burning at distal tibia
Rick Milen
Description
Collection
Title:
burning at distal tibia
Creator:
Rick Milen
Date:
8/18/2006
Text:
Dear Colleagues,
Bear with me.....
Case: 6' 3 220lb K2 Male w/transtibial amputation performed 09/2005. R.L. length is 5.5, fish mouth incision. Temporary socket fit 11/05 - TSB, gel sleeve & expulsion valve suspension, soft distal pad, gel socks, etc.
At time of temp fitting and before the socket was fit, practitioner noted and questioned the individual about rash-like irritation at lateral aspect of incision line. He said it just cropped up last night and itches like crazy.... Fitting went very well w/no signs of excessive pressures or further irritation to the area of concern, but moderate, localized pain with wt bearing. Referred individual back to his physician prior to his beginning PT. (Suspected it was an infected suture.)
Physician told the individual that he ...was fit with his prosthesis too soon.... (Same Dr. that wrote the Rx for the prosthesis). A revision was performed to remove infected tissue at the anterio-distal aspect of the cut tibia. The incision line is now invaginated & beneath the cut bone, with ~1/2 padding/tissue posterior to incision line. Overall length and shape of R.L. not effected. Dr. told him that invagination will fill in in a year or 2.
Socket was re-fit 02/06 with the same sock ply as original fitting: 3ply gel & a sheath.
PT begins and he does very well. Easily picking up sock management due to a hot foot sensation with volume loss. He'd add a ply or 2 and the sensation dissipated. R.L. always looked healthy. Probable adhesions at distal tibia addressed by PT with pt self massaging.
Definitive leg fit 07/06: expulsion valve/gel sleeve suspension, 6mm easy liner and sheath fit. Intermittent burning sensation in or out of prosthesis is becoming unbearable. He's been to see the surgeon and PCP, both say to see CP. PCP Rx'd pain meds and neurontin. Socket fit is good w/ good distal contact and no signs of excessive pressure. R.L. looks healthy.
Can elicit the same sensation with pressure distally that results in the distal padding/tissue folding anteriorly over incision invagination. Tried soft contoured pad between sheath and liner to fill invaginated area...caused burning immediately and full time. Your suggestions would be greatly appreciated.
Rick Milen, CPO
Pennsylvania
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Bear with me.....
Case: 6' 3 220lb K2 Male w/transtibial amputation performed 09/2005. R.L. length is 5.5, fish mouth incision. Temporary socket fit 11/05 - TSB, gel sleeve & expulsion valve suspension, soft distal pad, gel socks, etc.
At time of temp fitting and before the socket was fit, practitioner noted and questioned the individual about rash-like irritation at lateral aspect of incision line. He said it just cropped up last night and itches like crazy.... Fitting went very well w/no signs of excessive pressures or further irritation to the area of concern, but moderate, localized pain with wt bearing. Referred individual back to his physician prior to his beginning PT. (Suspected it was an infected suture.)
Physician told the individual that he ...was fit with his prosthesis too soon.... (Same Dr. that wrote the Rx for the prosthesis). A revision was performed to remove infected tissue at the anterio-distal aspect of the cut tibia. The incision line is now invaginated & beneath the cut bone, with ~1/2 padding/tissue posterior to incision line. Overall length and shape of R.L. not effected. Dr. told him that invagination will fill in in a year or 2.
Socket was re-fit 02/06 with the same sock ply as original fitting: 3ply gel & a sheath.
PT begins and he does very well. Easily picking up sock management due to a hot foot sensation with volume loss. He'd add a ply or 2 and the sensation dissipated. R.L. always looked healthy. Probable adhesions at distal tibia addressed by PT with pt self massaging.
Definitive leg fit 07/06: expulsion valve/gel sleeve suspension, 6mm easy liner and sheath fit. Intermittent burning sensation in or out of prosthesis is becoming unbearable. He's been to see the surgeon and PCP, both say to see CP. PCP Rx'd pain meds and neurontin. Socket fit is good w/ good distal contact and no signs of excessive pressure. R.L. looks healthy.
Can elicit the same sensation with pressure distally that results in the distal padding/tissue folding anteriorly over incision invagination. Tried soft contoured pad between sheath and liner to fill invaginated area...caused burning immediately and full time. Your suggestions would be greatly appreciated.
Rick Milen, CPO
Pennsylvania
********************
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
Rick Milen, “burning at distal tibia,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/227021.
