I was referred a patient today with an uncommon problem and I would
appreciate some suggestions from list members. He is a 74 year old
diabetic who is an ex Marine.(weighs about 250 lbs, down from over 300).
He underwent a Left BKA 4 years ago, but never wore a prosthesis due to
poor initial fitting. About 1 1/2 years ago, while transferring onto a
toilet, he fractured his L hip which resulted in a girdlestone
procedure performed at a VA hospital. He is now being treated for osteo
on R foot and is receiving PT to address contractures- bilateral hip
(15-20deg), R knee (25), L knee (15). This patient is very motivated
and “tough as nails”.
It would help him a great deal if he could use a prosthesis to transfer,
I’m not trying to make him a community ambulator. Some questions that
come to mind are: How much weight could he bear on a traditional
device? Would the addition of an ischial containment socket stabilize
the femoral segment? Should I consider a pelvic section to limit
rotation? Would LLD be a major problem? I am expecting to see X-rays
tomorrow.
Gerald L. Martin CPO C.Ped
