Monday, June 17, 2024

TRANSFEMORAL SUCTION SOCKETS – REPLY – PART 2

Lucy Fogarty

TRANSFEMORAL SUCTION SOCKETS – REPLY

(SEE PART 1 FOR THE FIRST HALF)

Dear Lucy

I was happy to read your suggestion. I think this would make the fitting

more accurate and precise.

the idea of taking measurements under muscle contraction is excellent,

because usually it causes a gap in the Rectus Femoris channel once the

client contracts his flexors. And this must solve that problem.

Please explain me: (highlighted in your letter)

a.. what I could not understand is to shorten the cast by 1–3 cms,

circumfrencaily? or what. please explain

b.. To use a nylon bag for donning the prosthesis, where is available?

I would highly appreciate if you could kindly send some more information

on making A.K Suction sockets.

Thanking you in anticipation.

Ajaz Zargar

REPLY: The length of the socket is shortened (see additional comment

above). The “nylon bag” is available from OttoBock – Easyfit donning

sheath, OC1560. It comes in 4 different sizes. Also the firm Arion,

(Arion International B.V., Kleinestraat 1, 6422 PS Heerlen, The

Netherlands. tel +31 (0)45 566 72 42, fax +31 ()) 45 566 72 44, has one

called “quickfit” and comes in 5 sizes.

Information for manufacturing sockets is available from Otto Bock – they

have a detailed manufacture manual with photographs and explanations. In

the manual is a rigid laminated suction socket and also a flexible ISNY

style socket. Blatchfords also have a manual and they describe how to

make polypropylene suction sockets.

**************************************************

Lucy – I am an intern prosthetist in Canada and am wondering about

elderly

patients pulling in to the suction socket – have you observed any

problems?

-Cathy McConnell

REPLY: A suction socket is definitely more difficult to don than a

prosthesis with a rigid pelvic band, or “TES” belt. However, once

correctly donned, the prosthesis is well controlled in terms of rotation

and stump movement is more directly tranfered to prosthesis movement.

Also pistoning with the resulting prosthetic limb lengthening is

reduced. Thus the patient can better control the suction prosthesis once

it is donned. The patients are fitted with a suction socket right from

the beginning and thus have help and guidance in the learning stages

from hospital staff. I think this makes a big difference from issuing a

suction socket after a year or so, when the patient has to cope at home

without assistance from physiotherapists and nurses. Elderly patients

would normally donn the nylon bag (see above) in sitting and donn the

prosthesis, still sitting. The bag is pulled through the valve hole,

pulling the stump partially into the socket. The patient then stands,

supported by a wall, or holding onto furniture or a crutch. The bag is

then totally pulled through. For patients who are unable to bend down

sufficiently, a device made from a walking stick is used: proximal half

of stick, with cut end shaped into a “V” fork. This is used to push the

“handle” of the bag downwards.

I must say, that when I first came I thought it was impossible for 80-90

year olds to manage this, but surprisingly most of them can.

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