I have been following some of the rhetoric the past few days on this
listserver regarding amputee unions, socket fit… etc….
I am a practitioner in Tampa Florida… I don’t profess to be the “best”, I
certainly hope I’m not the “worst”, I fancy myself a competent practitioner.
I would like to make a comment regarding my impression of “socket fit”
arguments.
there is no doubt that socket fit is important in all prosthetics. However,
It is, in my opinion, no more important than proper allignment and
appropriate design… here is my justification:
If there was one way to make a proper AK socket, why would there be so many
socket variations… Quadrilateral, Ischial containment, modified IC,
suction, SSS… etc…. then bottom line is that AK’s are mostly soft
tissue, and so hydraulic containment is the universal critical aspect of the
socket. which one is the best socket Mr. Boyer? shall you or your “amputee
Union” be made the authority of such decision?
Prosthetists understand that alignment impacts the forces inside the socket,
so when the patient perceives and reports a poor socket fit, it can actually
be an alignment problem. Fine details of alignment have such a huge impact on
outcome, yet to the patient, the main perception of a prosthesis is naturally
the component that interface with his/her anatomy… the socket…. so often,
alignment problems are articulated as socket fit problems by the patient. All
competent prosthetists know this…..
So when I hear this big uproar by the amputee community, (or is it just
George Boyer), stating that if we all could just cast and modify
appropriately, the world would be a better place for amputees… I don’t
think so… we work in a complex environment, juggling the business/cost
containment aspects of the field, the technology of the field, the
phsyco/social aspect of our work, and the actual evaluation, design and fit
of the devices. So, when Mr. Boyer summarizes “quality” or “competence” to
the taking of casts and modifying molds, I find those comments to be an
insult to myself and this profession.
Sincerely,
Wade Bader, LCPO
Tampa FL
Those who don’t practice, never make mistakes…..
Those who speak on a foundation of ignorance, often put their foot in their
mouth…..
