Responses to:FREEDOM INNOVATIONS EVOLUTION LINER WITH PIN
Jeff Zeller
Description
Collection
Title:
Responses to:FREEDOM INNOVATIONS EVOLUTION LINER WITH PIN
Creator:
Jeff Zeller
Date:
8/25/2005
Text:
Thank You ALL for your ideas, going to try some of the lubricants suggested first.
Original Post:
Good evening,
I have a patient who is a left below knee amputee. She is diabetic type 2., has 2 1/2 of redundant tissue distal to end of tibia. She has been a previous wearer of Alpha 6mm Uniform Locking Liner. Previous socket was made with 4 of distraction during casting by another practitioner. This caused reduced circulation, and purple contusions on distal end of limb. It did eliminate some of her pistoning action, made limb numb by the end of the day.
I suggested we go with something a little stiffer distally to not allow the elongation of tissue. I went with a custom made Freedom Innovations Silicone Evolution Liner with Locking Pin. I distracted 1/2 in 2nd check socket, no pistoning, no numbness, extra silicone over anterior distal tibia, and patella tendon bar. Walked in Check Socket for one week. She LOVED IT! I fabricated definitive socket, she walked another week, worked great! She called today and had been standing for 10 hours today, it never really hurt.
But got home and took it off along with a thin layer of her skin on distal end and posterior of residual limb. Also rashy bumps up at proximal edge of liner on thigh. Some bloody fluid also in liner. I am not sure what made the difference? The Standing?
I talked to her about hygiene and cleaning. She is going to stay off of it for a day or two, then we might try some A & D ointment.
Anyone else have these issues? I like the idea of how they can customize the thickness of the silicone, I personally have had one made for myself and have been very happy with the comfort level. I just remember how the Iceross Silicone used to eat some peoples skin up. I hope this silicone is more skin friendly.
Please give me your ideas out there, I want the best outcome and comfort for this lady!
Sincerely,
Jeff A. Zeller, CP
Spectrum
Prosthetics & Orthotics Inc.
Redding, CA 96001
530.243.4500
530.243.4554fax
<Email Address Redacted>
Jeff, Maybe a plain suction socket with an inner soft or semi-rigid
liner would work. I have diabetes,my amputation was from blood clots
and this type socket seems to work for me.
Jeff,
It sounds to me as if the locking pin liner and socket is perhaps not a real good option for this lady. Maybe a good, old fashioned suction socket and sleeve would perform better.
Jeff,
I don't know if your patient is having the same problem I had, but it sounds similar. I used a silicon liner with pin for years and then I started having lots of fluids in the liner, very sensitive skin (I have a lot of skin grafts at the distal end and anterior of my residual limb). I eventually developed a condition called verrucous hyperplasia.
Between Wayne Koniuk of SF Prosthetics and a dermatologist, Dr. William Levy (deceased now) they decided that it was the pin suspension that was causing the problems--the sort of vacuum/suction pulling down my skin and drawing down the fluid. Anyhow, my new socket doesn't have the pin and I'm doing great. Wayne made sure I have a lot of contact and even pressure on my limb.
The silicon liner was always a problem for me--I had to wear socks underneath to prevent rashing. I'm glad to be rid of it.
Hi try a-coco-butter cream on here skin
Dump the pin, embrace expulsion technology: ZERO pistoning, no arbitrary
distraction/elongation necessary. Regardless of interface material
(Ossur's or Freedom's silicone, O.B.'s urethane, O.W.W.'s mineral oil
gel), there's no rationale for material to adhere to skin.
Non-dissipating lubricant is useful. Please post responses. Thanks.
The rashy bumps on the proximal edge of the liner can be ameliorated by using those expensive specialized cutters that put a curve on the cut edge of the silicone liner. They are expensive and hard to use but they actually seem to work . . .
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Original Post:
Good evening,
I have a patient who is a left below knee amputee. She is diabetic type 2., has 2 1/2 of redundant tissue distal to end of tibia. She has been a previous wearer of Alpha 6mm Uniform Locking Liner. Previous socket was made with 4 of distraction during casting by another practitioner. This caused reduced circulation, and purple contusions on distal end of limb. It did eliminate some of her pistoning action, made limb numb by the end of the day.
I suggested we go with something a little stiffer distally to not allow the elongation of tissue. I went with a custom made Freedom Innovations Silicone Evolution Liner with Locking Pin. I distracted 1/2 in 2nd check socket, no pistoning, no numbness, extra silicone over anterior distal tibia, and patella tendon bar. Walked in Check Socket for one week. She LOVED IT! I fabricated definitive socket, she walked another week, worked great! She called today and had been standing for 10 hours today, it never really hurt.
But got home and took it off along with a thin layer of her skin on distal end and posterior of residual limb. Also rashy bumps up at proximal edge of liner on thigh. Some bloody fluid also in liner. I am not sure what made the difference? The Standing?
I talked to her about hygiene and cleaning. She is going to stay off of it for a day or two, then we might try some A & D ointment.
Anyone else have these issues? I like the idea of how they can customize the thickness of the silicone, I personally have had one made for myself and have been very happy with the comfort level. I just remember how the Iceross Silicone used to eat some peoples skin up. I hope this silicone is more skin friendly.
Please give me your ideas out there, I want the best outcome and comfort for this lady!
Sincerely,
Jeff A. Zeller, CP
Spectrum
Prosthetics & Orthotics Inc.
Redding, CA 96001
530.243.4500
530.243.4554fax
<Email Address Redacted>
Jeff, Maybe a plain suction socket with an inner soft or semi-rigid
liner would work. I have diabetes,my amputation was from blood clots
and this type socket seems to work for me.
Jeff,
It sounds to me as if the locking pin liner and socket is perhaps not a real good option for this lady. Maybe a good, old fashioned suction socket and sleeve would perform better.
Jeff,
I don't know if your patient is having the same problem I had, but it sounds similar. I used a silicon liner with pin for years and then I started having lots of fluids in the liner, very sensitive skin (I have a lot of skin grafts at the distal end and anterior of my residual limb). I eventually developed a condition called verrucous hyperplasia.
Between Wayne Koniuk of SF Prosthetics and a dermatologist, Dr. William Levy (deceased now) they decided that it was the pin suspension that was causing the problems--the sort of vacuum/suction pulling down my skin and drawing down the fluid. Anyhow, my new socket doesn't have the pin and I'm doing great. Wayne made sure I have a lot of contact and even pressure on my limb.
The silicon liner was always a problem for me--I had to wear socks underneath to prevent rashing. I'm glad to be rid of it.
Hi try a-coco-butter cream on here skin
Dump the pin, embrace expulsion technology: ZERO pistoning, no arbitrary
distraction/elongation necessary. Regardless of interface material
(Ossur's or Freedom's silicone, O.B.'s urethane, O.W.W.'s mineral oil
gel), there's no rationale for material to adhere to skin.
Non-dissipating lubricant is useful. Please post responses. Thanks.
The rashy bumps on the proximal edge of the liner can be ameliorated by using those expensive specialized cutters that put a curve on the cut edge of the silicone liner. They are expensive and hard to use but they actually seem to work . . .
********************
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
Jeff Zeller, “Responses to:FREEDOM INNOVATIONS EVOLUTION LINER WITH PIN,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/225310.
