Ski Prostheses - Summary of Responses

Ski Prostheses - Summary of Responses

Steve Scott, C.P.(c)

11/5/2007

Thanks to all who responded to my request, you've given me many great ideas
and much to think about. At this point I'm leaning towards the freedom
Slalom feet or making something along the lines of the skiing shoes
suggested.

 

I have summarized the responses below, and if anyone has any other ideas let
me know.

 

Thanks again

 

Steve Scott, CP(c)

 

 

 

 

Bilateral is no problem. Set him up on your choice of adjustable heel height
feet. He may be a little taller but if used for sport specific activities it
should not be an issue.

 

 

 

I haven't provided a ski leg but as a skiier, I'm inclined to reply:

 

1) Century XXII may still make the Total Concept ajustable foot and ankle.
It opperates on a push button slide to release a rotar for dorsi angle
setting contol. I think Ossur may make a similar product.

2) S.A.F.E.II adjustable heel height foot would require more effort for the
amputee to adjust, but is an option.

3) Activeankle [Rampro, Inc (619) 944-9595] would allow a free ankle for ski
mode and plantar lock for swim.

4) If these prior options aren't satisfactory and the College Park foot is
prefered; the anteior bumper can be manually removed by the amputee
compressing the posterior bumper, thus freeing up dorsiflexion; a foot shell
cut out antior-proximally may be required; once again, I haven't tried this.

 

I would suggest a ski equipment fix here rather than a prosthetic fix. Build
and align the legs for normal walking, as that is what they will be mostly
used for. Have your client shop for a boot with less forward lean
(dorsiflexion). Try one of the boots from Salomon, they are a bit more
upright as a general rule. Then, the key to this whole puzzle is to get that
forward lean back into the system somewhere, and that is best done by having
the bindings shimmed to increase the ramp angle. Basically this involves
adding a plate under the heelpiece, or removing the plate under the toe. In
this way the hyper dorsiflexed position will be built into the ski-binding
interface, freeing you to fit the prostheses with normal alignment. Really
critical to get a boot that is built more upright. Many boots have 20-25deg.
+ of dorsiflexion!!! Good luck - looking forward to other ideas!

My initial thought is to look at the problem from a different perspective.
Can you modify the ski boots to accomplish the proper stance for skiing? If
so, the patient only has to worry about a pair of light weight shoes to get
and from the slopes/lifts.

 

I2cm heel wedges in his ski boots. Try to stay with old school, rearentry
boots. f anything else comes to mind I will post again.

I have the Freedom Innovations ski foot and it not only vastly improved the
amount of force I could put into the ski it also walks and jogs very
smoothly. Since he's bilateral it should be no problem to set them up.
Disregard the traditional skiing alignment. Align him to walk and they will
ski fine. Encourage him to lean more downhill and load the ski tips to do
deep powerful carves in all snow conditions. Leaning back in the steep and
deep and riding the tails is very enjoyable too. The ski foot has an
anterior attachment relative to the total surface of the foot so the heel
compresses under load, allowing different degrees of bite into the snow.
Also not dangling heavy ski boots is extremely liberating.

 

Keep the list up to date with his progress if you would.

 

I have a client who is in his 50's and is in the same situation (bilateral
symes). I would be interested in hearing what tyour findings are.

What about removable shims or modifications to a pair of Skiing shoes

to compensate for the alignment?

 

Another choice would be one of the articulating feet like the freedom runway
or Ossur Elation? It would make him taller, but make the ankle adjustable.

 

Interesting case, I would love to know what you decide to do.

You could try a foot with an adjustable. Or depending on height issues.

Endolite has a new hydraulic adjustable heel height component that will fit
on any foot.

 

 

A tricky situation, for sure, and one idea that comes to mind is to use L.A.


Ankles on the prostheses. Locked for normal gait when not in his ski boots,
then unlocked and slipped into the boots for skiing. Alignment should be
acceptable and the boots will have to be really stiff and high, as they do
all the support and control of excessive dorsiflexion.

 

 

 

 

 

 


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