Hello O&P-L,
I am writing you regarding a patient of mine, “Mr. H”. He has been
using a Springlite Advantage Low Profile foot system for approximately
three months. During this time Mr. H has made excellent progress and
walks very strongly. He is using an ischial containment socket with a
flexible inner socket (suction suspension), a Bock Active Line
knee/shank with a Mauch Hydraulik unit, and the Springlite Advantage Low
Profile foot. He uses a TES belt for auxiliary suspension.
There is one nagging problem, however: upon heel strike, Mr. H’s foot
externally rotates about 20 degrees. This action repeats itself on just
about every prosthetic side heel strike, when it happens. There are
periods of time where it seems not to happen at all, and then times when
it happens every heel strike.
First, I checked his socket. Mr. H uses a wet fit, but his socket
doesn’t seem to fit too tightly or too loosely.
Then, we thought it could possibly be the hard leather heels of his
dress shoes (he had mentioned the rotation didn’t happen in sneakers).
Mr. H had the heels of his dress shoes replaced with a “cloud crepe”
type of material that compresses nicely upon heels strike. This reduced
the degree of rotation but did not eliminate it.
Reduction of the knee flexion resistance on his Mauch unit really
helped, but once again this reduced but did not eliminate the rotation.
Lastly, we considered the possibility that Mr. H’s dress shoes were
simply too tight through the heels and they were not allowing the
foot-shells to flex naturally (kind of like with a SACH foot and
too-tight shoes). He said he would try a shoe a half size larger.
I really don’t know how the Springlite Advantage Low Profile foot could
be the culprit. When I spoke to someone at Springlite last time, they
didn’t think the foot sounded like a probable cause for the rotation.
Other prosthetists I have spoken to have tended to suggest one of the
many things we already tried, and no one thought the foot would be the
cause.
Am I missing something? Have you or anyone heard about similar
situations? Any input you could provide would be helpful. Mr. H has
been extremely patient with this troubleshooting phase of prosthetic
fitting, and I would really like to remedy the situation for him.
Thank you very much for your time and trouble.
Yours truly,
William A. Lifford, C.P.
ARIMED Orthotics, Prosthetics, and Pedorthics Inc.
Brooklyn, NY
(718) 875-8754
personal email [email protected]
