In the November / December 2004 issue of the Journal of Rehabilitation Research & Development, an article was published by Beil and Street entitled Comparison of interface pressures with pin and suction suspension systems. This paper was a result of research funded by the former TEC Interface using urethane liners with distal pin locks. The following is a quote from the article that sums up its point of view regarding pin suspension:
More permanent changes observed in long-term pin users include a distal bulbous shape, darkening and thickening of the distal skin, and occasionally, verrucous hyperplasia.
Here is a link to the article:
http://www.vard.org/jour/04/41/6/pdf/Beil.pdf
I use Ossur liners exclusively (basically out of habit and good success) for my pin suspension limbs. I just have not seen the disastrous consequences of using a pin suspension as detailed in this article. I would like to find out if there are any practitioners out there who have had similar bad experiences with pin suspension as put forth in this article.
Specific questions:
1. Have you noticed any changes to the distal end of the stump when using a pin suspension?
2. Have you noticed any differences between different brands of pin suspension liners, both positive and negative?
3. Have you adopted any special techniques in shaping the distal end of the shuttle lock socket to counter act any negative pin suspension effects?
4. Do you use a suspension sleeve with your pin suspension limbs? (I occasionally supply them but the patients never use them).
I will post answers (anonymously, unless you would like me to include your name) to the list as well as the Northwestern State of Science Forum where a discussion is going on with Glenn Street, PhD about this article. Feel free to check it out under the section of Sockets and Liners (now spanning 3 pages).
Here is a link to the forum:
http://forum.repoc.northwestern.edu/index.php
Your comments are sincerely appreciated,
Charles King, CP
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