It sounds as though most practitioners are doing as we do for locking
liners- rigging something up with dacron attached to the liner and
buckles/velcro. I’ve used the Seal-in liner from Ossur a few times with
great results, but mostly at the transtibial level. While I wasn’t thinking
of one particular patient, I was thinking generally of someone with volume
fluctuations as in a prep. I was just curious to see if there was a system
off the shelf that people liked, but I didn’t get a consensus on that.
Thanks for your input, and a summary of results are below and separated by a
blank line.
Jacqueline Schmit, MS, CP
Certified Prosthetist
**********
We just cut a slot in the distal socket and bolt on a dacron strap.
Good question! It’ll be interesting to see the results. I use1″ dacron
screwed permanently into locking liner fed through slot as distal as
possible secured with a rapid adjust buckle (from McMaster and Carr or TRS).
Ossur’s seal in liners I’ve recently found useful for AK’s as well,
especially when clearance is an issue. PDI makes a nice offset plate
for HFC’s and you can still use a lock without sacrificing knee center
clearance (because the four hole patterns are independent of each other).
Bionix 866.469.5600. They have what you need. Order Flexion Integrated Lock
Kit With Length Offset. They can install a Lanyard into this system.
We generally use the KISS system. With the flexible inner socket kit (delrin
locking base) any amount of hip flexion and ab/adduction can be accommodated
in the socket. The system virtually eliminates pistoning and rotation within
the socket. You can get more information at www.kiss-suspension.com. The
video clip shows a transfemoral patient with a significant contracture.
use the glue from coyote to glue a velcro strap directly to the liner.
Create a slot as close to the distal end as possible and thread the strap
through the hole up to a chafe and velcro down. Cheap, effective, and easy.
I’ve used Ossur’s Seal-in liners with much success when length was an issue.
The knee center cannot be closer to the anatomical KC unlee you use outside
joints.
I have used dacron tape either velcro’d to the socket or better yet pulled
through a double D-ring. This seems to gives more tightening leverage.
After trying an Ossur lanyard system which broke the 2nd day I went to the
idea pool and have use very successfully a most simple and functional device
for the long AK/KD using roll on liners. Imagine cutting a stainless steel
screw, inserting into an adaptor available from Alps or even a metric foot
bolt, use a wing nut or hex head nut, washer with a rubber seal and wal-la.
Depending on the length of the limb, you can cut the flex socket off at the
distal end for more clearance using the lamination / washer to attach the
liner. Being in Wichita KS I call it a Wichita Wing Lock after all the
airplane industry here. Make sure your attachment for the 4 hole pattern
does not interfere with the attachment nut.
I use a 3/4 in HD dacron strap that I fold over at the end. I then burn a
hole through it and put a screw (with a large head) that fits into the
insert. (this is the insert used to accomodate a smaller pin for the
locking liners)
At the distal end of the cast, I put a half dome the size of a half ping
pong ball. In fact, I use the blister packaging to make the shape of the
half dome. This accomodates the screw distally. Actually it is about a third
of the ping pong ball shape. Of course it requires a double lamination. I
find the current lanyards in the lanyard system to not be strong enough and
difficult to replace the string if it breaks-and they do. I no longer use
pin systems for AK’s anymore.
We have been having great success with the Ossur Seal in liner for long
transfemoral and knee disarticulation amputees. Good suction suspension
with no pin/shuttlelock or lanyard.
We are using 1″ dacron strap with Velcro which exits the socket distally
through a slot. This strap is long enough to go through a 1″ chafe attached
to the socket anteriorly and the Velcro fold back over itself. The slot can
be anterior enough to allow for your patient with excessive hip flexion.
You could try Ossur’s 600 series lock system with the lanyard option. There
are two lamination adapters available with the system as well. One is a
pyramid and the other is a 4-hole adapter. This one would give you the
option of using an offset if you require it. The design is fairly low
profile, so you could do a double lamination to adjust for the alignment.
Check it out at: http://www.ossur.com/template110.asp?pageid=150
i’ve been using the Ohio Willow Wook locking lanyard system. It seems to be
working well though the 5 or so patients I have using it have not had it
long enough for me to comment on durability.
Hi Jacqueline. I’d be interested in getting the responses you are sent with
regards to the lanyard systems used. Have you read the article on the KISS
system on page 68 of the O&P Business News magazine, March 15? It sounds
like it’s worth trying.
