TF question
Rick
Description
Collection
Title:
TF question
Creator:
Rick
Date:
1/24/2012
Text:
Good day Colleages,
I am having an issue w/a foot externally rotating upon heel strike only to return to its proper orientation as the foot moves to foot flat. I have seen this before in a TF prosthetic users & corrected via heel durometer (of foot or shoe), but this fella is driving me crazy. It also occurred in his old socket- a non-descript, round bucket w/no ischial or femural control.
Gait is horrendous: 11 yrs of bad habits including aBduction, circumduction, hard knee extension/terminal impact, hard heel strike, long Px side step, very short, fast sound side step & very little wt shift over Px. Single point cane used for balance; Fwd trunk flxn w/slight Trendeleburg. He's used an Otto Bock 3R92 & Trias+ foot for the last 3yrs. Prior to that it was always Safety/wt activated knees & some sort of multiaxial foot. His wt has been consistant, foot category is correct, all screws are tight & shoe heel not an issue.
Dynamic test socket is IC/narrow ML w/very good lateral femural support. Adductor tendon in its channel & A/P socket shape matches quads & hams. Gel liner-locking pin suspension w/no socket rotation about residuum. Residuum musculature is avg, subQ tissues moderate. Flxn contracure ~8 degrees & limb hangs neutral aBd/aDd. Hip abductors 5/5, adductors 4/5. Hip flx/extn 5/5.
Using the Trais+ foot & various knee units (trialing to suit pt's needs). Alignment is correct: no whips noted. pt has been working w/a therapist for gait training- shows improvements during sessions & reverts to habits outside PT. During PT, this jerking motion of the foot at heel strike deminishes w/improved gait. Added a torsion adaptor at the ankle yesterday & saw improvements, but motion not completely gone.
Anything you can think of that I have not considered? Replies posted & as always, much appreciated.
Rick
Rick Milen, CPO, PTA
NEXSTEP, Inc.
Prosthetic Specialists
West Lawn, PA
www.iwalknexstep.com
I am having an issue w/a foot externally rotating upon heel strike only to return to its proper orientation as the foot moves to foot flat. I have seen this before in a TF prosthetic users & corrected via heel durometer (of foot or shoe), but this fella is driving me crazy. It also occurred in his old socket- a non-descript, round bucket w/no ischial or femural control.
Gait is horrendous: 11 yrs of bad habits including aBduction, circumduction, hard knee extension/terminal impact, hard heel strike, long Px side step, very short, fast sound side step & very little wt shift over Px. Single point cane used for balance; Fwd trunk flxn w/slight Trendeleburg. He's used an Otto Bock 3R92 & Trias+ foot for the last 3yrs. Prior to that it was always Safety/wt activated knees & some sort of multiaxial foot. His wt has been consistant, foot category is correct, all screws are tight & shoe heel not an issue.
Dynamic test socket is IC/narrow ML w/very good lateral femural support. Adductor tendon in its channel & A/P socket shape matches quads & hams. Gel liner-locking pin suspension w/no socket rotation about residuum. Residuum musculature is avg, subQ tissues moderate. Flxn contracure ~8 degrees & limb hangs neutral aBd/aDd. Hip abductors 5/5, adductors 4/5. Hip flx/extn 5/5.
Using the Trais+ foot & various knee units (trialing to suit pt's needs). Alignment is correct: no whips noted. pt has been working w/a therapist for gait training- shows improvements during sessions & reverts to habits outside PT. During PT, this jerking motion of the foot at heel strike deminishes w/improved gait. Added a torsion adaptor at the ankle yesterday & saw improvements, but motion not completely gone.
Anything you can think of that I have not considered? Replies posted & as always, much appreciated.
Rick
Rick Milen, CPO, PTA
NEXSTEP, Inc.
Prosthetic Specialists
West Lawn, PA
www.iwalknexstep.com
Citation
Rick, “TF question,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/233315.
