I’ve got a couple of clients with very poor circulation. Main vascular
flow is totally compromised, and they are relying on capillary flow only.
They are Bk prosthetic users, and are having socket issues. Total contact
compression of their tissue causes ischemic pain…. and being loose enough
for the pain to subside makes them way loose in the socket- causing MANY
other issues….
In an attempt to determine if it is just a socket fit issue, or a
tension/compression issue I have had these clients wear (properly mx’d, and
fitting) gel liners with no other compression forces: no socket etc.
These clients have pain from just wearing the gel liner!! Some last 30
min, some take the liner off instantly due to ischemic pain.
This tells me total contact is not a viable option; so i have tried PTB
type modifications thinking that the high pressure areas would compromise
blood flow, but low pressure areas would allow blood flow…. Many times
this has helped, and it buys time in the prosthesis before pain levels
dictate removal. In some cases i have taken this high/low pressure system
to the extreme, with mixed results…. I have used P-lite liner, Keasy cone
liners, bio elastic w’ silicon and a frame socket…..
I have a few of these clients, so i know we are all dealing with this
issue!!! I would love some feedback!
1) What are others doing to remedy this issue?
2) What socket designs have worked best?
Thanks,
Justin Tegerstrand CPO
