Translating Skills: Using Past Experiences to Solve Challenges in the O&P Lab

While some technicians gravitate toward the O&P lab early in their professional lives, others, like me, find themselves in the industry after careers in a variety of other fields. I entered the O&P profession well into my adult life, and as I have progressed in my career at Texas Scottish Rite Hospital for Children (TSRHC), Dallas, I have been amazed at how the knowledge from my past experiences has helped me problem-solve in O&P. I served six years in the U.S. Navy, during which time I served on the USS Long Beach CGN-9 and the USS Dixon. Then I worked for the U.S. Department of Defense for 12 years. My experience in these roles included welding and assembling submarine and ship parts. I also helped build ships and worked on submarines and carriers. When the Cold War ended, I helped to destroy all the unwanted vessels by cutting big submarines and ships into small pieces. I also worked in the engineering profession for more than 18 years before I decided to build something else- thus beginning my O&P adventure. I attended the Orthotics-Prosthetics technician program at Spokane Falls Community College, Spokane, Washington, and eventually became certified. I have found that what I learned about adapting and modifying components and devices through my prior experience has helped me to merge old techniques with new ones in the rapidly changing world of O&P. I have been able to apply the thinking and some of the skills I learned to tackle problems in the lab, such as adapting a vertical fabricating jig (VFJ) to accommodate pediatric foot bolts, and finding a solution that protects cabinet tops from machinery. Adapting a VFJ Some of my work in the Navy required me to find creative ways to work with the parts and equipment I had readily available rather than relying on something specifically designed for the job at hand. This sort of accommodation inspired my approach to adapting a standard VFJ for use in an environment that often demands pediatric-sized components. If you transfer prosthetic alignment using a VFJ, it is essential to maintain the correct toe-out in dynamic alignment established by the prosthetist. A standard VFJ footplate is predrilled for a 10mm, or adult-sized foot bolt. Thus any prosthetic foot that uses 8mm bolts or smaller, as is common for a pediatric foot, leaves space for that bolt to move around in the transfer plate (Figures 1-2). Figure 1 shows the two sizes of holes in which a bolt can fit loose enough to change the completed foot position or degree of toe-out. This kind of play can impact the finished device enough to require it to be realigned or remade. For patients who use pediatric feet, our technicians frequently have to transfer alignment using 8mm bolts or smaller in a footplate predrilled for larger bolt sizes (Figure 3). We needed a solution to enable smaller bolts to fit snugly into the larger holes (Figures 4-5) and help to ensure an accurate transfer. I found that a small pediatric metric Symes Nut turned upside down and threaded over the 8mm bolt from underneath the VFJ plate assures the bolt will fit snugly in the larger hole with no play (Figure 6). In some cases, I have had to drill out the threads of the Symes Nut to enable it to work for both metric and standard American engineer (SAE) threads. Overall, this has proven to be a simple fix using what was easily available. Cabinet Top Saver Another situation I encountered in the lab caused me to draw on my naval career both in terms of using available resources and presenting a neat, orderly appearance, ready for inspection. I noticed a large number of scuffs on some of our cabinet tops from the many times someone had set a cast saw on the counter before the blade had stopped vibrating. The scratched cabinets had become a bit of an eye sore, and because we give scheduled tours through our labs, we always want them to look their best. I believe we should take pride in our workplace, and its condition is a reflection of our professionalism. However, being hurried and pressured means that we don't always wait patiently for a piece of equipment like a cast saw to slow down and stop before we move on to the next task. The unfortunate result is that what seems to save time and make things easier at the moment can actually create problems, such as damage to the counters. Using scrap material from our lab, I devised a simple solution that has left our cabinets with a shine we can be proud of. A "countertop saver" is a portable plastic stand that makes it easy for someone in a hurry to lay a cast saw down while it is still vibrating without damaging the surface. It also provides the added bonus of helping to save wear and tear on the teeth of expensive cast saw blades since they are not impacting the hard counter surface. I made my first stand out of some scrap polypropylene sheets. First, I cut a strip of polypropylene, 30cm long by 15cm wide. Then I heated the plastic in the oven and draped it over the counter, letting about a quarter of the sheet hang over the edge, to create a 90-degree angle. After the plastic cooled, I centered and cut a half-moon shape out of the shorter end to fit the neck of the cast saw. This half-moon is about 2.5cm deep by 4cm wide. The result is a portable stand that supports the saw blade (Figure 7). The stand is easy to make with a few minutes of spare time, and with several of these strategically located, your countertops should stay scratch-free-or at least free from cast saw scratches. While our training in O&P technical programs and instruction from mentors in the field is invaluable, don't overlook the experiences you may bring with you from other industries. Robert Reeves, CTPO, works in the fabrication lab at Texas Scottish Rite Hospital for Children, Dallas. He can be reached at robert.reeves@tsrh.org

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