Question: tough AK case
Rick Milen
Description
Collection
Title:
Question: tough AK case
Creator:
Rick Milen
Date:
11/15/2006
Text:
Dear List,
Your input would be greatly appreciated. Thank you in advance.
Scenerio: 37 y/o male with mental retardation since birth and Dx of bipolar disorder. Has caregivers 24/7/365. Underwent AKA due to Lipomatous Carcinoma ( an aggressive CA w/prognosis of death 5 years after Dx). Was fit w/temp prosthesis: quad-like socket, no ischial wt bearing, no distal contact, a soft distal pad, a 3ply plug fit w/hip joint-pelvic belt, “Safety” knee and Sach foot. Oh, and the socket has flexible inner-rigid outer w/no windows cut out.
Patient is fearful of knee and does not wt bear on prosthesis; he hops utilizing his walker & sound leg w/the prosthesis tagging along. Family was told this prosthesis was “the best choice for him to ensure he doesn’t break his hip when he falls.” Pt told CP the prosthesis hurts so plastazote padding was added along brim from ischial area to the adductor and an ~ 1 ½” circumferential band of plastazote was applied inside the socket just distal to medial brim height (pseudo hyperbaric??? Poor socket shape for sure!) Case worker wants more appropriately fitting socket and a lock knee so that pt can learn to wt bear and trust his prosthesis. Pt is strong, case worker has been with this guy for over 5 years and feels he can learn to use a prosthesis IF he trusts it. Says pt told him he “wants to dance again”. He is never w/o supervision &/or assistance.
Q: Isn’t he more at risk for falls with an ill fitting socket?
Why not a lock knee? Cognition may not allow for body mechanics required
w/knee flxn.
Does the use of hip joint & pelvic band decrease chance for hip fractures in a fall?
Why not narrow ML, ischial containment with liner-lanyard system? Easy to don,
reliable suspension and appropriate socket shape.
Rick Milen, CPO, PTA
NEXSTEP, Inc.
Pennsylvania
---------------------------------
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Your input would be greatly appreciated. Thank you in advance.
Scenerio: 37 y/o male with mental retardation since birth and Dx of bipolar disorder. Has caregivers 24/7/365. Underwent AKA due to Lipomatous Carcinoma ( an aggressive CA w/prognosis of death 5 years after Dx). Was fit w/temp prosthesis: quad-like socket, no ischial wt bearing, no distal contact, a soft distal pad, a 3ply plug fit w/hip joint-pelvic belt, “Safety” knee and Sach foot. Oh, and the socket has flexible inner-rigid outer w/no windows cut out.
Patient is fearful of knee and does not wt bear on prosthesis; he hops utilizing his walker & sound leg w/the prosthesis tagging along. Family was told this prosthesis was “the best choice for him to ensure he doesn’t break his hip when he falls.” Pt told CP the prosthesis hurts so plastazote padding was added along brim from ischial area to the adductor and an ~ 1 ½” circumferential band of plastazote was applied inside the socket just distal to medial brim height (pseudo hyperbaric??? Poor socket shape for sure!) Case worker wants more appropriately fitting socket and a lock knee so that pt can learn to wt bear and trust his prosthesis. Pt is strong, case worker has been with this guy for over 5 years and feels he can learn to use a prosthesis IF he trusts it. Says pt told him he “wants to dance again”. He is never w/o supervision &/or assistance.
Q: Isn’t he more at risk for falls with an ill fitting socket?
Why not a lock knee? Cognition may not allow for body mechanics required
w/knee flxn.
Does the use of hip joint & pelvic band decrease chance for hip fractures in a fall?
Why not narrow ML, ischial containment with liner-lanyard system? Easy to don,
reliable suspension and appropriate socket shape.
Rick Milen, CPO, PTA
NEXSTEP, Inc.
Pennsylvania
---------------------------------
Sponsored Link
Mortgage rates near 39yr lows. $420,000 Mortgage for $1,399/mo - Calculate new house payment
Citation
Rick Milen, “Question: tough AK case,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/227633.
