When to make a change???

[madleggs]

Hi all I hope to get some other opinions out there about how to handle this situation.

I am a fairly new BKA(may 09), I have had my leg for about 6 weeks with fairly good results(my opinions anyways).

I was given the Seattle catalyst foot for the first 5 weeks and it worked fine but I was not really 100% happy with how rigid it was and with the lack of multi axial movement, so after several weeks of trying to convince my prosthetist that I would like to try a different foot she agreed to try the prefect stride by bio quest.

I have only had the foot a week and from day one the alignment has not been right! With my first foot I was already wearing the leg 8-10 hours a day and never had any sores/blister or any problems other than the stiffness of the foot it self. My lady has had a negative attitude about this new foot from the time she put it on, after only having the foot for 5 days I have a blister on the front of my shin wear I imagine it is rubbing inside my socket, and now the leg is just sitting there cause I dont want to make things worse!

She has already stated that she don't know if there is anything else she can do and I should just stick with the first foot. Even though I have only had the new foot for such a short time I can tell already that I like the feel and comfort of this foot over the first. I am torn between what to do. She is the expert and I am not, but at the same time I know that I would be more inclined to try different things with a foot that I believe in over one that I don't!

When I look at the leg it appears that it is not in perfect alignment and the foot is way out front of the pylon, in my limited experience wouldn't that be something she could adjust?

It boils down too how do you know it is time to look for a different prosthetist? I don't just want to run at the first sign of trouble, but I don't want to have any negativity about this stuff either.

[stinker373]

Definately get another opinion. Ask lots of questions about feet and the cost.

[allenuk]

Jason

Foot position is important, and can cause big problems if the alignment is way out, but at your early stage it could be other things doing your stump in - the stump itself changes very rapidly in the first months, so that could be the cause; often you need 2 or more sockets in the first year to keep up with the stump changes.

If it IS the foot: the foot should be fairly straight in relation to your knee, so that as you walk the knee is over the foot - and this might be quite different from your 'good' leg.

Most feet are very easy to adjust in terms of the angle at which they point, but if you are tempted to do it yourself, mark it first, so you can go back to the same point. Also, while (for example) my foot can point left/right by a few degrees and give me no problems at all, I know of one person where their foot alignment took AGES to get right, so only get the allen keys out as a very last resort.

Ted, who is a CPO, will no doubt see this thread in the next few days and give a more professional response.

Also, any chance of posting a photo of leg/foot, either from above (i.e. you looking straight down), or from the front (self-timer?)

Allen.

[tedatrowercpo]

The alignment of a prosthetic foot is pretty clearly described and documented in the literature. Regardless of the foot being used the optimal position over the foot from front to back tends to be pretty close to the following.

Divide the width of the socket in half from front to back at the level of the patellar tendon. From that midpoint drop a plum line to the foot. Divide the length of the foot from toe to heel into thirds, front third back third and middle third. Plumb line from the socket should fall very near to the junction of the back third and the middle third of the length of the foot.

Stated otherwise, roughly 2/3rds of the foot should be in front of the center of the socket and 1/3 behind.

All this is measured with the shoe on the foot and the prosthesis standing upon a level surface.