Re Bilateral Trans Fem
Phillip Francis
Description
Collection
Title:
Re Bilateral Trans Fem
Creator:
Phillip Francis
Date:
2/1/2001
Text:
We are curently providing rehab to a 26 yo male who was sandwiched between a
truck and a car resulting in bilateral trans fem amputations.
This fellow was/is a keen district cricketer and all round sportsperson who
is keen to return both to an active lifestyle and competive sport on his own
two pins.
He is now 15 weeks down the track and during this time his major
complication has been heterotopic ossification in both stumps. This has
received the usual medical treatment and has thus far been no problem.
We initally provided this fellow with bilateral stubbies which were
essentially TF prostheses without knee joints (modular titanium) but
including SACH feet. The prostheses were set up such that he was
approximately 150cm (in height) compared to his own height of about 180cm (6
feet for the USA). Over 4 weeks we have increased the height to about 170cm
now and 3 weeks ago we added Otto Bock single axis safety knees. This fellow
is now walking on his bilaterally articulated prostheses with the aid of
elbow crutches on most surfaces with surprisingly few problems.
The question is Where do we go from here?
Our rehab specialist is proposing to refer this fellow for opinions
regarding Osseous Integration although it is realised that the Heterotopic
ossification may prove to be a problem amongst other things.
Our patient/client/fellow (and lets not argue and marginalise him) is
interested also in the possibility of C-legs and judging from the degree of
stance phase stability and adjustability this would appear on the surface to
be an excellent prescription.
Therefore I am interested as to whether C-legs have been used on bilateral
TFs and if so how successful this was and if not what of the many
permutations might be seen as an alternative prescription. Certainly Four
Bar linkages with the inherent shank shortening in swing phase are a good
alternative.
Secondly our physio has been working with this fellow to get from the ground
to a standing position using only his elbow crutches. This has been a very
difficult task and we would appreciate feedback and advice.
Any advice and input would be greatly appreciated.
Phillip Francis
Grace McKellar Centre - Geelong - Australia
<Email Address Redacted>
truck and a car resulting in bilateral trans fem amputations.
This fellow was/is a keen district cricketer and all round sportsperson who
is keen to return both to an active lifestyle and competive sport on his own
two pins.
He is now 15 weeks down the track and during this time his major
complication has been heterotopic ossification in both stumps. This has
received the usual medical treatment and has thus far been no problem.
We initally provided this fellow with bilateral stubbies which were
essentially TF prostheses without knee joints (modular titanium) but
including SACH feet. The prostheses were set up such that he was
approximately 150cm (in height) compared to his own height of about 180cm (6
feet for the USA). Over 4 weeks we have increased the height to about 170cm
now and 3 weeks ago we added Otto Bock single axis safety knees. This fellow
is now walking on his bilaterally articulated prostheses with the aid of
elbow crutches on most surfaces with surprisingly few problems.
The question is Where do we go from here?
Our rehab specialist is proposing to refer this fellow for opinions
regarding Osseous Integration although it is realised that the Heterotopic
ossification may prove to be a problem amongst other things.
Our patient/client/fellow (and lets not argue and marginalise him) is
interested also in the possibility of C-legs and judging from the degree of
stance phase stability and adjustability this would appear on the surface to
be an excellent prescription.
Therefore I am interested as to whether C-legs have been used on bilateral
TFs and if so how successful this was and if not what of the many
permutations might be seen as an alternative prescription. Certainly Four
Bar linkages with the inherent shank shortening in swing phase are a good
alternative.
Secondly our physio has been working with this fellow to get from the ground
to a standing position using only his elbow crutches. This has been a very
difficult task and we would appreciate feedback and advice.
Any advice and input would be greatly appreciated.
Phillip Francis
Grace McKellar Centre - Geelong - Australia
<Email Address Redacted>
Citation
Phillip Francis, “Re Bilateral Trans Fem,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/215956.
