responses to TECliner for trans-femorals
Ron Hulshof
Description
Collection
Title:
responses to TECliner for trans-femorals
Creator:
Ron Hulshof
Date:
12/8/1999
Text:
On the 4th of November I posted the message below. Over the past few weeks
I received some very useful replies for which I want to thank all of those
who made the effort.
Does anybody have any good or bad experiences in using TEC-liners for
trans-femoral amputees, especially with regard to the distal pin attachment?
I am considering using this for a patient with limited dexterity due to a
partial one sided upper limb paralysis. He finds doffing and donning the
prosthesis to change stumpsocks during the day too much hassle and he is
not keen on a suction prosthesis. A silicon liner with distal pin wouldn't
allow much volume change during the day so would a TEC with distal pin be
the answer?
Thank you for your thoughts on this matter.
Ron Hulshof
>I just delivered a TF prosthesis to a patient who also has a shoulder
>disarticulation on the same side. He had tried various liners/pins but
>had difficulty donning independently. I fit him using a suction socket
>and flexible liner/frame. He lubricates his residual limb with a
>commercially available lotion and slides right in. It immediatly holds
>suction and He reports wearing the leg 16hrs/day with no suction loss or
>expensive liner to care for. This technique has been around awhile and is
>not my preference but it really works in the right case . There are
>several details about socket design that should be considered since you
>are trying to push the tissue in the socket rather than pull in. WOuld be
>happy to discuss further if you are interested.
>
>good luck!
>
>John Fergason, CPO
>Director
>UW Division of Prosthetics-Orthotics
>1959 NE Pacific St
>Box 356490
>Seattle WA 98195-6490
>(206) 543-7273
>I have one elderly female trans-femoral amputee who is using a 6mm Alpha
>Liner and is happy with the prosthesis and suspension. I don't see the upper
>limb paralysis being a significant problem for your patient, although it will
>likely take some training. However, if he/she has been using a prosthetic
>sock successfully, they should be able to master the roll on socket liner.
>TEC or Iceross might work equally as well. I use Iceross often too, but
>don't have any trans-femoral patients wearing one. Hope it helps.
>
>Wil Haines, CPO
> You will encounter the same volume problems with a Tec liner. Even
>though the material
>flows, It only flows the same amount as a silicone liner. A silicone liner
>might be even
>easier to don. The best thing is to see if your patient can don a liner
>single handed. You
>may see that this may be a major problem itself. Some of the liners have
>an outer material,
>and does enhance donning by keeping the liner shape so the patient can
>roll the liner up. A
>non-covered liner may bind from friction and hinder rolling on.
> I found the ALPS easy liner to be a good all around liner and has a
>pin attachment
>option.
> Hope this helps.
>Jeff Honma CPO
>My experience in the past has been to apply a guide to the pin (welded Bowden
>Cable) or replace the pin with a strap and secure it outside the socket with
>Velcro (Lanyard).
>
>
>Bob Brown, Sr., CPO, FAAOP
>I noticed your message on the O&P Online Listserve. Your message was directed
>to practitioners and not suppliers but I wanted to let you know that we are
>here if you want any technical support or direction.
>
>There is another source you may want to use. There is a prosthetist by the
>name of Bengt Soderberg in Sweden. He has a lot of experience with TEC
>transfemorals and has a keen mind to seek new variations for each case. I
>have copied this message to his e-mail. Feel free to contact Bengt or myself
>if you feel we can help you.
>
>Thanks,
>
>Scott Schneider
>TEC Interface Systems
>www.tecinterface.com
>I have had sucess using the custom made TEC for A/K's using total
>surface/push-in suction rather than the pin system. You should contact TEC
>regarding more info before you decide. If you would like to know more give
>me a wring.
>
>Ryan Gatlin, BOCP
>Georgia Prosthetics
>(912)272-6522
>The TEC may contribute to some flexibility in volume accuracy,at least in
>theory, but I am not sure it provides the answer you are looking for. I
>believe the the thickness of some of the TEC interfaces in combination with
>the material properties do allow a degree volume change.
>
>Equally important though, I think is the performance of the different
>interfaces when utilising distal connection for suspension purposes. One
>aspect of this which is specifically related to transfemoral users is the
>weight of the prosthesis which is considerable, especially if a reasonably
>sophisticated knee joint is used. For this reason, you will need to
>consider carefully your choice of locking mechanism and also the
>longituduinal stabilility of the interface you intend to use. A wind-in
>type of mechanism together with an interface including a distal matrix is
>in my experience the most efficient from that point of view.
>
>I am well aware I haven't have answered your question, but rather added to
>the complexity of the choice. Better to find out before the event than
>after though....
>
>Toby Carlsson
>Prosthetist
>I have made approximately 20 transtibial TEC liner prostheses, and zero
>transfemoral. I have made many transfemoral prostheses with Iceross liners
>and pins (or lanyards).
>Transfemoral prostheses with suction suspension w/ locking mechanism are a
>great choice for many clients. I only make other variants when the client
>insists on some other suspension mode. In your specific case, you mention
>two mitigating circumstances that might cause you to reconsider this choice
>for your client.
>People with upper extremity problems often have great frustration trying to
>don a urethane (TEC) or silicone gel liner. There are always exceptions,
>though, as I have a person who dons her transhumeral prosthesis with a gel
>liner with no problem whatsoever. Try to have the client attempt to don an
>Iceross liner if available to test his facility and patience. These liners
>are off the shelf unlike the TEC. The very helpful Ossur (the makers of the
>Iceross liners) guys may even send you an old or damaged liner to try if you
>ask. If this person lives with his mate or family and does not mind having
>help applying the liner, this may not be a problem.
>The other problem is your client's stated preference to not be bothered
>changing socks during the day. Volumetric changes are either dealt with as
>necessary, or consequences (pain, skin damage, time off the prosthesis) will
>ensue. TEC or Iceross liners with or w/o distal pin will not eliminate the
>need for attention to the right amount of socks.
>Finally, the lanyard system may be the better choice for a client with upper
>extremity problems.
>Good luck with your client, and also with the political changes that will
>hopefully bring your country the peace and tranquillity it deserves.
>
>Sincerely,
>Bob Traut, CP
>USA
Rockwater House
Ballymacmoy
Killavullen
Mallow
Co. Cork
Ireland
Tel. 00353(0)22 26725
00353 86 8367333
E-mail <Email Address Redacted>
I received some very useful replies for which I want to thank all of those
who made the effort.
Does anybody have any good or bad experiences in using TEC-liners for
trans-femoral amputees, especially with regard to the distal pin attachment?
I am considering using this for a patient with limited dexterity due to a
partial one sided upper limb paralysis. He finds doffing and donning the
prosthesis to change stumpsocks during the day too much hassle and he is
not keen on a suction prosthesis. A silicon liner with distal pin wouldn't
allow much volume change during the day so would a TEC with distal pin be
the answer?
Thank you for your thoughts on this matter.
Ron Hulshof
>I just delivered a TF prosthesis to a patient who also has a shoulder
>disarticulation on the same side. He had tried various liners/pins but
>had difficulty donning independently. I fit him using a suction socket
>and flexible liner/frame. He lubricates his residual limb with a
>commercially available lotion and slides right in. It immediatly holds
>suction and He reports wearing the leg 16hrs/day with no suction loss or
>expensive liner to care for. This technique has been around awhile and is
>not my preference but it really works in the right case . There are
>several details about socket design that should be considered since you
>are trying to push the tissue in the socket rather than pull in. WOuld be
>happy to discuss further if you are interested.
>
>good luck!
>
>John Fergason, CPO
>Director
>UW Division of Prosthetics-Orthotics
>1959 NE Pacific St
>Box 356490
>Seattle WA 98195-6490
>(206) 543-7273
>I have one elderly female trans-femoral amputee who is using a 6mm Alpha
>Liner and is happy with the prosthesis and suspension. I don't see the upper
>limb paralysis being a significant problem for your patient, although it will
>likely take some training. However, if he/she has been using a prosthetic
>sock successfully, they should be able to master the roll on socket liner.
>TEC or Iceross might work equally as well. I use Iceross often too, but
>don't have any trans-femoral patients wearing one. Hope it helps.
>
>Wil Haines, CPO
> You will encounter the same volume problems with a Tec liner. Even
>though the material
>flows, It only flows the same amount as a silicone liner. A silicone liner
>might be even
>easier to don. The best thing is to see if your patient can don a liner
>single handed. You
>may see that this may be a major problem itself. Some of the liners have
>an outer material,
>and does enhance donning by keeping the liner shape so the patient can
>roll the liner up. A
>non-covered liner may bind from friction and hinder rolling on.
> I found the ALPS easy liner to be a good all around liner and has a
>pin attachment
>option.
> Hope this helps.
>Jeff Honma CPO
>My experience in the past has been to apply a guide to the pin (welded Bowden
>Cable) or replace the pin with a strap and secure it outside the socket with
>Velcro (Lanyard).
>
>
>Bob Brown, Sr., CPO, FAAOP
>I noticed your message on the O&P Online Listserve. Your message was directed
>to practitioners and not suppliers but I wanted to let you know that we are
>here if you want any technical support or direction.
>
>There is another source you may want to use. There is a prosthetist by the
>name of Bengt Soderberg in Sweden. He has a lot of experience with TEC
>transfemorals and has a keen mind to seek new variations for each case. I
>have copied this message to his e-mail. Feel free to contact Bengt or myself
>if you feel we can help you.
>
>Thanks,
>
>Scott Schneider
>TEC Interface Systems
>www.tecinterface.com
>I have had sucess using the custom made TEC for A/K's using total
>surface/push-in suction rather than the pin system. You should contact TEC
>regarding more info before you decide. If you would like to know more give
>me a wring.
>
>Ryan Gatlin, BOCP
>Georgia Prosthetics
>(912)272-6522
>The TEC may contribute to some flexibility in volume accuracy,at least in
>theory, but I am not sure it provides the answer you are looking for. I
>believe the the thickness of some of the TEC interfaces in combination with
>the material properties do allow a degree volume change.
>
>Equally important though, I think is the performance of the different
>interfaces when utilising distal connection for suspension purposes. One
>aspect of this which is specifically related to transfemoral users is the
>weight of the prosthesis which is considerable, especially if a reasonably
>sophisticated knee joint is used. For this reason, you will need to
>consider carefully your choice of locking mechanism and also the
>longituduinal stabilility of the interface you intend to use. A wind-in
>type of mechanism together with an interface including a distal matrix is
>in my experience the most efficient from that point of view.
>
>I am well aware I haven't have answered your question, but rather added to
>the complexity of the choice. Better to find out before the event than
>after though....
>
>Toby Carlsson
>Prosthetist
>I have made approximately 20 transtibial TEC liner prostheses, and zero
>transfemoral. I have made many transfemoral prostheses with Iceross liners
>and pins (or lanyards).
>Transfemoral prostheses with suction suspension w/ locking mechanism are a
>great choice for many clients. I only make other variants when the client
>insists on some other suspension mode. In your specific case, you mention
>two mitigating circumstances that might cause you to reconsider this choice
>for your client.
>People with upper extremity problems often have great frustration trying to
>don a urethane (TEC) or silicone gel liner. There are always exceptions,
>though, as I have a person who dons her transhumeral prosthesis with a gel
>liner with no problem whatsoever. Try to have the client attempt to don an
>Iceross liner if available to test his facility and patience. These liners
>are off the shelf unlike the TEC. The very helpful Ossur (the makers of the
>Iceross liners) guys may even send you an old or damaged liner to try if you
>ask. If this person lives with his mate or family and does not mind having
>help applying the liner, this may not be a problem.
>The other problem is your client's stated preference to not be bothered
>changing socks during the day. Volumetric changes are either dealt with as
>necessary, or consequences (pain, skin damage, time off the prosthesis) will
>ensue. TEC or Iceross liners with or w/o distal pin will not eliminate the
>need for attention to the right amount of socks.
>Finally, the lanyard system may be the better choice for a client with upper
>extremity problems.
>Good luck with your client, and also with the political changes that will
>hopefully bring your country the peace and tranquillity it deserves.
>
>Sincerely,
>Bob Traut, CP
>USA
Rockwater House
Ballymacmoy
Killavullen
Mallow
Co. Cork
Ireland
Tel. 00353(0)22 26725
00353 86 8367333
E-mail <Email Address Redacted>
Citation
Ron Hulshof, “responses to TECliner for trans-femorals,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/213313.
