Symes liners responses
Kristin Schafer
Description
Collection
Title:
Symes liners responses
Creator:
Kristin Schafer
Date:
5/15/2005
Text:
Thanks to all.... what a great number of responses. Kristin Schafer, CP(c)
Try the Silipos Molding Distal Roll-On gel liner, article #1496, to add some
padding without too much bulk, to the distal end. Regarding feet, the Otto
Bock (Springlite) Lo Rider Foot, is a good choice for this gentleman. Nice
gentle roll-over action, dynamic, and easily adapted to Symes prostheses
-------------------------------------------------
Expandable bladder system symes which is much more cosmetic and creates very good suspension.
--------------------------------------------------------------------------------------
As far as I can see, the fellow to contact is Jan Stokosa. His email
address is <Email Address Redacted> There was a story in the Reader's Digest
a number of years ago about Jan and his father doing work with a family.
The father in this family lost his leg in a car explosion and the son was a
partial foot amputee due to trauma. The father went to see Jan Stokosa's
father and the son went there too after they had both been elsewhere with
less than desireable prosthetic results.. The Stokosa's made a prosthesis
for both father and son that worked and the story in Reader's Digest said
they were happy. A quick search for Jan Stokosa turns up this page.
<URL Redacted>
Another fellow that I can think of is an 80+ year old fellow in Sweden
that I stumbled across his web site. He became a Symes amputee in the
1950's with a streetcar accident. The web site traced what had been done for
him in the 50 years since his traumatic amputation and what about each thing
tried that didn't work out. I can't find that web page to save my hide
right now.
----> If you or someone else can find that web site, please let me know!!!
The purpose of this Swedish man putting the web page up was to help
people learn the right things to do with partial foot amputees
----------------------------------------------------
I have fit many symes amputees with custom silicone liners made to
special specs by Freedom innovations. If you decide to go this way talk
with Craig MacKenzie at 407-841-6335. As far as tension or shear forces
on the distal end sometimes we are have overcome this by A and D
ointment to keep these forces from occurring at specific areas.
-------------------------------------------------------------------------------------
In my experience I often find prefabricated liners too short for some Symes
amputations. If so, I have had good success with Otto Bock's custom TEC
liners. You can specify added thickness where you want. My choice of feet
depends on the length of amputation. I recently used an Impulse Symes
System from Ohio Willow Wood. It went well.
---------------------------------------------------------------------------------------
I had 2 very similar cases, and used a custom TEC liner and made a TSB symes socket. I used suction suspension. (Your guy would probably not get much life out of a suction sleeve.) I put this on a Low Profile Vari Flex (Ossur). The system works great.
--------------------------------------------------
Consider using a Seal-In liner. Same cushioning and a no-pistoning suspension. He will love it.
------------------------------------------------------------------------------
I've had good luck with ohio willow woods liners. Also consider a valva in
the distal end (or close to it)to reduce pistoning and shear forces.
Good luck hope this helps.
------------------------------------------------------------------------------
How about a custom made TEC liner with suction suspension?? I have had success with this method, my PT. also wears a OttoBock DP II foot (you can order one with low clearance)
Hope this is useful
--------------------------------------------------
I have recently used the new low profile Variflex, although it does not have as good an energy return as the standard Variflex my patient loved it compared to his Quantum foot. If you have room then I would recommend it or Freedoms low profile foot which has a slighty bigger build height, I have used this a couple of times and had positive feedback. In regard to the liner, one of the least bulky builds is to custom make a silicon or polyurethane inner socket and laminate outer. Just a couple of thoughts!
--------------------------------------------------------------------------------------
Otto Bock has a new lowrider symes set up that is very nice. The liner I use for this situation is an OWW with a extra distal cup for the patient to add when the distal end packs down. Good luck.
--------------------------------------------------
I'd use a 1C20 Otto Bock symes foot and a custom Tec liner. Good luck I've
had great luck with that combo.
-------------------------------------------------
Speaking from personal and prfessional experience. .... The best liner for a
symes is probably the Alpha Max. The Iceross sport has a distal attachment
which will be uncomfortable. The same is true for most of the Iceross gel
liners with the exception of the Comfort and the Dermo. The sizing on these
may not necessarily work for your symes amputee.
The Alpha Max has better protection of gel over the distal seam. The
regular Alpha liner can wear down in this area and cause skin irritaiton.
If your client has been wearing socks for a long time, it may take a while
for him to become accustomed to a gel liner. I would suggest trying a nylon
next to the skin.The following feet will work well with a symes... Freedom
Innovations symes foot or the Otto Bock Axion. I am not sure about
durability for the Axion, but the Freedom Innovation foot is very durable
and the split toe works well. I have found the Ossur feet to be functional,
but stiff.
-------------------------------------------------------------------------------------
If he has callus's on the distal end then he definitely has
too much dist. Pressure.
------------------------------------------------
We just worked on a woman with a symes and used an Ossur Seal-in liner and a
Springlite low profile dynamic foot (I don't have the part number, but the
clearance was the lowest I could find. It had the pyramid attached directly
and clearance of only about 1.) As long as you can get the seal in liner
long enough to cover the entire leg to the knee....
--------------------------------------------------
The 3mm sport liner sounds like a good option. I had a very long patient one time, for whom the standard liner wasn't quite long enough. I made a special request to get an untrimmed liner, which gave me about an inch more of length. May be of use for you. Good Luck
-------------------------------------------------
I have a similar case resulting from congenital absence of fibula.
Being a congenital malformation I don't have the same build height
problems as your case - the lack of tibial bone growth provided just
enough space to accomodate most types of feet. However, I was
presented with an aspiring paralympian with a very long and
tapered residual limb.
I found that the best liner for him was an Iceross Comfort+ cushion
liner size 16 (a custom made liner was not an option). Of course
that size liner isn't designed to fit an adult with highly developed
calf musculature; nor is it rated for his extreme activity level.
However, the Comfort+ proved to provide superior comfort whilst
being exceptionally durable. The extra length that Iceross
manufacture into their liners combined with the elasticity of the
grade of silicone in the Comfort+ gives just enough length in the
liner to fit his Symes length amputation.
-----------------------------------------------------------------------------------
Freedom Innovations offers the Evolution SP Liner, a custom silicone
interface that can be used for difficult Symes applications. The custom
design of the liner ensures a perfect fit and the firmer material
durometer (low 50s) reduces skin reactions caused by shear forces. The
Evolution SP Liner is manufactured using platinum-cured silicone, adding
the additional benefit of odor elimination and dramatically improved
hygiene. Amputees truly enjoy this!
While custom Symes liners can be challenging to fabricate (due to issues
in de-molding a mold with a bulbous distal end) and would not fall into
our standard 72 hour lead-time guarantee, it may be just what your
patient requires. We will provide you with a liner that not only fits
well but is extremely durable in a very timely fashion (usually within a
week of cast receipt.) I am proud to say that we have had great success
with several Symes amputees after their return from Iraq and Afghanistan
and I am confident that we would be able to assist you with your needs.
(As a side note about Symes applications, some practitioners have
requested extra material build-ups in the liner, above the bulbous
portion of the limb, which allows the amputee to slide into the
prosthesis without a door. They report that this has worked very well
for them.)
Freedom Innovations also offers a number of dynamic foot options for
your patient. I am happy to speak to you about our new Symes option,
which is currently in trials, and the Evolution SP Liner in more detail
if you would like.
--------------------------------------------------
Hi Kristin freedom-innovations .com has a-liner and great foot for your
pt.
--------------------------------------------------
hi,
I have one out and one going out soon on the variflex lp with
direct-lamination adapter. You need a good 3+ inches of clearance though...
but a great foot! AFAIK the only dynamic symes-type foot with
split-toe/heel, really seems to make a difference for symes wtih that long,
long lever! Good luck with the liner side of things...
---------------------------------------------------------------------------------------
********************
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.
Try the Silipos Molding Distal Roll-On gel liner, article #1496, to add some
padding without too much bulk, to the distal end. Regarding feet, the Otto
Bock (Springlite) Lo Rider Foot, is a good choice for this gentleman. Nice
gentle roll-over action, dynamic, and easily adapted to Symes prostheses
-------------------------------------------------
Expandable bladder system symes which is much more cosmetic and creates very good suspension.
--------------------------------------------------------------------------------------
As far as I can see, the fellow to contact is Jan Stokosa. His email
address is <Email Address Redacted> There was a story in the Reader's Digest
a number of years ago about Jan and his father doing work with a family.
The father in this family lost his leg in a car explosion and the son was a
partial foot amputee due to trauma. The father went to see Jan Stokosa's
father and the son went there too after they had both been elsewhere with
less than desireable prosthetic results.. The Stokosa's made a prosthesis
for both father and son that worked and the story in Reader's Digest said
they were happy. A quick search for Jan Stokosa turns up this page.
<URL Redacted>
Another fellow that I can think of is an 80+ year old fellow in Sweden
that I stumbled across his web site. He became a Symes amputee in the
1950's with a streetcar accident. The web site traced what had been done for
him in the 50 years since his traumatic amputation and what about each thing
tried that didn't work out. I can't find that web page to save my hide
right now.
----> If you or someone else can find that web site, please let me know!!!
The purpose of this Swedish man putting the web page up was to help
people learn the right things to do with partial foot amputees
----------------------------------------------------
I have fit many symes amputees with custom silicone liners made to
special specs by Freedom innovations. If you decide to go this way talk
with Craig MacKenzie at 407-841-6335. As far as tension or shear forces
on the distal end sometimes we are have overcome this by A and D
ointment to keep these forces from occurring at specific areas.
-------------------------------------------------------------------------------------
In my experience I often find prefabricated liners too short for some Symes
amputations. If so, I have had good success with Otto Bock's custom TEC
liners. You can specify added thickness where you want. My choice of feet
depends on the length of amputation. I recently used an Impulse Symes
System from Ohio Willow Wood. It went well.
---------------------------------------------------------------------------------------
I had 2 very similar cases, and used a custom TEC liner and made a TSB symes socket. I used suction suspension. (Your guy would probably not get much life out of a suction sleeve.) I put this on a Low Profile Vari Flex (Ossur). The system works great.
--------------------------------------------------
Consider using a Seal-In liner. Same cushioning and a no-pistoning suspension. He will love it.
------------------------------------------------------------------------------
I've had good luck with ohio willow woods liners. Also consider a valva in
the distal end (or close to it)to reduce pistoning and shear forces.
Good luck hope this helps.
------------------------------------------------------------------------------
How about a custom made TEC liner with suction suspension?? I have had success with this method, my PT. also wears a OttoBock DP II foot (you can order one with low clearance)
Hope this is useful
--------------------------------------------------
I have recently used the new low profile Variflex, although it does not have as good an energy return as the standard Variflex my patient loved it compared to his Quantum foot. If you have room then I would recommend it or Freedoms low profile foot which has a slighty bigger build height, I have used this a couple of times and had positive feedback. In regard to the liner, one of the least bulky builds is to custom make a silicon or polyurethane inner socket and laminate outer. Just a couple of thoughts!
--------------------------------------------------------------------------------------
Otto Bock has a new lowrider symes set up that is very nice. The liner I use for this situation is an OWW with a extra distal cup for the patient to add when the distal end packs down. Good luck.
--------------------------------------------------
I'd use a 1C20 Otto Bock symes foot and a custom Tec liner. Good luck I've
had great luck with that combo.
-------------------------------------------------
Speaking from personal and prfessional experience. .... The best liner for a
symes is probably the Alpha Max. The Iceross sport has a distal attachment
which will be uncomfortable. The same is true for most of the Iceross gel
liners with the exception of the Comfort and the Dermo. The sizing on these
may not necessarily work for your symes amputee.
The Alpha Max has better protection of gel over the distal seam. The
regular Alpha liner can wear down in this area and cause skin irritaiton.
If your client has been wearing socks for a long time, it may take a while
for him to become accustomed to a gel liner. I would suggest trying a nylon
next to the skin.The following feet will work well with a symes... Freedom
Innovations symes foot or the Otto Bock Axion. I am not sure about
durability for the Axion, but the Freedom Innovation foot is very durable
and the split toe works well. I have found the Ossur feet to be functional,
but stiff.
-------------------------------------------------------------------------------------
If he has callus's on the distal end then he definitely has
too much dist. Pressure.
------------------------------------------------
We just worked on a woman with a symes and used an Ossur Seal-in liner and a
Springlite low profile dynamic foot (I don't have the part number, but the
clearance was the lowest I could find. It had the pyramid attached directly
and clearance of only about 1.) As long as you can get the seal in liner
long enough to cover the entire leg to the knee....
--------------------------------------------------
The 3mm sport liner sounds like a good option. I had a very long patient one time, for whom the standard liner wasn't quite long enough. I made a special request to get an untrimmed liner, which gave me about an inch more of length. May be of use for you. Good Luck
-------------------------------------------------
I have a similar case resulting from congenital absence of fibula.
Being a congenital malformation I don't have the same build height
problems as your case - the lack of tibial bone growth provided just
enough space to accomodate most types of feet. However, I was
presented with an aspiring paralympian with a very long and
tapered residual limb.
I found that the best liner for him was an Iceross Comfort+ cushion
liner size 16 (a custom made liner was not an option). Of course
that size liner isn't designed to fit an adult with highly developed
calf musculature; nor is it rated for his extreme activity level.
However, the Comfort+ proved to provide superior comfort whilst
being exceptionally durable. The extra length that Iceross
manufacture into their liners combined with the elasticity of the
grade of silicone in the Comfort+ gives just enough length in the
liner to fit his Symes length amputation.
-----------------------------------------------------------------------------------
Freedom Innovations offers the Evolution SP Liner, a custom silicone
interface that can be used for difficult Symes applications. The custom
design of the liner ensures a perfect fit and the firmer material
durometer (low 50s) reduces skin reactions caused by shear forces. The
Evolution SP Liner is manufactured using platinum-cured silicone, adding
the additional benefit of odor elimination and dramatically improved
hygiene. Amputees truly enjoy this!
While custom Symes liners can be challenging to fabricate (due to issues
in de-molding a mold with a bulbous distal end) and would not fall into
our standard 72 hour lead-time guarantee, it may be just what your
patient requires. We will provide you with a liner that not only fits
well but is extremely durable in a very timely fashion (usually within a
week of cast receipt.) I am proud to say that we have had great success
with several Symes amputees after their return from Iraq and Afghanistan
and I am confident that we would be able to assist you with your needs.
(As a side note about Symes applications, some practitioners have
requested extra material build-ups in the liner, above the bulbous
portion of the limb, which allows the amputee to slide into the
prosthesis without a door. They report that this has worked very well
for them.)
Freedom Innovations also offers a number of dynamic foot options for
your patient. I am happy to speak to you about our new Symes option,
which is currently in trials, and the Evolution SP Liner in more detail
if you would like.
--------------------------------------------------
Hi Kristin freedom-innovations .com has a-liner and great foot for your
pt.
--------------------------------------------------
hi,
I have one out and one going out soon on the variflex lp with
direct-lamination adapter. You need a good 3+ inches of clearance though...
but a great foot! AFAIK the only dynamic symes-type foot with
split-toe/heel, really seems to make a difference for symes wtih that long,
long lever! Good luck with the liner side of things...
---------------------------------------------------------------------------------------
********************
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
Kristin Schafer, “Symes liners responses,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/224917.
