Hello List:
Last week I posted this question:
What methods do you employ to enable new partial foot amputees to ambulate?
How do you protect the suture line?
Responses follow. Thanks to those who replied.
Troy Fink, CO/prosthetic resident
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My choice is the Aircast Foam walker or pneumatic walker with a custom molded
poron and intuition foam or plastazote insole. This walker is the best to
offload the forefoot area because of its rigidity and circumferential.
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On our recent partial foot/transmetatarsal amputees, (usually seen at the
hospital shortly after surgery) the Dr’s request open toe cast shoes with
metatarsal bars attached. We usually go with their “normal” shoe size as
the extra length with act as a distal end “guard.” This is of course as soon
as the Dr is sure the suture site will not de-hiss upon weight bearing. The
met bar is nice as it keeps the weight more on the heel. If it is very
short then we do go with the TMA shoe which comes up around the ankle. But
the height of the sole seems to throw some pt’s balance off. All that to
say, the amputee is up ambulating and once the site is well healed, we cast
for toe filler/TMA.
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Hi, I’ve been using the springlite inserts for a while but have had problems
with them being too stiff just under the foot, even if it’s under a custom
insole. I started using the contoured insert and I cut the shoe sole as though I
was doing a shoe lift and I glue the springlite insert into the sole. It
creates a stiffer shoe with the added protection of nothing stiff inside the shoe.
Then I do a custom soft insole, maybe of plastazote as a filler.
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