Overweight TT amputee RESPONSES

Overweight TT amputee RESPONSES

Randy McFarland

4/24/2003

Original question:
Hello List Members:
What would you do with a 40 year old male client who sustained a TF
amputation about 5 years ago and has gained weight to ~ 440 lbs.,
clearly exceeding the specs on his prosthetic components.

I am not aware of TF prosthetic components that approach this weight
range. Has anyone been faced with this situation? Have you used any
option other than refusal to provide service? I will post responses. If
you don't want your name reposted to the list, put it in parentheses.

Thanks,
Randy McFarland, CPO
Sunny Hills Orthopedic Services
Fullerton, CA


Responses- (thanks to all who contributed)

Here in the land of beer, cheese, and sausage (Wisconsin) we run into a
lot of that. However in your case the only option is to not provide
service until some weight has been lost as I am not aware of any
components that support this kind of weight either. I currently have
someone who was in excess of 400 lbs. and they went through a gastric
bypass operation and have lost 102 lbs. in 4 months. Now we can begin to
fit them with a prosthesis. This might be something you want to suggest
they look into. Good luck.
Brian Gustin, C.P.

I had a 600 pound AK patient a few years back - fairly active,
considering, and self-employed in a manual trade. FlexFoot and others
could provide a foot/ankle, but no knee was on offer. Discussion with
the patient yielded a simple design: a socket set into a solid willow
wood pylon of the approximate dimensions of his sound side. The foot
was just a flared termination of this block with a rocker shape. This
was not foot-shaped at all - this termination was shorter and wider than
his own foot, and tire tread was applied to the sole. The wood was not
hollowed, and exterior laminated appropriately. He joked that he was no
less graceful on this kneeless pylon than he had been on his own two
feet, and that he was pleased that he did not have to be concerned about
it breaking or the knee remaining stable during stance.
   He returned to his former level of activity and occupation, dying
within a year of stroke secondary to morbid obesity.
   Daniel Watkins CPO

We were able to get Springlite to manufacture an
Advantage DP for a patient who weighs just a little
over 400 lbs. Maybe they can help you as well. CP

springlite has a system that will go to 500# (they can even go up to
600#) its the springlite gold medal with the springlite 2 you can reach
them at
1-801-956-2401
Brandon

I think we are all facing it! I just picked up a 15 year old weighing
375.
Epidemic may be the word. I believe I have more patients over 250 than
under. But I also live in Alabama, state that boasts the highest rate
of diabetes in the country.

I was faced with this last year and could not find anything that was
rated to this weight limit. Springlite and Flexfoot will make feet rated
to this weight limit but there are no endo components that I am aware of
that are rated to attach them. This leaves you with the direct
lamination option (Flexfoot has a lamination cup that I am sure you are
aware of which i used with a 400 # Bk last year in conjunction with a
custom mod 3). Worked well and has not broken, but patient complained of
stiffness. Of course a knee is out of the question. Some other
clinicians I have talked to suggested an exo design( with lots of
carbon) without a knee and a sach foot (ie the one used in the magnum
kit) Not rated to 440, but you could hope for the best :) Sorry not alot
of options. these folks have to realize when they get this fat its hard
to do anything for them. Please post responses. I bump into this problem
from time to time and would like to know if anything has changed since
last year.
Thanks,
Paul Meyer, CPO

  Have you considered going to exo-skel. have done this in the past and
may be your only option. Bill Copeland C.P.,L.P.

Exoskeletal can easily be beefed up to handle the weight.
Win Gasperson, CPO