Colleagues:
For those of you who are doing Transfemoral IPOP procedures, you are aware of
the problems with achieving appropriate suspension and rotational control of
the prosthesis.
Given that, I would be interested in hearing your thoughts and experiences on
how you are addressing this problem.
My brief thoughts and experiences have been as follows:
HIP SPICA TECHNIQUE – The IPOP rigid dressing extends circumferencially
around the pelvis and over the contralateral hip and iliac crest.
EXPERIENCE: This technique is great for suspension and rotational control,
but limits hip flexion to approximately 45 degrees or less for sitting and is
not well tolerated by the patient. It is also not well suited for the obese
patient. Further, it extends time in the OR and elevating the patient for
the application of the hip spica extension presents problems.
HIP JOINT, PELVIC BAND AND BELT TECHNIQUE – A traditional single axis hip
joint, pelvic band and pelvic belt is secured to IPOP rigid dressing.
EXPERIENCE: This technique can work fine on individuals who are slender,
understanding of the importance of suspension and rotational control, as well
as compliant with monitoring this.
SHOULDER STRAPS WITH BOWDEN CABLE SHEAVES – Medial and lateral bowden cable
sheaves are incorporated into the IPOP rigid dressing then secured to length
adjustable over-the-shoulder straps for suspension.
EXPERIANCE: The techniques works well for suspension but does little for
rotational control.
MOLDED PELVIC SEGMENT WITH HIP JOINT – A prefabricated and sized molded
pelvic segment with single axis hip joint is attached to the IPOP rigid
dressing.
EXPERIENCE: None yet – In theory, I feel this might be the best overall
approach, however the availiability and timliness of acquiring a properly
sized pelvic segment complicates coordination of the procedure with the
physician, as well as the possible urgency of the surgery. Has anyone
attempted this approach? What molded pelvic segment did you use? Did you
incounter any billing issues as the molded pelvic segment is not covered
within the IPOP coding procedure?
Thank you in advance to whomever responds to the above with your thought and
experinces, of which I will repost to the OANDP-L.
John N. Billock, CPO, Clinical Director
Orthotics & Prosthetics Rehabilitation Engineering Centre
700 Howland-Wilson Road, SE
Warren, Ohio 44484 USA
Voice: 330-856-2553
Fax: 330-856-4619
E-Mail: jnbillock@aol.com or oandpcentre@oandp.com
