Results: Hemipelvectomy sitting device
Dennis Farrell, CP
Description
Collection
Title:
Results: Hemipelvectomy sitting device
Creator:
Dennis Farrell, CP
Text:
Dear List Members,
Below please find my original question, followed by the responses I
received. Thank you to all who kindly shared their thoughts and experience.
original post:
Any experiences you can share regarding design and/or materials used in a
non-rigid, sitting device would be appreciated.
The patient is a 42 y/o female with a traumatic hemipelvectomy amputation
(pubic ramus, ischium and part of iliac wing are absent). The plan is to
initiate weight bearing tolerance via a sitting device, perhaps a garment
incorporating a flexible material (neoprene or equivalent) and an attached, external
buildup to establish symmetry for balanced sitting posture, as well as
comfortable pressure distribution. Patient's body weight = 90#.
If this is successful, a prescription for prosthetic fitting will
follow...if not, then a surgical revision to her pelvic skeletal structure may be
considered to create a more supportive residuum.
_________________
Responses:
I am well out of my league when looking at a device of this kind,
but there is a doctor named Christina Skoski who is a part of this list
that you should contact if she doesn't reply to you. She herself has a
hemipelvectomy and follows very closely any developments in this area.
If there is something going on with this field, I am sure that she would
know. *christina*@hphdhelp.org is her email address. More information
about her is here:
<URL Redacted> Her web site is
www.hphdhelp.org/default.htm
I can recommend her because I had some questions about
hemipelvectomies because 2 people I know have them. One was having
trouble walking with his prosthesis.
____________
I used to do these for a cancer hospital (probably did 6-8 over a 2 to 3
year period.) I had them lie on their intact side and I draped plaster bandage
to take an impression to the waist. After making a mold, I formed 1/2
plastazoate foam liner (to use as a spacer) over the mold and then pulled 1/8
copoly over that. I then trimmed the copoly and used the Roho cushion sheets
(with the small, 1 pre-inflated cells) as the liner and glued that in place
onto the inside of the copoly shell. (You can cut those into strips or
individual cells to arrange them to cover the irregularities of the inside of the
shell.) I then attached a waist strap and took it to the patient for a fitting
with some pieces of cloud crepe to use as shims to estimate the thickness
and depth of the external build-up. After that, I would atttach (with glue)
the appropriate amount of crepe build-up and go back to do another fitting and
so on until the the finished device met the patient's needs and was suitably
comfortable. It's a bit time consuming, but the finished device seemed to
provide the sitting support and balance that was needed. I'm not quite sure
why I don't get those referrals anymore. I hope this helps spark your
creatinve thinking. If it does, let me know whot works for this client. These are
some of the more unusual devices that I've had the opportunity to make and the
patients are great to work with.
____________
It is possible to make a total contact socket. This acts as if a balloon
filled with water is being contained, that means that only soft tissue needs to
be present and the forces then act on the remaining body parts. the technique
is very simple. if you cannot find a solution please e mail me and I will go
through the procedure.
___________
I suggest simply to cast your patient as if proceeding with fitting a
prosthesis.
Have Otto Bock central fab build you a check socket of polyethylene or equal
flexible material. They just completed one for a patient of mine.
They will foam up and shape the gluteus area over the polyethylene socket
for sitting balance. Bock tech's will also secure a lamination plate within
the foam for future use later if you proceed to a static weight bearing
fitting and subsequent dynamic fitting.
This would serve to help your patient know what a prosthesis (socket) will
feel like sitting and standing.
I had a similar project a few years back.
Remove all body hair
Cover all Aires with Siran Wrap taped on
Fit a panty hose
Cut a way leg part
Overlap nylon and use spray adhesives to hold together
Suspend a plastic bag or other container and fit to the depth under the
body part + a little extra depth
Remove plastic bag and fill partially with silicone so that you can mix the
last application of silicone and pore into the bag.
You can have the bag on the patient and just pore the mix in, or mix and
pore before applying the bag which is ez'er but need to be applied faster.
After cureing you can shape using an electric knife and drum sander.
Suspension can be achieved in several configurations.
__________
About your question on the HD device..you may want to contact Dr. Christina
Skoski who has a HP and great help site
<Email Address Redacted> (mailto:<Email Address Redacted>) I think, or do a
search. Good Luck My cell phone is listed here.
__________
A hammock handing from a sturdy overhead beam etc will be the best way to
deal with your dilema. Hammock naturally conforms and a urethane, temprafoam
block will be very comfortable.
________
Kurt Collier (Freedom Innovations) called me via phone to inform me of a new
gel liner available for Hip disarticulation and hemi-pelvectomy patients.
This product will be launched at the National AAOP meeting. For more details
contact Kurt, (301) 695-1113.
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Below please find my original question, followed by the responses I
received. Thank you to all who kindly shared their thoughts and experience.
original post:
Any experiences you can share regarding design and/or materials used in a
non-rigid, sitting device would be appreciated.
The patient is a 42 y/o female with a traumatic hemipelvectomy amputation
(pubic ramus, ischium and part of iliac wing are absent). The plan is to
initiate weight bearing tolerance via a sitting device, perhaps a garment
incorporating a flexible material (neoprene or equivalent) and an attached, external
buildup to establish symmetry for balanced sitting posture, as well as
comfortable pressure distribution. Patient's body weight = 90#.
If this is successful, a prescription for prosthetic fitting will
follow...if not, then a surgical revision to her pelvic skeletal structure may be
considered to create a more supportive residuum.
_________________
Responses:
I am well out of my league when looking at a device of this kind,
but there is a doctor named Christina Skoski who is a part of this list
that you should contact if she doesn't reply to you. She herself has a
hemipelvectomy and follows very closely any developments in this area.
If there is something going on with this field, I am sure that she would
know. *christina*@hphdhelp.org is her email address. More information
about her is here:
<URL Redacted> Her web site is
www.hphdhelp.org/default.htm
I can recommend her because I had some questions about
hemipelvectomies because 2 people I know have them. One was having
trouble walking with his prosthesis.
____________
I used to do these for a cancer hospital (probably did 6-8 over a 2 to 3
year period.) I had them lie on their intact side and I draped plaster bandage
to take an impression to the waist. After making a mold, I formed 1/2
plastazoate foam liner (to use as a spacer) over the mold and then pulled 1/8
copoly over that. I then trimmed the copoly and used the Roho cushion sheets
(with the small, 1 pre-inflated cells) as the liner and glued that in place
onto the inside of the copoly shell. (You can cut those into strips or
individual cells to arrange them to cover the irregularities of the inside of the
shell.) I then attached a waist strap and took it to the patient for a fitting
with some pieces of cloud crepe to use as shims to estimate the thickness
and depth of the external build-up. After that, I would atttach (with glue)
the appropriate amount of crepe build-up and go back to do another fitting and
so on until the the finished device met the patient's needs and was suitably
comfortable. It's a bit time consuming, but the finished device seemed to
provide the sitting support and balance that was needed. I'm not quite sure
why I don't get those referrals anymore. I hope this helps spark your
creatinve thinking. If it does, let me know whot works for this client. These are
some of the more unusual devices that I've had the opportunity to make and the
patients are great to work with.
____________
It is possible to make a total contact socket. This acts as if a balloon
filled with water is being contained, that means that only soft tissue needs to
be present and the forces then act on the remaining body parts. the technique
is very simple. if you cannot find a solution please e mail me and I will go
through the procedure.
___________
I suggest simply to cast your patient as if proceeding with fitting a
prosthesis.
Have Otto Bock central fab build you a check socket of polyethylene or equal
flexible material. They just completed one for a patient of mine.
They will foam up and shape the gluteus area over the polyethylene socket
for sitting balance. Bock tech's will also secure a lamination plate within
the foam for future use later if you proceed to a static weight bearing
fitting and subsequent dynamic fitting.
This would serve to help your patient know what a prosthesis (socket) will
feel like sitting and standing.
I had a similar project a few years back.
Remove all body hair
Cover all Aires with Siran Wrap taped on
Fit a panty hose
Cut a way leg part
Overlap nylon and use spray adhesives to hold together
Suspend a plastic bag or other container and fit to the depth under the
body part + a little extra depth
Remove plastic bag and fill partially with silicone so that you can mix the
last application of silicone and pore into the bag.
You can have the bag on the patient and just pore the mix in, or mix and
pore before applying the bag which is ez'er but need to be applied faster.
After cureing you can shape using an electric knife and drum sander.
Suspension can be achieved in several configurations.
__________
About your question on the HD device..you may want to contact Dr. Christina
Skoski who has a HP and great help site
<Email Address Redacted> (mailto:<Email Address Redacted>) I think, or do a
search. Good Luck My cell phone is listed here.
__________
A hammock handing from a sturdy overhead beam etc will be the best way to
deal with your dilema. Hammock naturally conforms and a urethane, temprafoam
block will be very comfortable.
________
Kurt Collier (Freedom Innovations) called me via phone to inform me of a new
gel liner available for Hip disarticulation and hemi-pelvectomy patients.
This product will be launched at the National AAOP meeting. For more details
contact Kurt, (301) 695-1113.
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Dennis Farrell, CP, “Results: Hemipelvectomy sitting device,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/224605.
