Beyond the Headlines
August 2014 Issue
Individuals with lower-limb amputations often make headlines, from Paralympic runners with high-tech carbon fiber feet, to Amy Purdy's recent appearance on the television show Dancing with the Stars, to stories of wounded warriors returning to duty after being fitted with the newest generation of rugged prostheses that can withstand environmental and physical challenges. But most of these high-profile stories, and in fact most of the patients with lower-limb loss that the average prosthetist encounters, have transtibial or transfemoral amputations. In this issue's cover story, however, we asked experienced practitioners to share their knowledge about a patient population with a type of lower-limb loss that you may not have treated before: hip disarticulation. Because this patient population is relatively small, it has not garnered headlines or the abundant research dollars needed to further advances in hip disarticulation prosthetic technology, but work has been taking place beyond the headlines. "Improving Fit + Function for the Hip Disarticulation Patient" introduces some more recent alternatives to the traditional bucket-style socket for this type of presentation. With better treatments for injuries sustained in the conflicts in Iraq and Afghanistan, as well as other trauma situations, the experts we spoke to report increased focus on hip disarticulation patients. There's also a need for prosthetists who have had successes with this patient population to share their knowledge so that other prosthetists and their patients can benefit, says Zach Harvey, CPO.
While there is no doubt that lower-limb orthoses make a significant impact on the lives of their users, as Phil Stevens, MEd, CPO, FAAOP, points out in his article, "Bracing the Intrepid," their contributions "often tend to be marginalized" in the academic literature with little description of their design characteristics. The detailed descriptions of the components and theory behind the development of the Intrepid Dynamic Exoskeletal Orthosis (IDEO), then, stand in sharp contrast and provide us with an opportunity to examine the manner in which one area of lower-limb orthoses has evolved to improve patients' lives-and perhaps give others incentive to take another look at the merit of documenting this important area of O&P.
Also, going beyond the headlines, I was compelled to include a story quite different from this issue's original theme of optimizing lower-limb solutions, when Ellie Boomer, CPO, approached me with her commentary on the study highlighted in May's New York Times article that refutes the efficacy of helmet remolding orthoses. Her in-depth critique of the study's methods and conclusions helps to reinforce the profession's strong response to this damaging article and provides information for practitioners and parents alike to use in battling third-party payer claim denials based on that study.