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Here are the responces I recieved to the:TEC liner problem I posted.
After reviewing the responces I doubt that its a fitting problem. When
the patient came in to pickup his new liner I did a displacement check
as per TEC. The ink mark was in the correct position!
I am inclined to believe that the cloth material bonded to the gel is the
problem. There being less stretch or elongation in the cloth area causing
the separation at the junctiion of the gel and cloth because the gel stretches
more than the cloth.
By the way TEC has refused to honor their warranty. Also made me put it
on a visa card. I have been in this profession for 30 years and I never had
any supplier do that to me before. All the total surface bearing I do now are
Icex…..
Happy Trails Bill Lewis C.P.
<< have a BKA patient that is presently wearing a total surface bearing > socket with a TEC liner. He does not use vaseline as a friction reducer
>.He donns and doffs the TEC liner by using a roll on roll off medthod .
> He applys a stump sock over the outside of the TEC liner and uses the
> stump sock as the friction reducer rolling the TEC liner and sock off at
> the same time.
> His residual limb is approximently 9″ long and cylinderical shaped with
some
> what of a bulbous distal end . Which turns out to be advantages . He is
able
>to flex his calf muscels enough to suspend the prosthesis.
> We had two Tec liners made for his present Prosthesis . The prosthesis is
> about 8 months old . He alternates the liners so they will last longer.
Each
> liner has been worn an equal amount of time. Two weeks ago he tore the
> posterior section of the liner . The separation was at the junction of the
> reinforcement material.
> I am told that the separation is caused from a ill fitting socket due
>atrophy ect..
> which lets the gel migrate proximal to distal thinning the gel therefore
>making it
> susceptible to tearing . Has anyone had simular or this particular problem?
> I would like to see some comments and will post the results.
> Send your comments to [email protected].
>
> Happy Trails Bill Lewis C.P.
>Hello Bill
Sorry it’s taken so long to reply. Have you had any other responses yet? I
too have had this same problem. Very frustrating. TEC advises to make a mark
at the top of the liner at the proximal brim. This should be used as a “gas
guage”. If the line migrates above the socket “the tank is to full” and
socks should be removed, if the line migrates into the socket “the tank
needs to be filled” and socks need to be added. TEC has also advised that
the r.t. is not necessary and can actually cause the problem due to
dissimilar materials. I’ve started using liners without the r.t. with better
results. Good luck.
Brian L. Gustin CP.
>
Subj: TEC liner tear
Date: 97-10-18 16:30:36 EDT
From: [email protected] (rcurby)
Dear Bill,
I have had 2 similar occurences with tearing of the TEC at the junction
of the liner and the reinforcement material.
One was I believe due to the patient wearing to many socks causing
excessive elongation of the liner, resulting in a tear.
The other was approximately 2 years old, appeared to fit well with
correct amount of elongation but seperated only on the lateral aspect.
I can only presume it was due to fair wear and tear.
Regards,
Richard
Subj: Re: TEC liner
Date: 97-10-16 20:35:38 EDT
From: JWLISTON
To: WLewis379
Bill,
Thats right. The only time you will have problems with a Tec is if the socket
doesnt fit correctly. You’ve got to do things the way Tec Tells you. I’d
highly recommend going to St. Cloud for a TEC course. They have a deal you
can’t refuse. Give Scott, Carl, Fred or Lisa a call. Theres not even a reason
your patient needs to have more than one Liner. Best of luck, Jim Liston CP
Subj: Re: TEC liner
Date: 97-10-17 08:18:35 EDT
From: [email protected]
This is one of the major problems we have encountered with all the
TECs fitted in Edinburgh. Interestingly, this is not a major problem
with liners which have no reinforcement! Time wise, the liners which
tear, are lasing around 6-8 months as well. Perhaps we should be
manufacturing/modifying in a different way? I’d be interested to see
what other comments you get.
Julie Callan – Scotland
Subj: Re: TEC liner
Date: 97-10-11 08:55:45 EDT
From: Arfur64
To: WLewis379
Dear Bill
I had a similiar problem earlier this year. I fitted a very long B/K with a
TEC liner as part of a new prosthesis. The fitting took quite some time, but
the patient was satisfied with the end result. A few months after delivery,
the patient noticed very small tears appearing in the distal end, on the
inside of the liner. I contacted TEC and was given the same answer as you –
poor fitting socket, lack of distal contact etc. I know however, from fitting
2 check sockets, that socket fit was not the problem. I believed it was a
manufacturing defect. TEC said return the liner and they would repair it. The
repair was totally ineffective and the tears re – appeared in a matter of
days. When you looked very closely at the distal end of the liner, you could
see that there were bubbles in the urethane, and the tears were appearing in
the same place as the bubbles.
I called TEC again and, full credit to them, they replaced the liner at no
charge. The patient has had no further problems.
If you believe that socket fit is not the problem, speak to TEC again and
suggest that it may be a manufacturing defect. Good Luck!
Regards
Arthur Graham CPO(UK)
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From: Brian
Subject: Re: TEC liner
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At 09:41 PM 10/10/97 -0400, you wrote:
> I have a BKA patient that is presently wearing a total surface bearing
> socket with a TEC liner. He does not use vaseline as a friction reducer
>.He donns and doffs the TEC liner by using a roll on roll off medthod .
> He applys a stump sock over the outside of the TEC liner and uses the
> stump sock as the friction reducer rolling the TEC liner and sock off at
> the same time.
> His residual limb is approximently 9″ long and cylinderical shaped with some
> what of a bulbous distal end . Which turns out to be advantages . He is able
>to flex his calf muscels enough to suspend the prosthesis.
> We had two Tec liners made for his present Prosthesis . The prosthesis is
> about 8 months old . He alternates the liners so they will last longer. Each
> liner has been worn an equal amount of time. Two weeks ago he tore the
> posterior section of the liner . The separation was at the junction of the
> reinforcement material.
> I am told that the separation is caused from a ill fitting socket due
>atrophy ect..
> which lets the gel migrate proximal to distal thinning the gel therefore
>making it
> susceptible to tearing . Has anyone had simular or this particular problem?
> I would like to see some comments and will post the results.
> Send your comments to [email protected].
>
> Happy Trails Bill Lewis C.P.
>Hello Bill
Sorry it’s taken so long to reply. Have you had any other responses yet? I
too have had this same problem. Very frustrating. TEC advises to make a mark
at the top of the liner at the proximal brim. This should be used as a “gas
guage”. If the line migrates above the socket “the tank is to full” and
socks should be removed, if the line migrates into the socket “the tank
needs to be filled” and socks need to be added. TEC has also advised that
the r.t. is not necessary and can actually cause the problem due to
dissimilar materials. I’ve started using liners without the r.t. with better
results. Good luck.
Brian L. Gustin CP.
>
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