Scleroderma Transtibial Amputee - How to Fit?
James Beggs
Description
Collection
Title:
Scleroderma Transtibial Amputee - How to Fit?
Creator:
James Beggs
Date:
12/18/2011
Text:
I have a patient we recently inherited from another facility, a geriatric
but active transtibial amputee with Scleroderma.
She said that with her previous company, they had a great deal of
difficulty getting a good fit with her prosthesis, and even had flown in an
expert of some sort to help, the issues were so difficult. As she is not a
practitioner, she isn't sure quite what their final result was.
What she did recall was that they had to switch to elevated vacuum with a
gel liner, but beyond that, the other modifications were beyond her. She
had shrank significantly and needs a new prosthesis.
However, we are now having the same issues that the previous company had,
and examining her socket design has not shred much light on the subject. In
the meantime, she stopped wearing her current prosthesis, ended up swelling
back up, but her current still hurts even with her swelling - in other
words, it appears her overall shape has changed, or perhaps her scleroderma
has advanced somewhat and is causing some additional discomfort.
She says she's never been able to wear a prosthesis completely without
pain, but that it was minor until all these changes. As it is, she cannot
tolerate much sheer forces, hence the elevated vacuum, but even then,
apparently the previous company had had a great deal of frustration and a
lot of test socket modifications before they finally got a fit that worked.
We considered duplicating her old socket and reducing the volume, but as I
said, she has since swelled up again, but says her current socket now
bothers her even when swelled up like it had not done so before.
I'm hoping someone out there has some experience with fitting a scleroderma
patient who can offer us some advice on how to proceed.
Thanks in advance!
James A. Beggs
Gulf Prosthetics & Orthotics
San Antonio, TX
but active transtibial amputee with Scleroderma.
She said that with her previous company, they had a great deal of
difficulty getting a good fit with her prosthesis, and even had flown in an
expert of some sort to help, the issues were so difficult. As she is not a
practitioner, she isn't sure quite what their final result was.
What she did recall was that they had to switch to elevated vacuum with a
gel liner, but beyond that, the other modifications were beyond her. She
had shrank significantly and needs a new prosthesis.
However, we are now having the same issues that the previous company had,
and examining her socket design has not shred much light on the subject. In
the meantime, she stopped wearing her current prosthesis, ended up swelling
back up, but her current still hurts even with her swelling - in other
words, it appears her overall shape has changed, or perhaps her scleroderma
has advanced somewhat and is causing some additional discomfort.
She says she's never been able to wear a prosthesis completely without
pain, but that it was minor until all these changes. As it is, she cannot
tolerate much sheer forces, hence the elevated vacuum, but even then,
apparently the previous company had had a great deal of frustration and a
lot of test socket modifications before they finally got a fit that worked.
We considered duplicating her old socket and reducing the volume, but as I
said, she has since swelled up again, but says her current socket now
bothers her even when swelled up like it had not done so before.
I'm hoping someone out there has some experience with fitting a scleroderma
patient who can offer us some advice on how to proceed.
Thanks in advance!
James A. Beggs
Gulf Prosthetics & Orthotics
San Antonio, TX
Citation
James Beggs, “Scleroderma Transtibial Amputee - How to Fit?,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/233138.
