Replies to Odd BK request?

Rick Milen

Description

Title:

Replies to Odd BK request?

Creator:

Rick Milen

Date:

12/12/2006

Text:

ORIGINAL POST:
  66 y/o, 6'1, 250 lb male with a R-BKA who drives a small pickup with a regular cab. He had the pedal adaptation done to the vehicle, but he cannot get his R knee &/or hip to flex enough to get his 28cm foot into the cab (short limb, big belly). Being a regular cab, the seat cannot go back any farther ... Questions: Is this medically justified for a BK prosthesis? Has anyone ever been reimbursed for L5984 in a transtibial case?
   
  RESPONSES SUMMARIZED:
  Responses from Certified Practitioners, one PT and one O&P student (who donated a hardly used rotator to this gentleman-- THANK YOU!).
   
  Many folks thought using the Ferrier Coupler, but concern was expressed for pts safety removing the foot entirely.
   
  One practitioner described using a 4-bar knee on a short BK w/a fused knee & thought a rotator was not out of the question
   
  Another practitioner had already done this for a BK who is a plumber. Used the rotator just proximal to the foot so he could spin the foot out of the way to facilitate kneeling on the job. Felt it was medically necessary to resume his livelihood.
   
  Another interesting thought was the use of a lock knee below the BK socket, pt manually unlocks knee and positions pylon & foot out of the way to slide into the truck.
   
  About 40% of responders felt anything to help pts return to their lifestyle w/appropriate documentation is justified, but also felt it would be interesting to see if you get reimbursed.
   
  About 20% of responses dealt w/getting a bigger truck, or w/modifications to his truck, truck seat or pts body mechanics when attempting to get into the truck. I can tell you that we have tried everything concerning his positioning, approach and body mechanics to address this issue. AND the guy does not want to butcher his truck in anyway to get his butt behind the wheel.
   
  We will be trying the donated positional rotator to spin his foot out of the way, swing his leg into the truck and once positioned behind the wheel, spin the foot back into place. We will focus on safety risks while performing the action, and foot position once behind the wheel for safety and liability issues. He will sign a waiver with all liability and safety issues we discuss and list. He will also sign verifying that he will not perform the task unsupervised for the first several attempts. His son, wife or I will be present.
   
   
  Thank you all for your thoughts.
  Sincerely,
   
  Rick Milen, CPO, PTA
  Certified Prosthetist-Orthotist; B.S.
  Physical Therapist Assistant; A.S.
   


 
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Citation

Rick Milen, “Replies to Odd BK request?,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/227716.