Saturday, December 3, 2022

High Heel SACH feet users responses

frances berg

Dear List serve, thank you to everyone for your thoughtful answers.

Dear List serve, thank you to everyone for your thoughtful answers.  Here are the responses:

-ORiginal message:–
Sent: Sunday, July 31, 2011 8:58 PM
Subject: High Heel SACH feet users
Hi.

I am a student in P&O.  I have been looking at adjustable heel feet and got interested in the SACH Hi-Style and the Cowboy-High.  Do you know of anyone who has used these since the 80’s?  Are they completely obsolete?  I see that they are still manufactured, so I assume someone is buying them!
I am also looking into the Runway foot. Have people had good luck fabbing foam covers with these or any adjustable heel feet? Do alot of people wear them without covers?
Since I’m mainly looking for pt use info, I am relying on people’s experience instead of the internet to answer these types of questions.  I appreciate any personal experience with these feet, especially the poor, forgotten SACH.

Thank you for any information,
Frances Berg

Responses:

1.  have a patient on the 3 1/2 ” foot. She loves it.The foot is from kingsley and they still make them
She has an adjustable foot from ossur. She is a level III but she wears
heel all the time. The high heel she wears is a three and half inch
stialetos for dancing and clubbing. She is thirty five years old

2.  Hi Frances, I am an old prosthetist and have used a number of these feet
successfully and even fit one to an amputee on a C-Leg (2000). I would
also teach my clients how to switch feet to a lower heel foot.
What more do you want to know? These feet still have their place until
something better comes along to replace them. The adjustable feet on the market do not have the range of heel height.  
Al Pike, CP

…to a follow up question

The client was a former model in Europe and made a special trip here to see me so
that I could fit her with a foot so that she could wear 3” high heel
shoes again.  I have had a number of amputees come to me so that they could wear high heel shoes.
3.  The cowboy  SACH foot is probably the best for a boot wearer.  The shape
of it is the closest to a boot shape with the high instep.  The adj feet
might get the height, but not the shape of the boot.
 
4.  Hey Frances
I just finished my prosthetic residency and we used the
college park accent. The cover was no problem, we used two part soft
foam and daw skins and they had plenty of give. I would say that most
individuals that are interested in an adjustable heel height foot prefer a natural looking cover. of course, there are exceptions.
Hope that helpsNiki

5.  Dear Ms. Berg,

I did use the USMC ankle joint and the other types
of feet when I was and intern. That was about 18 years ago. The Runway
and Elation were hydraulic versions  of the heel height adjustable
device. Unfortunately they had leakage problems as do many hydraulic
piston devices do not have a compensating accumulator.

The
Motion Ankle from Motion Control does not require an accumulator since
it has a double rotary vane hydraulic system. Also it allows 60° of
motion instead of locking the motion as with the Runway and Elation.

Although
simple the SACH was really the first “rollover shape”. In fact much of
the motion from midstance to late stance if very similar to the FlexFoot
actually. It is late in stance at about 65% of the effective foot
length. The wooden keel of the SACH cannot support the load and it
exhibited drop off. The rollover could not be extended since the wood of
the keel would be too weak to extend further. Also the curve would
extend beyond the foot. Composite feet allowed this rollover to continue
to the toes so that the physiologic 84% EFL could be found. Also the
SACH could be enhanced for Transfemoral patients by plantarflexing it
slightly to move the load to the metatarsal heads.
I hope that helps,
Gerry Stark

…to a follow up question:

Dear Ms. Berg,
The Runway was a first version of the Elation. 
Both were hydraulic systems that you pushed a button and indexed the amount of plantarflexion or heel height you wanted.
The SACH has been unfortunately a whipping boy. Much of the
criticism is that it had prolonged heel contact and increased pelvic
instability. Some of this could have been do to the alignment, but it is the acceleration or the support to the toes where modern feel perform better.
Hope that helps,
Gerry

6.  Hi:
I use the odd 1D11 from bock, and the sach feet for a few
cowboys.  Maybe 1 a year. 1 guy wanted the endolite multiflex foot –
(used it once, I think u can set it to stay between 25 and 35 mm heel
height)
I have tried the runway 2x and it was rejected, as it is
awkward to use the pushbutton system w the cosmetic shell in the way.
Maybe the allen key style is better. Likely never use this again.
I
have used the Ossur elation w/ sucess 3x, and have been told that the
college park is VERY good, and will test that out next time.
The proprio is also a neat option 😉
E

7.  The Cowboy or high SACH are great for folks who wear the high
heels everyday. Much cheaper and lighter than the adjustable HH. Plus less noisy
and easily maintained. Underutilized and out dated are not really the same
thing.
 
James O.
Young Jr., LP, CP, FAAOP
Amputee Prosthetic
Clinic
888FAKELEG
888fakeleg.com

8.  No matter whichever adjustable heel foot we use, the foam ankle cosmesis always pulls away from the foot once it’s been adjusted a few times. If a silicone cover has been added, you have the same problem with even
costlier damage. If somebody wants to wear a high heel, buy a Kingsley
SACH, and accept that you can’t change the angular position, other than
adding heel or sole inserts to the shoe for ‘faux’ plantar/dorsiflexion.
Liz Rainey, prosthetist

Frances,

9.  I have used the high style for a very high heel height
shoe on an AK.  The elation and runway only accommodate heel heights up
to around about 2.5″, and with shoes having heel heights of  4″+, these
feet don’t fit flush in the shoe.  The sach, however, fits these shoe
profiles well. 

Zach Harvey, CPO

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