Re: Fw: C-leg statement correction
Anthony T. Barr
Description
Collection
Title:
Re: Fw: C-leg statement correction
Creator:
Anthony T. Barr
Date:
1/13/2003
Text:
Gary, of course there are other elements to consider in order to provide
successful rehabilitation and there was no assumption otherwise implied.
The discussion was not meant to elude that all problems can be attributed to
improper surgical amputation and improper choices for prosthetic components
to be utilized.
In my opinion, the growing trend of passing amputation surgery off solely
to vascular surgeons, not familiar with all issues of amputation, is a
mistake to begin with.
Most surgeons don't have enough knowledge of prosthetics to write a proper
prescription for a specific device and prosthetists don't have the knowledge
to fully determine that the problem may result from post op physiological
amputation conditions.
When will both professionals recognize the need to work together for the
best outcome for the patient!
Tony
----- Original Message -----
From: Gary M. Berke < <Email Address Redacted> >
To: < <Email Address Redacted> >
Sent: Monday, January 13, 2003 12:05 PM
Subject: Re: [OANDP-L] Fw: C-leg statement correction
> I am having some real problems with this discussion. The concept that
> these issues may be thrown out on-line is ridiculous! Do we know the
> history of this patient, is he a smoker? does he have vascular disease?
> diabetes? Aneurism? Clots? Heart Disease? Pulmonary problems? Night
> pain? other co-morbidities? To assume that these problems are related to
> the prosthesis or amputation surgery is indicative of the level
> simplicity that we often approach complex problems, this gentleman needs
> to be referred to a vascular surgeon as a primary concern.
>
> Gary M. Berke MS, CP,FAAOP
> Director of Prosthetics
> CIRS-Stanford
> VCE-Clinical Instructor, Orthopedic Surgery
> Stanford University
>
>
>
> -----Original Message-----
> From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
> Behalf Of Anthony T. Barr
> Sent: Sunday, January 12, 2003 10:02 AM
> To: <Email Address Redacted>
> Subject: [OANDP-L] Fw: C-leg statement correction
>
>
> In a message dated 1/12/2003 1:54:01 AM Central Standard Time, to the
> Amputee Information Network Listserve, <Email Address Redacted> writes:
>
> I can't walk more than 50 yds. without resting. My stump feels like the
> circulation has been blocked.
>
> Al Pike said:
> This would remain unchanged with a C-Leg. The feeling in your stump
> relates to socket fit not knee components.
>
> Tony Barr said:
> There is no prosthetic device currently on the market today or will
> ever be made, at any cost, that can cure the problems that are listed
> below. Unfortunately, amputees and some prosthetists often ignore the
> likely hood that lack of circulation, muscle instability and
> regeneration of nerve endings are most often the culprits preventing
> successful and long term prosthetic rehabilitation.Reconstruction
> surgery should be considered as a solution.
>
> Before spending $50,000, amputees, Medicare and other healthcare
> providers should investigate the ability to receive proper amputation
> surgery before appoving funding alternate high end prosthetic devices
> and components.
>
> The feeling described above of the circulation being blocked is
> more likely related to post operative conditions as the result of
> guillotine amputation which is the standard amputation procedure
> performed today.
>
> 1)The bone is simply transected, leaving an open medulary canal, and
> losing intermedulary pressure.The blood pressure flows out.
> 2) Muscle attachments are cut and allowed to retract no longer
> assisting in pumping blood or controlling the limb.
> 3) Often times veins & arteries are tied together to prevent bleeding,
> but an artery pumping right into a vein causes stress on the heart.
> 4) the bone may atrophy due to lack of loading.
> 5) The cut nerve ends will form neuromas if they are not placed in a
> scar-free, quiet environment and allowed to restore their gliding
> ability.
>
> There is no prosthetic device currently on the market today, or will
> ever be available, that can cure the problems described above and as the
> result of improper amputation surgery
>
> (# 1-5 taken from the script of the recently produced video:The Ertl
> Procedure: Beyond the Bridge)
>
> Tony Barr
> Barr Foundation
> www.oandp.com/barr
>
> Question for prosthetist professionals:
> How many prosthetists discover and disclose to the patient upon thier
> intitial evaluation,, that the stump he has been left to work with, is
> less than perfect for delivering long term mobility and pain free
> prosthetic rehabilitation?
successful rehabilitation and there was no assumption otherwise implied.
The discussion was not meant to elude that all problems can be attributed to
improper surgical amputation and improper choices for prosthetic components
to be utilized.
In my opinion, the growing trend of passing amputation surgery off solely
to vascular surgeons, not familiar with all issues of amputation, is a
mistake to begin with.
Most surgeons don't have enough knowledge of prosthetics to write a proper
prescription for a specific device and prosthetists don't have the knowledge
to fully determine that the problem may result from post op physiological
amputation conditions.
When will both professionals recognize the need to work together for the
best outcome for the patient!
Tony
----- Original Message -----
From: Gary M. Berke < <Email Address Redacted> >
To: < <Email Address Redacted> >
Sent: Monday, January 13, 2003 12:05 PM
Subject: Re: [OANDP-L] Fw: C-leg statement correction
> I am having some real problems with this discussion. The concept that
> these issues may be thrown out on-line is ridiculous! Do we know the
> history of this patient, is he a smoker? does he have vascular disease?
> diabetes? Aneurism? Clots? Heart Disease? Pulmonary problems? Night
> pain? other co-morbidities? To assume that these problems are related to
> the prosthesis or amputation surgery is indicative of the level
> simplicity that we often approach complex problems, this gentleman needs
> to be referred to a vascular surgeon as a primary concern.
>
> Gary M. Berke MS, CP,FAAOP
> Director of Prosthetics
> CIRS-Stanford
> VCE-Clinical Instructor, Orthopedic Surgery
> Stanford University
>
>
>
> -----Original Message-----
> From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
> Behalf Of Anthony T. Barr
> Sent: Sunday, January 12, 2003 10:02 AM
> To: <Email Address Redacted>
> Subject: [OANDP-L] Fw: C-leg statement correction
>
>
> In a message dated 1/12/2003 1:54:01 AM Central Standard Time, to the
> Amputee Information Network Listserve, <Email Address Redacted> writes:
>
> I can't walk more than 50 yds. without resting. My stump feels like the
> circulation has been blocked.
>
> Al Pike said:
> This would remain unchanged with a C-Leg. The feeling in your stump
> relates to socket fit not knee components.
>
> Tony Barr said:
> There is no prosthetic device currently on the market today or will
> ever be made, at any cost, that can cure the problems that are listed
> below. Unfortunately, amputees and some prosthetists often ignore the
> likely hood that lack of circulation, muscle instability and
> regeneration of nerve endings are most often the culprits preventing
> successful and long term prosthetic rehabilitation.Reconstruction
> surgery should be considered as a solution.
>
> Before spending $50,000, amputees, Medicare and other healthcare
> providers should investigate the ability to receive proper amputation
> surgery before appoving funding alternate high end prosthetic devices
> and components.
>
> The feeling described above of the circulation being blocked is
> more likely related to post operative conditions as the result of
> guillotine amputation which is the standard amputation procedure
> performed today.
>
> 1)The bone is simply transected, leaving an open medulary canal, and
> losing intermedulary pressure.The blood pressure flows out.
> 2) Muscle attachments are cut and allowed to retract no longer
> assisting in pumping blood or controlling the limb.
> 3) Often times veins & arteries are tied together to prevent bleeding,
> but an artery pumping right into a vein causes stress on the heart.
> 4) the bone may atrophy due to lack of loading.
> 5) The cut nerve ends will form neuromas if they are not placed in a
> scar-free, quiet environment and allowed to restore their gliding
> ability.
>
> There is no prosthetic device currently on the market today, or will
> ever be available, that can cure the problems described above and as the
> result of improper amputation surgery
>
> (# 1-5 taken from the script of the recently produced video:The Ertl
> Procedure: Beyond the Bridge)
>
> Tony Barr
> Barr Foundation
> www.oandp.com/barr
>
> Question for prosthetist professionals:
> How many prosthetists discover and disclose to the patient upon thier
> intitial evaluation,, that the stump he has been left to work with, is
> less than perfect for delivering long term mobility and pain free
> prosthetic rehabilitation?
Citation
Anthony T. Barr, “Re: Fw: C-leg statement correction,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/220353.
