Thanks for the responses. My patient, on second walk, now seems to have no
problems, without much intervention from me!
If this situation changes I will keep you posted.
Herewith the posts:
The brim may be too wide in the ML !!
Personally prefer ischial containment sockets.
Good luck Allan Wicks
The forces causing the irritation may be dynamic (alignment) rather than
static (socket shape). Double check whether the socket needs to be
abducted or the foot outset. I would suspect that outsetting the foot
would be more helpful.
(Ted Trower)
You may want to reexamine the ramus. If you are using a quad brim with a
medial wall the that is straight, the ramus may be trying to exit out the
anterior third but is unable to. This is more so in females due to the
pelvic structure. (Just an idea.)
(Mark Taylor)
Take a look at the radius of the medial shelf. I’ve found that a slopping
shelf is more comfortable on the soft tissue than a defined “roll out” to a
flat horizontal surface. If this explaination is hard to visualize give me
a call.
Brian Gustin CP.
920-435-3537
Leg could be to long, medial wall to low-creating a adducter roll a d flesh
being pinched during weightbearing. good luck,
Eugene Banziger, CPO
Just this past week I had the same problem. You look at everything, and it
s seems normal. My patient is wearing a quad socket with a thin sock and
lightweight sileasian belt. He came in last week saying he was a little
loose but everything was OK. I added a thin lining to the socket. It seemed
to do the trick. He came back yesterday in complaining of medial proximal
pressure at mid-stance. He felt like he was getting a
lateral thrust. I was baffled as to how it had fit so good and then went
bad. Not knowing what to try, Idecided to remove the lining just on the
medial wall. Patient response…NO pressure, No lateral thrust. My thoughts
are that maybe your M/L dimension is to narrow or too much tension on the
tissue from the 1″-4″ level. Hope this helps
Steve Childs, BOCP, C.Ped.
It seems that you have insufficient radius between the posterior and medial
walls.
Phil, P&O Student
