Tib-fib scissoring?
Rick Milen
Description
Collection
Title:
Tib-fib scissoring?
Creator:
Rick Milen
Date:
4/2/2008
Text:
Hello everyone,
pt: 69 y/o, 5'1, 160lb with a non-problematic TTA for the last 6yrs. Prosthesis is a pseudo-TSB with pt wearing a 6mm Alps easy liner and a 2 ply sock, expulsion valve and contexgel sleeve for airtight environment. Suspension is excellent, residuum shows no signs of excessive pressure and there's no complaints of pain.
She has recently had a decline in health due to CHF and diabetic complications resulting in extreme weakness, fatigue and LE cramping. Cognition also appears altered. Medications are plentiful and under PCP's supervision. She is still ambulatory using a rolling walker; household only. Weight shifting is appropriate, steps length are equal, but very short. After approximately the 3rd step on the prosthesis, she is getting a very loud, low decibel, THUNKing sound which she claims is not painful. Sensation is fair+. She reports feeling like she is ...balancing on two balls and then one moves...
Are we dealing with tib-fib scissoring? What's our best non-surgical intervention? I eliminated the gel liner today and went with all cotton sock fit w/distal pad to take up space gel in liner usually fills, and the thunking got quieter, but not enough.
Your thoughts on this matter are greatly appreciated.
Rick
Rick Milen, CPO, PTA
NEXSTEP, Inc.
Prosthetic Specialists
West Lawn, PA
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pt: 69 y/o, 5'1, 160lb with a non-problematic TTA for the last 6yrs. Prosthesis is a pseudo-TSB with pt wearing a 6mm Alps easy liner and a 2 ply sock, expulsion valve and contexgel sleeve for airtight environment. Suspension is excellent, residuum shows no signs of excessive pressure and there's no complaints of pain.
She has recently had a decline in health due to CHF and diabetic complications resulting in extreme weakness, fatigue and LE cramping. Cognition also appears altered. Medications are plentiful and under PCP's supervision. She is still ambulatory using a rolling walker; household only. Weight shifting is appropriate, steps length are equal, but very short. After approximately the 3rd step on the prosthesis, she is getting a very loud, low decibel, THUNKing sound which she claims is not painful. Sensation is fair+. She reports feeling like she is ...balancing on two balls and then one moves...
Are we dealing with tib-fib scissoring? What's our best non-surgical intervention? I eliminated the gel liner today and went with all cotton sock fit w/distal pad to take up space gel in liner usually fills, and the thunking got quieter, but not enough.
Your thoughts on this matter are greatly appreciated.
Rick
Rick Milen, CPO, PTA
NEXSTEP, Inc.
Prosthetic Specialists
West Lawn, PA
********************
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, “Tib-fib scissoring?,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/229260.
