I am approaching my 1st year anniversary of amputation (6/10). I have been issued a pin and socket prosthetic and ~ 2months ago a vacuum (still trying to decide if it's for me). My question is that it seems my Fibula has skewed and is now rubbing against the skin on the right side of my stump and therefore against the socket causing bruising and a sore. This has happened over the last 2~3 weeks and am wondering if it is normal. I will try to get in to my doctor as quickly as I can but am wondering if this is a consequence of the prosthetic or the surgery? I appeal to the knowledge of the group to give me an idea how serious this may be and if it has happened to you what was done. Thanks.....Terry
Post by stonecutter on May 30, 2016 7:16:14 GMT -7
Hey there... I have a similar issue. In fact, I've had this same issue since they've done away with plaster casting and started using the laser scanning thing and then using a CNC mill to create the socket.
My last hand-made (plaster casted) prosthesis was canst in 2000 and lasted relatively unadjusted until late 2008 and into 2009 with a repair. Then the new sockets were started using the new modern technique and I haven't had a socket that didn't give me a problem on the tib end since.
My guy will grind that area of the socket to give me a little more room, but it'll last a day or so and I'm hitting the socket with every step. It feels like I'm sinking in too far and like I need another sock, but if I add a ply or two I end up choking off because the problem isn't at the top of the socket.
I'd be very interested in hearing if they provide a solution for you...
If you've made it this far, I appreciate you sticking it through my rant.
Trevor Edmonton, Alberta, Canada
Left Below-the-Knee Amputee since June 1994
Revision surgery February 2012
I have an appointment with the technician at Hanger clinic tomorrow and with my Dr. next Monday. When fitted they used plaster but of course everything was fine with my stump. I am wondering if the vacuum socket caused the bone to shift? I will keep you posted with the progress. Thanks....Terry
You know, I've been through three prosthetists over the past 12 years...and each of them at some point tried laser scanning briefly and then went back to plaster casting. I do think there's a difference there. Fortunately, I never went through a scanning for a prosthesis...but I was scanned a couple of times for the orthotic on my remaining foot, and that was a genuine disaster and I ended up having each of those scans replaced by, yes, hand-casting and forming a "traditional" orthotic.
I've also had the chance to wear both a pin-lock socket and a vacuum system. Overall, I truly like the vacuum suspension, but I have learned that it can take more time and effort to get it fitting well. Once all the "tweaking" is done, my vacuum suspension feels really close to having my actual leg back.
John, do you perchance have a "bony" stump? I've noticed that as I've continued to shrink and my stump is showing more defined boniness, my guys have had to work harder and harder to fit my sockets. It's now extremely easy to tell when my prosthesis is "on straight," but it's also much more apparent when I either shrink or swell...those protruding bones can rub--or even bang--against the inside of the socket. It can make for a true "bad leg day."
My particular solution has been a set of "half-length" one-ply stump sox. If I feel any sore spots when I first don my leg, the whole thing comes off and I add one or two plies that cover only the base of my stump. That solves my problem and I can go on with my day.
Sorry for the delay in responding. Turns out the compression ring on my vacuum leg was wonky so they put on a lower pressure ring and I am now getting proper pressure. I think the first ring was working for a while and got clogged with stuff. My first visit to Hanger the clinician cut a void in me=y pin socket to eliminate rubbing. I just got the new ring today and will have to go through fitting and adjustments for a bit. The vacuum leg I have has the pump at the ankle position making my foot fixed. My pin has an articulated ankle making it feel much more natural. There are advantages to both systems along with disadvantages like the ease of care of the pin sleeve. I clean this nightly with Clorox wipes but the vacuum sleeve must be cleaned with a soapy solution. The vacuum leg doesn't sweat as much so that's nice. Users of the vacuum can you recommend an easy cleaning routine? Thanks for your replies and support....Terry
Hi, New here...been an amputee for 25 years. Just went through a new right BKA fitting...and have the finished leg at home with me.
I had an unpleasant previous fitting with a different guy...who I bailed on. Couldn't wear the leg he built and he couldn't/wouldn't fix it.
I am a wanderer and have worked with close to a dozen practitioners. I had one build me a leg that needed 8 ply to keep from bottoming out. Another was arrested and imprisoned for Medicare fraud. My point is that there are lots of bad practitioners out there and if yours isn't getting the job done...switch.
John...no, the pressure area and subsequent skin breakdown is not normal and should be avoided at all cost. Skin breakdown can lead to infection with loss of mobility and ultimately even...losing your stump. You said you're seeing your Doc soon...please do so. Skin irritation is from a poorly fitting prosthesis. I have never had a pressure sore. It can be avoided.
I've never used a vacuum system and all my sockets have been done with plaster. My stump has shrunk down pretty much as small as it will get. Very bony and mine is angled 10 degrees inward...from fracture. Which really complicates fitting.
The most important thing for me is to really pay attention to the cues you get regarding stump socks. Best to have 10 to n15 pounds on distal stump. So as I go through the day and my stump shrinks...as soon as I feel things being a little tight on the bottom...I add 1 ply sock to pull me up in socket. That sort of thing. Your cues may work different then mine...just pay attention to what's happening down there.
With a bony stump like mine...all the detail built into the socket means it is almost impossible to don the prosthesis crooked. Mine just won't engage if not lined up properly. So now...that rotational positioning is an issue...but in 10 years...you all can ignore it.
I'm pretty good doing my own adjustments and stuff. I only go in to practitioner to have a new leg built. I buy my liners on Craigslist because I usually can find them cheaper then paying the Medicare copay. That's all for now, JD