Casting

[stonecutter]

Question for everyone.   

What method does your professional use to cast?  

Mine uses the Omega Scanner to scan my stump.  This system has replaced the plaster cast method.  

Since moving to this new system, my prosthetic device has never fit properly.   I always bottom out on the tibula end.  So much so that I have a callus there.   I wear holes in my liners in about 8-10 months at the pressure point.  When I go for adjustments, they grind away at that spot in the socket, however the problem returns fairly immediately.  We've tried pads in the back of the socket to decrease movement as a result of grinding out the front, but it makes the prosthesis fit differently. 

The difference in the texture of having socks slide down the fibreglass finished socket and leather or neoprene pad causes the bottom of the stump to twist a bit from front to back, changes the angle of the pin and makes it difficult to land in the pin lock...  

I don't want to seem like I'm on a huge complaint here...   but I feel we'd be getting better fits if we return back to the days of plaster.  It left the interpretation of the socket in the hands of the very talented professional.  As it sits with this scanner system - we have a device that bounces light off your stump, but doesn't necessarily allow for the little hard knobbies, bones and problem areas under the skin - it sees it all as the same thing. 

I wonder if they even have plaster kicking around anymore?   What would they say if I ask to go back to the plaster the next time I need a socket? 

Thoughts?

[ann-]

Hmm... well we still have casting here Trevor, but still seem to encounter similar problems,so not sure of the answer regards getting a good fit.

[cherylm]

I've had nothing but plaster casting...never, ever been scanned for a socket fitting. I WAS once scanned for an orthotic insert in my non-amp shoe, and that was a complete disaster...nearly destroyed my foot and the whole thing had be be re-done after doing a casting off an old-fashioned pressure impression and then further customized by hand. That pretty much soured me on scanning systems!

Now the plaster casting for my new elevated vacuum socket was a rather different experience from what I've had done in the past. They did the casting in three separate stages: first they "mapped out" the structure of my knee and cast just the knee area; next they "captured" just the front of my leg, starting at the bottom of the knee casting and going down to the end of the tibia to get the layout of the bones and tendons; finally they wrapped the entire thing, distal end to knee, and then supported the tissue on the back of the leg in a sling to keep it from shifting. At each of these casting steps, they would put a sort of suction balloon over the leg and pump all the air out while the plaster hardened. The result was an amazingly detailed cast of my leg...and the best-fitting socket I've ever had in my life. It DID take about three times longer than any previous casting, but it sure was worth it!

I don't know if the result of that procedure would work well with a pin-lock system...but it seems to me that it would be worth a try!