Bilateral Hip Disarticulation Pesponses
Gary Cheney
Description
Collection
Title:
Bilateral Hip Disarticulation Pesponses
Creator:
Gary Cheney
Date:
8/13/2008
Text:
Rsponses to my post regarding bilateral hip disarticulation.
Rsponses to my post regarding bilateral hip disarticulation.
I've seen this fitting done, and for reference the otto bock catolog uses a young bilateral as a plster child in the pediatric component section of thier catolog. But I have never done it myself. I used to know a young man who had a similar amputation and his prosthesis was just set up to be on single axis knees to allow swifng through gait on crutches.
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I recommend fitting this patient with a single side (left or right)
prosthesis only. Probably it would be too complicated and difficult for
this patient to ambulate effectively with bilateral prostheses, in spite of
what he may be telling you.
He will be able to manage with crutches and a swing-through gait, with
reasonably good components such as the Endolite 019222 Hip Joint and Otto
Bock 3R60=HD knee.
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Bilateral hip disarticulation patients are always a challenge but they are
very similar to lumbosacral agenesis patients. The socket is more of a
bucket style with the hip joints and knees setup to follow through like an
RGO system. The patients ability to move his low back and pelvic area
dictates the flexibility and or rigidity of the socket. Some of these
patients do well with a flex frame setup which allows more rotation while
maintaining the socket fit others do well with a more traditional socket
setup. Once the socket is set, the establishment of patient stability and
how tall they will be with good balance becomes the issue. In the past I've
started with a static setup in parallel bars to determine the best weight
line for activation of reciprocal swing of the limbs. You must also be
mindful that this is a very time consuming process and that the patients
usually do not wear the prosthesis for too long before they decide that they
move faster without the prosthesis. That is not to discourage you from
taking care of him that's for you to understand that these patients are also
a psychological challenge . If you have any questions feel free to email me.
-------------------------------------------------------------------------------------
How do you lose bl hip prosthetics. Sounds fishy! C legs would be
great if he had coverage.
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Pleas let us know at O & P1 if we can be of any assistance to you and your patient. As we have handled many Hip-Disartic patients ranging from the normal to the extremly difficult as this would fall along those lines. We look forward to helping out in any way we can.
--------------------------------------------------------------------------------------
Since beginning teaching the Marlo Ortiz MAS socket courses 4 years ago, I have had the priviledge of working with John Michael and Marlo for close to 50 courses. By far, John and Marlo both excel in HD fittings. I would be happy to directly consult with both of them for you if you do not get the responses you are seeking. John consulted with me on a similar patient, female, in Nashville several years ago and he has some great ideas. My personal experiences are non-existant on this one.
--------------------------------------------------------------------------------------
Check out:
Spence et al (2001) Reciprocating gait prosthesis for the bilateral hop disarticulation amputee. Proc Inst Mech Engrs Vol 215 Part H pp3 09-314.
--------------------------------------------------------------------------------------
Kevin Carroll is definitely aperson to speak with he has enligtened us to
Hips in conversations and outcomes. He is with Hanger.......
--------------------------------------------------------------------------------------
Hi Gary, I once saw patient presented in a video that was in a similar situation as yours. She was fit at Shriners with a hip bucket and two legs that were connected to a reciprocating gate orthosis and she walked step over step with crutches for balance only. Good luck.
Gary Cheney, CPO, FAAOP
American Prosthetics & Orthotics, Inc.
1250 NW 142nd, Suite 100
Clive, IA 50325
515 223 8900
515 223 1879 (Fax)
515 249 4366 (cell)
www.apoinc.com
If you have received this e-mail in error, please immediately notify the sender by e-mail at the address shown. This information is intended only for the use of the individual(s) or entity to which it is intended even if addressed incorrectly. Please delete it from your files if you are not the intended recipient. Thank you for your compliance.
Rsponses to my post regarding bilateral hip disarticulation.
I've seen this fitting done, and for reference the otto bock catolog uses a young bilateral as a plster child in the pediatric component section of thier catolog. But I have never done it myself. I used to know a young man who had a similar amputation and his prosthesis was just set up to be on single axis knees to allow swifng through gait on crutches.
--------------------------------------------------------------------------------------------------------------------------------------------------------
I recommend fitting this patient with a single side (left or right)
prosthesis only. Probably it would be too complicated and difficult for
this patient to ambulate effectively with bilateral prostheses, in spite of
what he may be telling you.
He will be able to manage with crutches and a swing-through gait, with
reasonably good components such as the Endolite 019222 Hip Joint and Otto
Bock 3R60=HD knee.
-------------------------------------------------------------------------------------
Bilateral hip disarticulation patients are always a challenge but they are
very similar to lumbosacral agenesis patients. The socket is more of a
bucket style with the hip joints and knees setup to follow through like an
RGO system. The patients ability to move his low back and pelvic area
dictates the flexibility and or rigidity of the socket. Some of these
patients do well with a flex frame setup which allows more rotation while
maintaining the socket fit others do well with a more traditional socket
setup. Once the socket is set, the establishment of patient stability and
how tall they will be with good balance becomes the issue. In the past I've
started with a static setup in parallel bars to determine the best weight
line for activation of reciprocal swing of the limbs. You must also be
mindful that this is a very time consuming process and that the patients
usually do not wear the prosthesis for too long before they decide that they
move faster without the prosthesis. That is not to discourage you from
taking care of him that's for you to understand that these patients are also
a psychological challenge . If you have any questions feel free to email me.
-------------------------------------------------------------------------------------
How do you lose bl hip prosthetics. Sounds fishy! C legs would be
great if he had coverage.
------------------------------------------------------------------------------------------------------------------------------------------------------------
Pleas let us know at O & P1 if we can be of any assistance to you and your patient. As we have handled many Hip-Disartic patients ranging from the normal to the extremly difficult as this would fall along those lines. We look forward to helping out in any way we can.
--------------------------------------------------------------------------------------
Since beginning teaching the Marlo Ortiz MAS socket courses 4 years ago, I have had the priviledge of working with John Michael and Marlo for close to 50 courses. By far, John and Marlo both excel in HD fittings. I would be happy to directly consult with both of them for you if you do not get the responses you are seeking. John consulted with me on a similar patient, female, in Nashville several years ago and he has some great ideas. My personal experiences are non-existant on this one.
--------------------------------------------------------------------------------------
Check out:
Spence et al (2001) Reciprocating gait prosthesis for the bilateral hop disarticulation amputee. Proc Inst Mech Engrs Vol 215 Part H pp3 09-314.
--------------------------------------------------------------------------------------
Kevin Carroll is definitely aperson to speak with he has enligtened us to
Hips in conversations and outcomes. He is with Hanger.......
--------------------------------------------------------------------------------------
Hi Gary, I once saw patient presented in a video that was in a similar situation as yours. She was fit at Shriners with a hip bucket and two legs that were connected to a reciprocating gate orthosis and she walked step over step with crutches for balance only. Good luck.
Gary Cheney, CPO, FAAOP
American Prosthetics & Orthotics, Inc.
1250 NW 142nd, Suite 100
Clive, IA 50325
515 223 8900
515 223 1879 (Fax)
515 249 4366 (cell)
www.apoinc.com
If you have received this e-mail in error, please immediately notify the sender by e-mail at the address shown. This information is intended only for the use of the individual(s) or entity to which it is intended even if addressed incorrectly. Please delete it from your files if you are not the intended recipient. Thank you for your compliance.
Citation
Gary Cheney, “Bilateral Hip Disarticulation Pesponses,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/229725.
