Replies: shock pylons

Replies: shock pylons

J Bindi

2/8/2002

Thank you all for your responses to the following:
I have a patient who has worn the Seattle Air Stance shock, but has blown the seal a couple of times. He's a skiier and otherwise very active. He has tested the TruStep foot and likes that for the dorsiflexion it affords him while skiing. He would like to try another type of shock and use it with the TruStep foot (so ReFlex VSP and Pathfinder are out). I haven't used many shock pylons. I would welcome any recommendations and the reasons you like one over another.

Replies:

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Try using an endolite TT pylon they are very durable.
I have 2 guys using this pylon that are both 220+ lbs and active. I have yet
had to service them in over a year. You can also talk to Malcolm at endolite
if you want to fine tune the bumpers. He has done some special work in the
past for me with their multiaxial ankles.


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I prefer the Total Shock. I have found that with the increased surface area for the piston gives you increased durability for your active patients. TT pylons seem to wear through in to the pylon rather quickly


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try the Century twenty two system, I had a used one apart and liked
what I saw. You have a urethane bumper that appears durable, occasional
lubrication is all the maintenance I see necessary.
I have heard alot of problems associated with the TEC systems so I would not
suggest trying one as of yet.


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              We don't often answer list-server queries, but as we fit all
of the Australian Paralympic skiing team, thought we may assist.

We've fitted the Total Shock to a number of our skiers over the years,
amongst other shocks. The reason we principally fit the Total Shock is
firstly because of the simple adjustability of the torsion & axial
compression bumpers, secondly because of the large bearing surface (unlike
the Blatchford TT), thirdly because of its maintenance simplicity (such as
Air-stance), fourthly because of weight and fifthly because temperature does
not alter the function (ala pneumatic/hydraulic shocks).


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The TT pylon from Endolite is a good product and worth a try. Another
suggestion is one I have heard of but have not had the opportunity to try
yet. It will require some mechanical ability on the part of your patient or
a quick disconnect unit. The idea is to use an Endolite ankle. The ankle
allows plantarflexion but has a flange on the anterior side to prevent
dorsiflexion. The novel approach is to reverse the ankle ONLY for use in a
ski boot. A ski boot requires the ankle be dorsiflexed some but allowed to
dorsiflex even more to work with the knees/hips to help absorb the impacts
of skiing. With the ankle reversed there is no flange on the anterior side
and will allow a lot of dorsiflexion. I heard this from an avid
skier/amputee that uses this system to ski with. One other thought. If
your patient is pleased with the movement of the college park foot, he
should try the genesis II foot from Jim Smith Sales. I have used many of
these feet and am amazed at the amount of dorsiflexion it allows.


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I have been loyal to the air stance for 5 years, the seals and the 3-4 times
a year rebuild got old but it worked well, it was a good solid unit, I have
now started wearing the Mercury TT pylon from Endolite it is much lighter
and easier to maintain I have had it since June with no problems I an using
it with a mercury foot, this combination works well and with minimal
maintenance should last a long time I had a new leg made with this same
components, and am very happy with it.


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I highly recommend the Ossur Total Shock - there are 2 or 3 different styles
depending on the application. Not only is it a shock pylon, it is also a
torque absorber. Try it-your patients will like it!


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Randy Whiteside has developed a very nice and lightweight shock/torque
absorbing pylon. His company is called Medventions.


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Blowout is a common problem with the Airstance and Seattle acknowledges that fact but they honor their warranty. Try the Century XXII. It uses solid elastomer bumpers. Avoid the ICON as it isn't designed for high activity (amazing!)for anyone over 110 lbs.


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There are a couple of things you may want to consider trying.

Using an endolite t/t shock pylon with the TruStep.
Using an Endolite t/t shock pylon with either the mercury or endloite dyn
resp foot with ankle.
Using a century XXII shock pylon/adapter.


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Julie Bindi, CP