Hemicorporectomy, Trans-lumbar prosthesis "HELP"

Hemicorporectomy, Trans-lumbar prosthesis "HELP"

Andy Wolfe C.O.

1/14/2000

Hello listserve members, I have been presented with the prospect of
providing a seating system for a Trans-lumbar level amputation. While I
have made a few in the past (25 years ago) I am confident there is most
likely improved methods.

I have referenced the 1992 issue of JPO as well as the Atlas of
Prosthetics; what I am really looking for is some broader clinical counsel
and real life application.

My first question is in regard to the shape of the residual torso. In your
experience, are there any surgical considerations, such as suture location
and/or soft tissue coverage, that would facilitate the most favorable
outcome. Any information regarding this topic is appreciated.

Please offer recommendations regarding the overall structure of the device,
thermoplastic vs. laminated, etc. Also, one of our ideas is to use a
custom, urethane based socket interface, is this reasonable and technically
possible? Other suggestions welcome.

Also, it is my understand the individual is insensate from the lower
thoracic area down, another clinical consideration. The physician has not
carried out the amputation yet, he is in the process of researching his
options and is looking for my input as well. I am working on this project
in conjunction with our certified prosthetist and seating specialists.

Thank you in advance for your input, I am looking forward to your
responses.

Andy

 Andy Wolfe, C.O.
 Manager/Certified Orthotist
 The Brace Place
 Munroe-Meyer Institute
 for Genetics and Rehabilitation
 A University Affiliated Program