Ron,
In reading your question, I just thought I’d put my two-cents worth in.
In my opinion, if you take precise measurements of a patient’s residual
limb, i.e. circumfrences, length, AP, ML, troch. to ischium, etc., are
you not providing a custom fit prosthesis? After all, the measurements
will be used to modify a plaster model (or similiar) to these specs. by
hand, or they can be used as input for a cad/cam program to accomplish
the same results( hopefully ).
With this in mind, have I not made a unique patient model from which I
will fab. the patient’s socket? My understanding of the language used
in the H.C.P.C.S. codes of “Molded Socket” is to delineate between a
prefrabricated socket ( small, medium, large, etc. ), and a custom made
socket. ( I have ask this question at Medicare seminars and this is the
answer that I get. ) But, by the above method I am still producing a
socket that is “molded to patient model”. We don’t make this our “norm”
by any means, but we have used this method on more than one occasion.
The bottom line is that the socket MUST still fit the patient and be
comfortable, or we have not done our job very well, if at all.
E. Reed Coleman, C.P.
Advantage Prosthetics & Orthotics
Shreveport, LA
