Prosthetic

Hi,

If your daughter is getting bruises like that then you should think about going to a different protheticist or perhaps an orthoticist.

We had similar issues with our first prosthesis and looking at your picture - it looks very similar to the one we first had. We also had giant nasty bruises and usually within an hour or so of wearing it. The problem was the design and the prostheticist.

I wrote about our first few prosthesis at http://www.pffd.org/node/160. The main thing was that the prostheticist had lots of experience with removing weight from the bones and putting that on the skin. He cast the leg all the way up to the hip and the prosthesis was a snug fit all the way up like he was working with an amputee.

Whew - what bad memories that brings back.

We ended up switching providers (Noel Chladek) and its been wonderful. Instead of a device designed to bear weight on the skin, it puts the weight on the bones. We've been told its called a "prosthosis" a combination of prothesis and orthosis.

One big difference is that the old prostheticist would say "Some bruising is normal." Noel says "There should be no redness still there after a few minutes with the lift off." When we go in for a fitting after a while of our daughter running around, kicking balls, climbing stairs, etc. Noel will look for red marks and then grind, pad, re-adjust the prosthosis accordingly. We have no bruising or skin changes at all until she starts to outgrow the prosthosis (Usually in 3-4 months).

From looking at the picture you sent some differences I see are
1) We don't have the prosthosis go to the hip. It stops at just below the knee. For a while we also had a neoprene hip support, but it was determined that it didn't do much for her so we don't use it any more

2) We use nylon ankles, not metal. The design is similar to an AFO (Ankle-Foot-Orthosis) with a skate at the bottom. You don't have to go to a prostheticist for it, an orthoticist can do it.

3) We don't use the "Pedio-foot" or whatever it is called. We use a "skate" which is much ligher weight and fits in shoes just as easily. I recall the first protheticist insisting that it was needed, and as new to the world of prosthetics, we just accepted it. In retrospect - it was not needed. It was heavy. It added a lot to the bill. When we went to a physiarist the doctor confirmed that the skate would have been fine.

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Pants fitting over the real foot: We just have the pants come down to the ankle and leave it there. On many toddler pants it is easy to get them to go all the way down since many are designed for fussy todlers, but our daughter prefers to keep the pants stopping at above the ankle. I think it is because it helps with climbing to have the extra foot (e.g. the "rock walls" that some playgounds have), but it also makes it easier to get in and out of shopping cart seats. In winter we velcro a "boot mitten" over the foot. Its similar to the ones that snowboarders put over their snow boots for extra warmth.

We have no rotation in the ankle. When she runs she inverts a bit to swing the foot through faster, but standing is normal. One thing I should mention is that our daughter's pffd leg is unaffected from the knee on down so it is well formed to support the weight on the foot, ankle, tibia, etc.

Cheers,
rar

Thank you Beth , it is helpful