bulk
and high-friction of plaster or fiberglass, it can be a challenge to pull
this over a direct-applied rigid dressing. Some sort of interface usually
has to be applied over the cast to facilitate pulling on the TES belt (like
duct tape).

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Date: 10/27/99 1:45:14 PM Eastern Daylight Time
From: <Email Address Redacted> (Susan Kapp)
CC: <Email Address Redacted>
John: What Zach Harvey described to you is the method I've always used, it
is simple and easy to apply. I'm not aware of any published reference for the
use of the Silesian belt specific to post op prostheses. In fact other than
Joe Zettl's book there isn't a lot on the application of post op prostheses.
I've always preferred the double anterior attachement points for the
Silesian, such as the style you get from Fillauer. I think it gives you more
control. Of course the primary indication for a Silesian is rotational
control. Let me know if this method works for you.

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Date: 10/27/99 6:27:07 PM Eastern Daylight Time
From: PFBJKD

   I usually use a combination of an over the shoulder strap (no bowden
cables- simply attached mid line ant and pos socket) and a TES belt that has
been split down the side and velcro added for ease of donning after the cast
is applied. I think overall this works fairly well, particularly bearing in
mind that I am not overly critical of control I can get on an IPOP.
   Just thinking outloud here- I wonder what would happen if you used an
Ischial containment brim?
Paul Burnette, CP

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