Wednesday, May 25, 2022

Distal Stump Pain

One fine day Dave Fenton asked:

DF> Patient is a 77 years old male, bilateral BK (level 3+). Tried 3S

sockets. Patient expressed sharp pain when leg is lifted, no pain

while standing in legs. I assumed that distraction of the pin cause

by the weight of the prosthesis was the source of the pain but we

were unable to replicate discomfort by manually manipulating the

pin. Any thoughts on this phenomenon.

I am R-BK since 1969. Trauma due to motorcycle accident. Chuck Dillard,

CPO, has made rigs for me since about 1980. Fact, I see him at 9am

tomorrow.

When the 3-S system first hit the scene he suggested it for me, since I

was much younger than your patient and was then speedwalking up to

10K/day.

We tried it. The distal pain was, uhhhh, serious. Exactly what your

patient is describing to you. Just lifting the leg caused serious

annoyance on the distal portion of my stump, which I can assure you was

severe enough to capture my complete attention.

Chuck, being a very conscientious prosthetist, had forewarned me that

yes, there would be some discomfort at first, but after a week or so it

would dissipate and I would eventually be a happy camper. He was also

aware that my stump was, even after many years, quite sensitive. It

still is.

Now I am no stranger to pain. We are old friends. I can and will

tolerate short-term pain for perceived long-term gain. I realize life is

a series of little trade-offs. But, in the final analysis, I was too

much of a woos and sissy to tolerate the discomfort. For me, it did not

work.

Manually manipulating the pin is one tact. Another might be to manually

manipulate your patient’s stump…put both hands around the distal end

and pull downward. If the resulting pressure causes him pain, well,

maybe your patient is similar to me. Tho slightly older.

Amazing, ain’t it, how as I celebrate 30 years of having a stump (this

November 1) it is still quite sensitive. Happy birthday to me. And my

stump.

Wayne Renardson

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