[AMP-L] FREEDOM INNOVATIONS EVOLUTION LINER WITH PIN

[jeffspectrum at sbcglobal.net]

Good evening,

I have a patient who is a left below knee amputee. She is diabetic type 2., has 2 1/2" of redundant tissue distal to end of tibia. She has been a previous wearer of Alpha 6mm Uniform Locking Liner. Previous socket was made with 4" of distraction during casting by another practitioner. This caused reduced circulation, and purple contusions on distal end of limb. It did eliminate some of her pistoning action, made limb numb by the end of the day.

I suggested we go with something a little stiffer distally to not allow the elongation of tissue. I went with a custom made Freedom Innovations Silicone Evolution Liner with Locking Pin. I distracted 1/2" in 2nd check socket, no pistoning, no numbness, extra silicone over anterior distal tibia, and patella tendon bar. Walked in Check for one week. She LOVED IT! I fabricated definitive socket, she walked another week, worked great! She called today and had been standing for 10 hours today, it never really hurt.
But got home and took it off along with a thin layer of her skin on distal end and posterior of residual limb. Also rashy bumps up at proximal edge of liner on thigh. Some bloody fluid also in liner. I am not sure what made the difference? The Standing? 

I talked to her about hygiene and cleaning. She is going to stay off of it for a day or two, then we might try some A & D ointment.
Anyone else have these issues? I like the idea of how they can customize the thickness of the silicone, I personally have had one made for myself and have been very happy with the comfort level. I just remember how the Iceross Silicone used to eat some peoples skin up. I hope this silicone is more skin friendly. 

Please give me your ideas out there, I want the best outcome and comfort for this lady!

Sincerely,
Jeff A. Zeller, CP
Spectrum 
Prosthetics & Orthotics Inc.
Redding, CA 96001
530.243.4500
530.243.4554fax
jeffspectrum at sbcglobal.net
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