Re: Replies to:Transfemoral Post Op Preparatory Systems

Re: Replies to:Transfemoral Post Op Preparatory Systems

Bob Brown

1/13/2002

As the inventor of the APOPPS and co-owner of FLO-TECH, I too casted almost
every one of my patients for nearly 30 years. The whole time I agonized over
the constant cast changes (a high percentage that were not necessary - fear
because the patient complained or spiked a fever and the doc just wanted to
see what was going on), the struggle to get reimbursed adequately for the
amount and quality of mine time and the lack of total contact caused by an
ever changing patient in a static unchanging and unforgiving (patients swell
as well as shrink in casts) cast.

APPOPS sockets are made in 1 circumferential increments, with appropriately
corresponding AP dimensions, from 114 molds. I also do custom orders (from
measurements) sent to you the same day if ordered by noon. The sockets
provide total contact at all times and they maintain it much better than
casts because they adjust to fluctuations (up and down)in volume.

The APOPPS-TF is equally beneficial in its control and reduction of volume
and can only be improved through feedback. If anyone has a problem with any
portion of either the APOPPS or the APOPPS-TF please bring it to my
attention either by calling at me 800-356-8324 or submitting a question via
our home page at www.1800flo-tech.com.

Thank you,

Bob Brown, SR., CPO, FAAOP

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-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>]On
Behalf Of Practitioner
Sent: Friday, January 11, 2002 8:43 PM
To: <Email Address Redacted>
Subject: [OANDP-L] Replies to:Transfemoral Post Op Preparatory Systems


Thank you to all who replied.

 The Question:
Good Evening,
I have a patient who has been a transtibial amputee several years. He went
to work for Fed X delivering packages. Went to the mini lube and slipped on
oil. Broke femur, had to have a knee replacement. He has limited motion in
the knee and arthritis has set in. Very painful.

He has decided to have a transfemoral amputation. Doctor and patient would
like to have a temp. prosthesis to help unload the opposite hip which also
will need replacing in the next few years.
Patient is, or was Very active 49 year old BK. Has anyone been successful
with the Flo-Tech APPOPS system?
What other ideas do folks have to make this a smooth transition from BK to
AK?

Thanks for the help...

Jeff A. Zeller, BOCP
Ray Tegerstrands Orthopedic Appliance
Redding, CA
<Email Address Redacted>

The Replies:

dear jeff, the primary goal of any post op lower ext. fitting is wound
healing . minimal weight bearing is critical.i still cast all my post ops,
but transfemorals shrink faster so you have to stay on top of them more.the
flo-tech seems o-k but i have not used it.the b-k system may fit 20% post
operatively ,in my opinion.total contact is most important first thing.post
op fittings are the way to go,but realistic goals need to be understood by
all in the team and mostly by the patient.once wound healing is on it's way
then increase the weight bearing and temp fitting.i can understand the
concern about the other hip but swift healing will far outweigh one month of
pain on the other side.i hope all goes well with your case.mike beck cpo

Jeff,
Would your patient be interested in having Dr.Jan Ertl at Kaiser Hospital in
Sacremento preform the surgery?
We are looking for a primary and revision candidate for filming the famous
Ertl Procedure of corrective and primary amputee surgery. Let me know and
Ill put you in touch with Dr.Ertl to evaluate the patient.
Tony Barr
Barr Foundation




  We use the Flowtec Protector immediately following surgery. I usually put
them on in the surgical suite or in recovery. Certainly, my information and
assumptions are antedotal; however, I feel we have a shorter time to achieve
the goals of preprosthetic care(shaping and reduction of edema). I do not
place the Flowtec Protector on anyone that is significantly debilitated or
has to deal with anything like sacral decubitus ulcers.I have used the
Flotech Appops system. The trans-tibial system works well.
  The trans-femoral is a pain in the ass


  I just wanted to let you know we could custom make our system for your
  patient if there is any need beyond our standard sizes. I am always
  available to answer any questions you might have at 1-800-356-8324
  (FLO-TECH) or you could access our home page at www.1800flo-tech.com.
There
  a Q&A section that you might find helpful and you can also submit your own
  questions.

  Thanks and good luck,

  Bob Brown, Sr., CPO, FAAOP
  Inventor of the APPOPS by FLO-TECHnd very hard to fit well. I won't
  use the tranfemorals anymore.

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