Responses: A/K Casting Brims
Paul Rieth
Description
Collection
Title:
Responses: A/K Casting Brims
Creator:
Paul Rieth
Date:
10/14/2003
Text:
Thank you to those who replied. I was hoping for more. Below is the
initial inquiry, followed by the two responses:
I would like to hear opinions of those who use A/K casting brims, then
> modify by hand. I currently hand cast, but would like to try using
> brims, thinking it would cut down on modification/adjustment time.
> Which type do you prefer? Pros and cons? Best to use a brim stand
to
> cast (i.e. Ipos) or not? Any other useful info appreciated.
**I use either an IPOS thermoplastic brim (ischial containment design),
OR a custom ETS socket (via Otto Bock). Both are reusable. I take a
weight bearing cast by mounting the brim onto an Otto Bock interim
prosthesis adaptor with sidebars (part # 5R4) using Chicago screws, and
assembling this onto a manual locking knee + pylon + postop foot.
By using the 5R4 with outside attachment bars, I can cut away as much
or as little of the brim as I prefer. I then complete the molding by
using plaster splints and/or wrap cast. I also heat form the proximal
brim, or again cut away the brim and customize using plaster splints. If
you are incorporating a liner, then have the patient don the liner and
then don the brim and then cast.
**We have the lot - Hosmer, Blachford, NYU and Otto Bock full
casting systems (plus IPOS brims etc. etc.) - however, our best
results are still achieved using hand casting with two P&O's
performing the casting. I should add that we use a BioSculptor
CAD CAM system and employ a variation of the Alan Finnieston
style of proximal brim.
All brim casting systems have severe limitations - the major two
being:-
1) you are stuck with a socket design/style that the developer of
the system thinks is ideal,
2) brim stands require correct positioning of the patient on the
stand plus correct positioning of the brim on the patient. We have
found that elderly clients usually sag as they tire resulting in a
flexed residuum within the brim (banana shape cast) with internal
rotation.
My advice - save your money to invest in a CAD CAM system.
**I did receive two offers to sell brims. If anyone is interested,
email me.
initial inquiry, followed by the two responses:
I would like to hear opinions of those who use A/K casting brims, then
> modify by hand. I currently hand cast, but would like to try using
> brims, thinking it would cut down on modification/adjustment time.
> Which type do you prefer? Pros and cons? Best to use a brim stand
to
> cast (i.e. Ipos) or not? Any other useful info appreciated.
**I use either an IPOS thermoplastic brim (ischial containment design),
OR a custom ETS socket (via Otto Bock). Both are reusable. I take a
weight bearing cast by mounting the brim onto an Otto Bock interim
prosthesis adaptor with sidebars (part # 5R4) using Chicago screws, and
assembling this onto a manual locking knee + pylon + postop foot.
By using the 5R4 with outside attachment bars, I can cut away as much
or as little of the brim as I prefer. I then complete the molding by
using plaster splints and/or wrap cast. I also heat form the proximal
brim, or again cut away the brim and customize using plaster splints. If
you are incorporating a liner, then have the patient don the liner and
then don the brim and then cast.
**We have the lot - Hosmer, Blachford, NYU and Otto Bock full
casting systems (plus IPOS brims etc. etc.) - however, our best
results are still achieved using hand casting with two P&O's
performing the casting. I should add that we use a BioSculptor
CAD CAM system and employ a variation of the Alan Finnieston
style of proximal brim.
All brim casting systems have severe limitations - the major two
being:-
1) you are stuck with a socket design/style that the developer of
the system thinks is ideal,
2) brim stands require correct positioning of the patient on the
stand plus correct positioning of the brim on the patient. We have
found that elderly clients usually sag as they tire resulting in a
flexed residuum within the brim (banana shape cast) with internal
rotation.
My advice - save your money to invest in a CAD CAM system.
**I did receive two offers to sell brims. If anyone is interested,
email me.
Citation
Paul Rieth, “Responses: A/K Casting Brims,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/221963.
