Wednesday, April 24, 2024

AK Socket Rotation Issues Responses

Stan Vydrzal

Thanks to everyone who replied.

Original Problem

I have an active 50 year old patient that I made an AK prosthesis for. He plays golf and rides a bike. When claims when he is active and sweats his socket internally rotates. I have deepened the socket slightly and decreased the tensions because I though maybe it was shallow or too tight.
Not sure the depth was an issue but it was a little tight. His tissue is firm. I thought it was tight and not letting his muscles fire. All the measurements seem good now but he still has the problem. The new socket is without proflex and he uses pure suction. Myself nor the guys I work with have come up with a good solution.

Recommend Certain-Dri. Available at Wal-Mart and most pharmacies, OTC. Will help control sweat issues. Hope it helps.

I have a patient who was in a similar situation. He was in a skin fit suction socket when I first started seeing him and he had the same issues.
I believe the patients lose suction because when they are active and perspire, they actually lose volume. We ended up switching him to an Ossur seal-in liner. After a few weeks his skin became used to wearing a liner and the suspension is very good. He does still perspire during certain activities, but it is much better than when he was in the skin fit socket.
He has been in the system for four years now and loves it. He uses a belt when he is doing really active things, like cycling which is for added security in case he loses suction. The system is nice because he can add socks if he loses a lot of volume over a long period of time and gives him a barrier between the socket and his skin.
Hope this is beneficial information. Good Luck!

I would consider a OKC channel. This is done by adding a piece of pelite down the posterior of the Femur. This should cut down on the rotation. You could also consider a Narrow M-L socket.

How is he donning the socket? Is it with a pull sock or does he use a wet fit, like lotion to get in? If it’s a wet fit I’d try to get him to use a pull sock to don. He could also use an antiperspirant; I know there are ones specific for amputees. I’d also check the valve to make sure he is maintaining suction. Maybe it’s not as airtight as it could be. Finally, check the type of bike he rides, if it is a racing bike and he’s leaning over to the handlebars could be a matter of the anterior trimline hitting his stomach or the seat causing internal rotation, not sweating. Hope this helps..

Stan Vydrzal CP
Muilenburg Prosthetics Inc.


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