Friday, May 27, 2022

Transhumeral with humeral flexion osteotomy socket design.

Chet Burdette

Hello list members,
I was referred a young patient who was a new long transhumeral amputee as a
result of compartment syndrome. He was well healed but had been scheduled
for TMR surgery at one of the larger east coast centers so we had to wait
to have that completed before fitting him. He returned after the TMR
surgery with a completely different limb shape. I read the surgical notes
and the surgical team had performed a humeral flexion osteotomy on him
during his TMR procedure. This was something I hadn’t encountered in my
education or 24 years of practice. I researched it for weeks while my
patient healed and wore a shrinker. The information I found was limited at
best. If anyone has experience fitting patients who have had this surgery
I would love to see how you approached the socket design. I understand the
flexion osteotomy benefits to suspension, rotational control and shoulder
range of motion but it seems like some of these benefits can be negated by
an imperfect socket design. I tried quite a few and came up with the one
pictured below. I’m just really curious to see how others have fit these
patients and solved some of the issues that are created by this
modification. From my experience donning is made more difficult and at
least with my patient the flexed end of the humerus is very sharp. I’d
appreciate any feedback or advice as I feel as though I’m reinventing the
wheel here.

Thanks,
Chet Burdette CPO

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