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.
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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.
