Thursday, May 26, 2022

Replies to Pediatric Swim Leg

Keven Dunn

Dear List,

Thank you for all the replies some included pictures which I did not include in this reply due to privacy.

Two recommended Shin Fins:

Shin fins from Australia work great. Strap onto residual limb. Order online about $100+

Below knee amputation fins (BKA)

Some recommended not providing anything:

–I learned swimming at the same age with an ak amputation (very small stump) without any problem. No prosthesis at all is the best for learning. He will adapt to its disability very quickly, let him choose himself later if he wants to add some extra devices…..
a good alternative is using just one fin on his healthy leg. That should do the job!
I’m not so fan of getting young kids used of artificial devices too early, they should feel what their disability is and you will see how quick he will adapt to it! Once he knows how to do he will have himself the choice of using or not additional devices.

Creative Fabrication Ideas:

The kids I work with typically choose to swim without. I have been involved with the making of 1 swim prosthesis as you describe. It was a thermoplastic socket draped and seamed (cool fish pattern of course) that had a space keeper at the distal end oriented coronally (word?). After the plastic cooled, we removed the space keeper. Within the space we bolted through and through a fin shaped piece of Proflex With Silicone. It seemed to fit the bill. Don’t get your feelings hurt when you see pictures of him swimming without anything though!

— Fill the swim fin with a soft to medium shore urethane at the toe and a rigid mix at the heel. Imbed a Coyote lock into it and either let him just wear a silicone insert with the pin or use a poly pro socket with a hole it if you need the increased stability. Sounds like fun.

— I am a congenital symes amputee and made myself a swim fin last year for my honeymoon. I used a non covered Alps Winters Gel cushion liner (available from SPS only) and a bivalve socket with 5 velcro straps. I had to leave the anterior distal open because I have nubbins. I shaped a foot out of AB foam and laminated it in place. I would recommend angling the fit a few degrees less plantar flexed then i did. A regular fin was able to slip on it. It worked really well. The liner is tacky and you have to don it with alcohol but it worked so well. I went snorkeling for the first time in my life! It was very easy and cheap to make. I hope this helps.

— I did something very similar to this for a congenital syme Amputee. We basically just made a flexible socket with a very small fin at the bottom and drape molded the whole thing in one shot. It was suspended with a knee sleeve so it was functionally a suction fit but the main thing is to not make the fin too big you wanted to offer similar propulsion to the opposite foot. Later, for scuba diving we did something very similar but we mocked up a foam foot at around 45° and then pull the pro flex over it and the residual limb model so they could stuff the foot into a flipper. Think foot shaped distal end pad 🙂

— I did something like this. Young lady wanted to scuba, didn’t care about walking on it just wanted a swim fin. Used a proflex thin inner socket, built up co-poly frame with Alps Clear Gen silicone locking liner and a Coyote Design small Airlock ( Water Proof). Attached fin directly to co-poly frame with Stainless Steel Chicago screws. Patient Puts it on pool side. Trick is to get Fin paddling in the correct direction for her, first time pushed her more to the right, had to change the pitch. Ended up going to her apartment swimming pool with tools and doing dynamic alignment. It was great.

— When I was younger and wanting a swim fin, they creatively made one for me that I swam with competitively. Using a flipper I bought from the store, the kind with and open back and strap to hold the foot in place, they built up the end of my socket using two part foam and shaped it into the shape of the inside of the flipper, kind of like a big wedge. They also made a lip for the strap on the anterior surface proximal enough that it would hold tension on the strap and then laminated over the whole thing. Worked very well, and getting the flipper on and off was a huge pain which means it held on well in the water. I was also using a Silesian belt at the time and found the water really tore apart the loop side of the Velcro, FYI.

— You could make a relatively low cost unitized system out of silicone. like making a custom gel liner on the inside and flair it out distally and mold it into a fin. Reynolds products in Orlando is where we get our silicone for custom liners and distal pads. It would roll on just like a liner. There product line or trade name I believe is Smooth On.

Again thank you for your thoughts and helpful ideas.

Keven

Keven P. Dunn, MSPO, CPO, LPO

Gainesville Prosthetics
3870 NW 83rd Street
Gainesville, FL, 32606

Office: 352.331.4221
Fax: 352.332.8074
Email: [email protected]

[Gainesville Prosthetics]

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