Response:Polio/TT

Response:Polio/TT

zach harvey

6/3/2002

Thanks to the one person who replied. I welcome any other suggestions. I might add that I talked to one CP colleague on the phone that suggested treating the pt. as if she were an orthotic case by using an HKAFO w/ drop locks and the lower uprights attached to a TT prosthesis. Also, I forgot to mention that this pt. has no flexion contracture or recurvatum of the amputated side.
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Original post:

I have a unique and challenging case that I'm working on right now, and I'm asking for feedback on similar experiences. Pt is ~50 y.o.f, 100#, 4'10 w/ R. 7 yr post TT amputation (~5). She elected to have the amputation because her leg was so deformed sec. to unbraced polio. R. knee is stable in AP plane, but not ML.

R. MMT of knee/ hip is grade 0. L. quads are grade 3. Pt. manages to walk with a crutch on the R. side, and without an orthosis on the L. She was fit with a gluteal wt. bearing brim attached to metal uprights and foot, with a hip jt/pelvic band in her home country, but she disregarded the prosthesis b/c it caused her excessive pain. Pt. is otherwise active and motivated and wants to try using a prosth again. She can kneel with full wt. on the R. side. I am considering either 1) a bent knee prosth or 2) a gl. wt. bearing brim attached to drop lock knee jts, and TT skt. Both designs would implement a hip jt/ pelvic band to utilize trunk motion. I will post replies in a few days. Thanks in advance, Zach Harvey, CO, P.res

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Reply:

You didnt indicate whether the patient had a flexion contracture. If not you might consider a standard thigh lacer with joints, although bent back is a viable choice
also.Patient has already turned down glutial wt. bearing. You might also consider
some form of PTS with high M-l walls to stablize the knee. You can even go with
a silicone liner, locking or not, with the correct modifications. Reply if you want to discuss further.
CP



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