"One way" valves Trans-tibial Sockets- RESPONSES (part one)

"One way" valves Trans-tibial Sockets- RESPONSES (part one)

Randall McFarland, CPO

ORIGINAL QUESTION:
How vital do you find one-way valves to be in the success of your
trans-tibial suction sockets?


      THANK-YOU TO ALL RESPONDENTS!!

Randy McFarland,CPO
Sunny Hills Orthopedic Services, Inc.
Fullerton,CA

     REPLIES- (each separated by a blank line)

They help but are not absolutely necessary.
Ted A. Trower C.P.O.

   I use one-way valves in many of my TT prostheses, and have had very good
success with them. I have just about stopped using pin type suspension, and
feel that a suction system with good proximal seal provides great suspension
and minimizes pistoning and pull on the distal end of the residual limb for
my TT clients/patients. The feedback that I have been getting has been very
positive, especially from the individuals that I have switched from pin
suspension to the suction systems. The problem has been the proximal
suction seals that tend to wear out quickly. I have tried a number of
different types, and each person has a style that is better suited by a
different seal- for example, some folks really need the strength and
durability of an Active Sleeve, some love the thin Alps suspension sleeves,
and others can make an OWW sleeve last for 4 months. Once an individual
loses the suction by even a small tear in a liner, although the limb may
have physical suspension, there is a noticeable difference to the wearer-
which shows that the suction itself plays an important role in both comfort
and suspension.
     Specifically addressing the one-way valve issue, in a very well fitting
socket (especially for a fleshy limb) the valve is very helpful in distal
air removal, and in general the valves are helpful in preventing noises from
air escaping up the side of the socket/sleeve- as well as helping to
maintain consistent environment within the socket. A blocked valve results
in less constant fitting, and increased movement within the socket.
Paul Prusakowski, CPO

     I've been using the ESP Lyn Valve /RV (autoexpulsion valve) exclusive for
the past 3 years and am very pleased with it. You can also get the housing
with a manual expulsion valve.
Call 1-800-932-7377
Tony van der Waarde, CP(c)

      I have used valves for many of my patients. The options, that I like
best is using the ICEX system (or the Icelock system) with the Dermo
liner. That system gives you the possibility to try both systems. And in
that way you can give the patient both opportunities, with out changing
the socket. I cannot recommend you what kind of patient would get the
best benefits out of it. There are so many other things that are
involved, but the choice will be there's and not the CPO.
If you are going to the ISPO meeting in Glasgow, we could meet and have
a discussion about it. I talk better English than I write...
Anton Johannesson CPO
Ortopedteknik AB
Ortoped tekn avd
Centralsjukhuset
Kristianstad
Sweden

   We have used pee wee valves and like them. We have also used Tec just
recently. Function okay but bulky so is fine for double wall socket but I
would not use it otherwise. OWW pyramid valves did not impress us.
(Teri Powers-Watts, CPO,CPed)


    We have started using more one-way valves with gel liners and gel
suspension
sleeves than pin systems. We feel this method results in a more stable
suspension system because of two reasons:
* The patient/client does not experience distal draw on the lower third of
the residuum (especially when using some of the heavier componentry such as
multiaxial ankles, rotators, shock absorbers)
* The use of the suspension sleeve provides the seal and assists in
suspension during swing.
    It is a little more work to don and doff but worth it for the better
stability. The valve itself (we use USMCs socket adapter/valve
combination) facilitates the evacuation of air during donning. All our
wearers comment on how surprised they are that there is no motion within the
socket.
Eric Schwelke, C.P.O.

-
   I and my associate have fit a few. I have fit a few with two socket
designs - one with a cushion liner and valve with latex or equall
suspension sleeve, and one with an HSI (Hypobaric Suspension/Compliant
Interface - the pin type). Most choose the pin type suspension over the
valve/sleeve design. They list the benefits to them as greater ROM, less
material covering skin which is more comfortable. When I fit a person who
has undergone an Ertl type trans-tibial amputation, I feel that we are
better able to achieve maximum end-loading via the valve design.
   -Jan

when you put your patient into the check socket, go without a minivalve
initially. have the patient walk, sit, stand, etc. for fifteen minutes or so
then evaluate the suction fit. if you have the patient sit, then pull on the
prosthesis and have movement , you need a valve to evacuate the air. if you
don't use a valve the possibility of pistoning is going to be much greater.
pistoning is going to cause friction. friction causes breakdown.
 luke richards

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