Monday, November 4, 2024

Hemipelvectomy prosthesis technical questions

Paul Prusakowski

Hello,

Christina Skoski requested that I post this to oandp-l. Please direct all

responses directly to her at [email protected].

Thanks-

Paul Prusakowski, CPO

Dear Paul,

Could you please post this to the O&P?

It’s Christina again, L hemipelvectomy. Been walking without assitive

aid for 37+yrs. Two yrs ago I broke a rib (10th, R, anterior axillary

line), right at the edge of my old hard laminated socket. Got a new

prosthesis with the double layer, carbon fiber, rigid support to the waist,

and inner “bioplastic” liner brought up high up over the ribcage. I like

and need this support for my back, it keeps me from twisting and dipping.

The opening is R side. It has been extremely comfortable, no problems at

all for 2 yrs, until last week when I broke the same rib again, same place.

I didn’t think this plastic stuff could do that, nor did I feel I was

weight bearing in the ribs. It may have been excessive repetative

stresses, ( I had the leg on for about 14 hrs before it cracked, active as

usual, bending a lot), OR I might be slipping out underneath. I have a

significant scoliosis and some degree of osteoporosis.

Question: How can I get these stresses off my ribs? I know this concept

works for me, we just need to refine it. Anyone have any suggestions as

to how to specifically modify my existing socket to get more containment

and support below? Can this be accomplished with thermoflex only, or will

I require a new rigid frame as well? Do we need to come under the sound

side? Will thinning the plastic at the edge be sufficient? I don’t want

to trim it down, I will just piston and drop into the socket more. I like

this style socket, it works for me, have no interest in silicone or rubber,

also like my CP, not looking for another. Just need some input and some

suggestions from those with experience as to how best build a solid

foundation and get the stresses off my ribs, with a minimum of time and

effort. Any suggestions or solutions are appreciated. Now in my early

50’s, must I curtail my activities or time spent walking/wearing my leg? I

still have a lot of energy.

Thank you,

Christina Skoski MD

[email protected]

www.hphdhelp.org

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