Obese transfemoral patients and proximal socket discomfort
William Lifford
Description
Collection
Title:
Obese transfemoral patients and proximal socket discomfort
Creator:
William Lifford
Date:
10/7/2002
Text:
Hello fellow listmembers,
Recently I've had several transfemoral amputee patients in to be fitted for new sockets. What are some typical modifications or changes that you find you have to make in order to accomodate these types of patients?
For example: The patient's thighs touch together quite firmly all the way up into the perineum. Rolling the medial brim of the flexible inner socket is not really possible because then the contralateral thigh is chafed; however, cutting the brim shorter but leaving it almost vertical produces some discomfort upon weightbearing. If the brim is cut too short, there is a medial roll of tissue. What can you do in these circumstances?
Another example: The patient's pendulous abdomen is chafed by the anterior flexible brim. A standard size rolled edge helps while standing, however, when sitting the edge really irritates the tissue. If you build out the brim of the cast and then have a large rolled brim, it protrudes too far anteriorly to have an acceptable cosmesis. Any thoughts on what other options are available?
I'm sorry if these examples are poorly articulated/worded, but I'm trying to illustrate the Catch-22 type situations I seem to find myself in while serving these patients. I'd really appreciate your thoughts on this matter.... I'll post a summary of responses in a few days.
Thanking you in advance,
Bill Lifford, C.P.
Recently I've had several transfemoral amputee patients in to be fitted for new sockets. What are some typical modifications or changes that you find you have to make in order to accomodate these types of patients?
For example: The patient's thighs touch together quite firmly all the way up into the perineum. Rolling the medial brim of the flexible inner socket is not really possible because then the contralateral thigh is chafed; however, cutting the brim shorter but leaving it almost vertical produces some discomfort upon weightbearing. If the brim is cut too short, there is a medial roll of tissue. What can you do in these circumstances?
Another example: The patient's pendulous abdomen is chafed by the anterior flexible brim. A standard size rolled edge helps while standing, however, when sitting the edge really irritates the tissue. If you build out the brim of the cast and then have a large rolled brim, it protrudes too far anteriorly to have an acceptable cosmesis. Any thoughts on what other options are available?
I'm sorry if these examples are poorly articulated/worded, but I'm trying to illustrate the Catch-22 type situations I seem to find myself in while serving these patients. I'd really appreciate your thoughts on this matter.... I'll post a summary of responses in a few days.
Thanking you in advance,
Bill Lifford, C.P.
Citation
William Lifford, “Obese transfemoral patients and proximal socket discomfort,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 27, 2024, https://library.drfop.org/items/show/219848.
