Locking liner w/ least elongation summary

Locking liner w/ least elongation summary

Paul Prusakowski

8/16/2012

Thank you everyone for your recommendations.

Overwhelming responses for the following:

 

Willow Wood's Alpha Hybrid Select Silicone

Ossur Comfort Liner

 

I ordered one of each and will see what works best for the patient.

 

Others were mentioned, but these took the prize. A lot of duplicate
responses were left out of the response summary.

 

Paul E. Prusakowski, CPO, FAAOP

Gainesville Prosthetics

 

 

Here is the original question and a summary of responses:

 

What has been your 'off the shelf locking liner' of choice when looking for
the least amount of distal elongation? My patient is currently using an
ALPS locking liner with distal matrix, but it has too much elongation and
distal distortion. I will be recasting patient over the new liner that I
order so it does not have to retrofit his old socket.

 

 

Responses:

 

That out of the way, working with another prosthetist on the project has
exposed me to OWW's alpha hybrid select with pin. I think it is the best by
far and pistoning is one the things I obsess over. Previously, I'd say
Ossur, but this seems better.

 

Ossur comfort liner. Very little elongation, mush more durable than the
other Ossur liners. If you call Ossur, they will send you a free casting
liner.

 

Elongation is a misnomer. What tends to happen to the limb/liner is more of
a shape change. But to answer the question in a goal oriented
response....go with the an original iceross.

 

I almost always use the Iceros Comfort Locking liners for my patients.
This is the same liner I have worn since 1998 with a pin system. But
starting in about 2005 I made myself a socket using suction, and can keep
the leg on by flexing my calf muscles enough when just walking around, and
normal ambulation. When I am running or rock climbing, I put the knee
sleeve on to make sure my leg doesn't fall off.
 
I will not use Alps liners because they elongate the most of any liner I
have seen. The Alpha liners also elongate a lot. The Iceros Comfort liners
are the only ones that I have found that do not elongate. Even for a very
high level amputee (like me, mountain biking, skiing, etc.) that is the
liner I used for a pin locking system, and I never had any problems.

 

Ossur Original with or without cover will eliminate the distal
elongation/distortion problem.

 

MEDI

While I love ALPS for certain applications (like sleeves), their liners,
from my experiences, are notably some of the worst for their elongation
resistance. The gel has always been pretty soft and the matrix a little lax.
A couple suggestions, Ossur's Stabilo has been a viable option and
WillowWood's new Silicone systems seem to have a nice matrix that resists
elongation while allowing for circumferential stretch especially over the
knee window which patients seem to like.

I'd go with the Ossur locking liner.(not the G-series which is the Alpha gel
profile) It has a size-specific distal umbrella that doesn't distort the
distal shape when distracted. The recommended casting protocol has a bit of
distal distraction built into the cast that reduces pistoning as well. I
have a PDF casting manual if you'd like it.

 

I prefer the alpha select locking liner. I have a new patient with 3 of
redundant distal tissue, so I will be dealing with this issue. He is in a
snf, but still walks the loop of the building. The alpha fabric is awesome
for prevention of elongation. With my situation, the distal tissue issue
magnifies the elongation, so I will also be using a removeable medial brim
on the socket to provide an additional anchor on the medial femoral condyle.
This will provide an additional benefit of elongating the lever arm for
sagittal stability, so my patients with short limbs love it.

 

Second... ESP's Secure Ring can help eliminate elongation on just about ANY
liner! Just glue a ring to the outside of the liner, anywhere you want it.
When the patient slips back into the socket, the ring will create a suction
seal. Ring with adhesive....$19.75

The new hybrid from Oww is not bad but also have had good luck with alps

Have you tried Bock's 6Y75? I think you'll find these provide minimal
elongation as compared with the ALPS or Alpha's. Much more durable as
well(in my humble opinion)!

 

 

 

 

 

 

 

 

 


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