BK socket design
Alicia Payne
Description
Collection
Title:
BK socket design
Creator:
Alicia Payne
Date:
4/22/2009
Text:
Hey all,
I have an interesting case and need suggestions from anyone who may have seen something similar. I have a 55 year old male that is a left BK amputee, secondary to trauma. The left lower leg and knee were crushed in a motorcycle accident 2 years ago. The surgeons tried to salvage the knee by putting screws and a plate in for stability. The screws were later removed because they were pushing through the skin surface and causing issues. After the screw removal, it was determined that there is a non-union fracture in the tibial tubercle that causes severe pain with motion and weightbearing. To add to the difficulty, he has a dis-attached patella and patella tendon that greatly reduces the ability for active knee extension. Despite months of therapy, he only has about 20 degrees of knee ROM. This guy has gone to see numerous orthopedic and trauma docs for advice on what he should do. Every doctor he has seen has refused to do a reconstruction to reattach the patella or to do a total knee replacement. Most doctors have told him that a transfemoral amputation will be his best bet. I have consulted with the patient to discuss AK prostheses and options that will be available to him. He absolutely refuses to wear an AK socket. He thinks that they are way too bulky and will not fit well under his tight jeans. He has chosen to have his knee fused and has found a surgeon to do this for him. He has a fairly long residual limb and wants to have a standard BK socket with pin liner. I am concerned about having such a long lever arm and the high concentration of forces around the proximal socket during gait. I am also concerned about toe clearance during swing phase. Obviously the prosthesis will need to be a little shorter than sound side, but I am looking for ideas or suggestions on feet with a good deal of dorsi/plantarflexion.
does anyone have any suggestions on socket design or foot selection? thanks in advance for your help.
Alicia Payne, LPO, CPO
I have an interesting case and need suggestions from anyone who may have seen something similar. I have a 55 year old male that is a left BK amputee, secondary to trauma. The left lower leg and knee were crushed in a motorcycle accident 2 years ago. The surgeons tried to salvage the knee by putting screws and a plate in for stability. The screws were later removed because they were pushing through the skin surface and causing issues. After the screw removal, it was determined that there is a non-union fracture in the tibial tubercle that causes severe pain with motion and weightbearing. To add to the difficulty, he has a dis-attached patella and patella tendon that greatly reduces the ability for active knee extension. Despite months of therapy, he only has about 20 degrees of knee ROM. This guy has gone to see numerous orthopedic and trauma docs for advice on what he should do. Every doctor he has seen has refused to do a reconstruction to reattach the patella or to do a total knee replacement. Most doctors have told him that a transfemoral amputation will be his best bet. I have consulted with the patient to discuss AK prostheses and options that will be available to him. He absolutely refuses to wear an AK socket. He thinks that they are way too bulky and will not fit well under his tight jeans. He has chosen to have his knee fused and has found a surgeon to do this for him. He has a fairly long residual limb and wants to have a standard BK socket with pin liner. I am concerned about having such a long lever arm and the high concentration of forces around the proximal socket during gait. I am also concerned about toe clearance during swing phase. Obviously the prosthesis will need to be a little shorter than sound side, but I am looking for ideas or suggestions on feet with a good deal of dorsi/plantarflexion.
does anyone have any suggestions on socket design or foot selection? thanks in advance for your help.
Alicia Payne, LPO, CPO
Citation
Alicia Payne, “BK socket design,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/230304.
