Reply summary - ? most durable foot ?

Reply summary - ? most durable foot ?

Ted Trower

6/11/2008

The original question was:

I have a client coming in for his once-every-ten-years fitting of a
new transtibial prosthesis. He's a beefy guy and drives a cement
truck so he's hard on everything. He's also a bit unusual in that he
fabricates his own sidejoints and lacer and stubbornly insists upon
exoskeletal construction. He has requested a different foot on the
new prosthesis. The old foot is a Flex-Walk and he does not like the
feel of it.

His top priority for the new foot is maximum durability. What foot
would you describe as the most durable foot you have used? I will
post responses.

Responses follow:
=====================================================
I wonder if your patient wouldn't like a good old Otto-Bock 1D10 dynamic
foot. I think the weight limit is 275 lbs., which may not work for your guy.
The only other foot I can think of, seeing how your guy is something of an
old-school wearer, is the Campbell-Childs SAFE II foot, which can be
engineered for heavier patients.

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Otto Bock 1D10 rated to 275#. He will love it.

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I too continue to encounter individuals, such as you have described,
with similar requests. Given the fact he wants an exoskeletal
prosthesis and I expect he would want some degree of mobility in the
foot, I would suggest either the Otto Bock Multi-Axis Greissinger Plus Foot
<URL Redacted>
or
Otto Bock Single Axis Foot
<URL Redacted>

The links above are to the Otto Bock UK web site, should you wish to
provide him with some technical information on the feet, as you will
not find such information on the US web site.

In my 30+ years of experience these would be my feet of choice for
long-term durability and reliability for the individual you have
described, unless you are looking for a less functional SACH type foot.

I will be interested in seeing our results!

----------------------------------------------------------------------------------------
If he's a beefy guy and drives a cement truck he would probably do
well with a simpler foot like the Magnum from OWW. For exoskeltal
prostheses another choice would be a Campbell Childs foot or even a
Kingsley energy storing foot. Durability,ease of fabrication and use
are all good reasons for these feet. If you want something with more
features College Park makes an exo adaptable foot. The issue with
most feet like flexwalk and other carbon feet is that the footshells
don't wear as well as the foot.
Based on maximum durability though the OWW feet seem to last pretty
well for the Beefy guys.
Good Luck!

----------------------------------------------------------------------------------------
I have had no problems ever when using an Ohio Willow Wood Magnum
foot. It is very stiff feeling to the wearer, but I get the feeling
that is what your guy wants. Many of my heavy duty users like the
foot to feel stiff.

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I put my roughest wearers in Freedom feet.

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Probably I could help in fulfilling his desires to this requirements,
as I also fall in that same line.

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Springlite II or whatever they call it now. You could land a plane
on those things. Not great motion, but you asked for durability, no?

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In Iowa, there is still nothing compared to the original SACH for
these patients. Farming puts such demands on everything from walking
on frozen, uneven terrain to climbing silos and tip toeing through
the hog lots! They love the rollover and will not accept anything
else. For durability, I make sure my techs understand gluing to the
ankle block, and MANDATORY for durability, having them come back in
two days to retighten the footbolt to torque specks. Good luck.

----------------------------------------------------------------------------------------
Depending on his weight, I've had pretty good luck with the SAFE 2
foot. They reinforce it substantially when you request
heavy-duty. The weight limit for the heavy-duty foot, for High
Activity, is 250 lbs. It's very affordable as well.

----------------------------------------------------------------------------------------
jaipur

=====================================================
End of responses.

The one complaint that I did not share with you in my original
posting was his concern that the Flex-Walk heel tended to cut thru
his socks in short order. Given that concern I intend to avoid the
feet with carbon heels even though I agree that they are easily among
the most durable, even if their footshells are not. Prior to posting
I was thinking of the SAFE II foot. Having looked at the responses I
believe that I'll go with the 1D10. I've excluded the articulated
feet as I'd like to avoid the issues with wear and tear on bumpers
and the associated maintenance.

Thanks to all who responded. Once again this listserv has proven to
be an invaluable resource for professional communication.

Ted A. Trower C.P.O., FAAOP
A-S-C Orthotics & Prosthetics
Jackson, Michigan, USA

www.amputee.com

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