[OANP-L] Responses to TF foot rotation issue
Rick
Description
Collection
Title:
[OANP-L] Responses to TF foot rotation issue
Creator:
Rick
Date:
2/7/2012
Text:
Original Question:
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.
Thank you all. I ended up shifting the knee & foot laterally via offset plate, plantarflexing the foot & slightly creating an medial leaning pylon. This, along w/ PT has reduced the issue 90%. Now it is most notable when pt increases velocity significantly- creating a very hard heel strike & returning to all bad habits. Of note: pt refused trying seal-in liner & will ...never use a belt.
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.
Thank you all. I ended up shifting the knee & foot laterally via offset plate, plantarflexing the foot & slightly creating an medial leaning pylon. This, along w/ PT has reduced the issue 90%. Now it is most notable when pt increases velocity significantly- creating a very hard heel strike & returning to all bad habits. Of note: pt refused trying seal-in liner & will ...never use a belt.
Citation
Rick, “[OANP-L] Responses to TF foot rotation issue,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/233429.
