Responses to post about Symes/Chopart prostheses

Responses to post about Symes/Chopart prostheses

Mark Benveniste CP

3/14/2005

Dear Colleagues,
I have not posted some of the responses, and names ,in many cases, because
of privacy issues.
 I will say that this idea has been done and is also being worked on by
different groups, so I think we will see more of it. I am pleased to hear
that.

 I am glad to hear that others have done it and are thinking of it.
 Nothing is so powerful as an idea whose time has come!

I actually don't have a pt in mind at the moment to try it on unless I call
back some of my pts.
I know they always seem to want something lighter and easier to don than
conventional prostheses. I have even made a shorter socket with cut-outs in
the front and back and a liner made out of an Everflex liner. Velcro straps
tightened the sides together. I put a custom made pod foot on it -(similar
to a Trowbridge or Stomper)
Still, I think the light weight floor reaction carbon fiber AFO base with
modifications would be far better.

Original Post

Dear Colleagues,

Recently I have used the ToeOff for partial feet.
Later I learned that people have been doing this for awhile.
I now see that Ossur is making a similar product called the AFO Dynamic.

I am wondering if anyone has tried a beefier version for Symes and Chopart
levels.
I am not sure if they can be made stronger on request by Ossur and may have
to be custom made somewhere.

I could imagine different cup shapes with padding that would attach to the
bottom.

Any thoughts on why this wouldn't work,
other than some pt's that may require significant off-sets? Some degree of
accommodation could be done at the level of the shoe (e.g. medial or lateral
wedge)

I like the idea of it being lighter, less bulky, cooler and easier to
fabricate

Mark Benveniste RN BS CP
MEDVA Medical Center
Houston, TX
USA

Responses:

Mark check with Fillauer, they do alot of custom work the guy to talk to is
Steve Hughes
(800)251-6398
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Call Wade at Kinetic Research in Tampa, Fla
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Try Barry McCoy in Cranston, R.I. I think his company is called Custom
Composites and has been advertising lately in our Journals.
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For our TMAs, we have been using a company called Custom Composite
( <URL Redacted>) for a few years now. They make a VERY beefy
partial foot prosthesis. For our less aggressive walkers, we've been
using a lateral strut model, and they build in a toe-filler. When it
comes in, we fit it, then cover the toe-filler with some leather to make
it more finished. Call Barry, he's a great guy to deal with.
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   We can do this for you. We make custom prepreg orthoses and partial
feet. These can be made for any patient weight or size.

    David Lindsey, C.O.
    British Columbia, Canada
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I was working in Norway for a couple of years and the idea is used commonly
there and in Sweden. They are almost all custom made by pre-preg workshops
(Ottobock was doing some similar work in Canada I think). The main use were
very light, thin sockets, usually the 4 poing pressure system as ToeOff,
onto symes/chopart foot plates by regular manufacturers. Some companies also
use total customized designs, manufacturing their own feet/footplates.
Please bear in mind that litigation is less common in Europe and one of the
biggest problems is making the devices strong enough and still maintaining
the lightweight characteristics. If you've used ToeOff on orthotic patients
then you will know that dedicated users can destroy them pretty quickly! It
is a good idea but fabrication may not be as straight forward as you might
hope.
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