Thanks everyone for your advice regarding donning considerations for my
patient. Following is the original question with responses.
Hello all,
Are there any liner-donning aids or techniques for a patient that lacks
bimanual upper extremity capability? My patient is an adult male with a
history of left side AK and recently, became a right side BKA. He also has
a history of left side upper extremity paralysis from a CVA six years ago.
His left side hip strength and range of motion are within functional
limits. He lives in a care facility, but assistance with donning and
doffing is an unknown quantity. I could use some advice regarding
suspension systems that might work, at least for his right BK so that he
can transfer independently. Thanks.
Sock fit, pickup billet and waist belt. Easy to use and is reliable.
Sometimes olden things work best and not everything has to be in gel liner.
Sounds like a challenging case…..maybe a MagLock would be a good option
for the B/K side if he has the ability to don primarily with his right
hand. Also you could consider a Click system with a single adjustable dial.
Just some ideas…I realize reimbursement might be an issue with either
system.
We have recently worked with a gentleman that presented with similar upper
extremity deficiencies. Went with pin lock suspension for him. The
practitioner that worked with him ended up mounting a dowel rod to a used
lock body and a rubber cane tip on distal end of dowel. Patient could lock
liner onto top of dowel and invert one handed. With dowel on the floor
could get set limb onto inverted liner and hold in place. With pressure
down onto floor via the dowel could then roll liner up one handed. Hope
this makes sense. Very simple and inexpensive means. This was a
transtibial amputee. Could be applicable to transfemoral with some
modification.
There were other variations on this idea of a stationary “holder†for the
distal pin and then reflect the liner over it. These included the above
suggestion, the use of a 2 liter bottle, and a piece of wood with a hole
which was attached to a dresser. I will share the adobe file with photos.
This particular patient is still in progress, but I had already determined
that a liner wasn’t necessary at this point. I plan to use a fork strap (or
similar) and suspension belt for the initial BK prosthesis.
Martin Bailey, CPO
