Transtibial question results

Transtibial question results

Jake Wood, CP

(the original question)
Dear list server:

I have a patient that is a 46 year old transtibial amputee, 6'3', 361
pounds. He has worn artificial legs for years. As you may expect his problem has
been durability. His present prosthesis has the VSP foot design. We both believe
 he needs to stay with some type of vertical shock system (he will not go
back to the straight pylon configuration). Additionally he carries 140 pound
items twice a day for 2 to 3 days. He wants to be able to jump off walls 3 to 4
feet high. All this and maintain long term reliability/durability.

If we need to go outside the standard prosthetic industry componentry, we
will consider that option.

Any suggestions would be appreciated. All responses will be reposted. Thank
you.
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(responses)


Answer is very simple you need the hardware which will sustain 361+140 = 501
pounds of weight. I used to have a patient like him who would physically
lift up engine block plus his weight for living.
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If you find out who is manufacturing hardware for such abuse let us all know.

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My very straight forward heart to heart talk with this giant whose weight
plus the additional weight exceeded 700 pounds resulted in his using over head
hoist at work which was already there. Problem of breakage was solved.
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Your patient inspite of vsp and all the gizmos one day may learn that one day
 when adrinalin does give out and he hurts his back may teach him proving to
be superhuman specially vsp tend to harm the backs more readily and if you
are not convinced have him carry the loads in a gait lab and place some
electrodes and sensors and evaluate the demand this puts on his back. Been there
done that.
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Take a look at the Freedom Renegade-good verticle response.
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Thank you everyone that responded. Originally, the patient before, had worn
a prosthesis that did not have a vertical shock absorbing system. I have
recommended a vertical shock system concept, plus the patient will not have a
prosthesis made without some type of vertical shock absorbing componentry. I did
receive recommendation, from practitioners, to provide the Renegade foot
from Freedom Innovations. The practitioners were very happy with the vertical
displacement absorbing capabilities of that foot. Unfortunately Freedom was not
able to provide that foot with the overall body weight requirements, plus the
 140 pound items he would carry. Freedom Innovations was very cooperative
with me and offered another foot. Unfortunately, my interpretation of that foot
would not provide vertical shock absorbing capabilities. Presently I am
recommending the VSP design to the patient. Even though this patients overall body
weight is 361 pounds plus the 140 pound he is lifting, Ossur will provide a
limited warranty. But Ossur will provide this foot with the weights
discussed. I thank them for that option.

Presently the patient is contacting a company that provides shock absorbers
to the automobile industry. We may be making a prosthesis with an automobile
shock absorber. This will only be done if that component can be designed to
accommodate our industry connectors. I will let you know if that prosthesis is
built.

Thank you again for the assistive comments, Jake




Jake R. Wood C.P., F.A.A.O.P.
Orthotics & Prosthetics Associates Inc.
10101 Innovation Dr., Suite 500
Milwaukee, WI 53226

414-257-2727
414-257-9898 (Fax)

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