[AMP-L] Pin vs. Suctionj Suspension dilema

[Jeff Zeller]

Good Evening,

 

I would like to add my two cents to this discussion.

 

I lost my right leg below the knee 28 years ago at age 17. I started out in
a hard exoskeletal prosthesis with sach foot and wool socks in a hard socket
with a Velcro and leather cuff strap for suspension. It worked well at the
time. But I didn't know anything different. Then I was introduced to the
same design but had a Kemblo rubberized insert between my limb and the hard
socket. Better. Then I was introduced to impregnated gel socks instead of
wool socks, more cushy even better. Then I had someone make me a pin liner
socket with the old 3mm pink and white silicone pin liner. It sucked,
literally on the end of my residual limb  I had a hickey!  It caused a lot
of distal discomfort. But then the TEC and ALPHA elastomer liners came out.
I had a socket made with a 9mm gel cushion liner without a pin and used an
ALPS SFR suspension sleeve. I was in heaven!!! 

 

This combination did several things for me. I had some bone/skin grafting
done to my limb in order to retain a reasonable limb length. 28 years later
the bone has developed asteroid like boney prominences all over the place
where the grafting was done. The gel acts like a shock absorber between
these boney areas and the hard socket wall. Is it perfect? No, you sweat,
the sleeve suspension limits knee flexion. But using the Cushion type liner
for socket skin protection rather than for suspension like with the pin it
now puts all the weight of the prosthesis up on the thigh rather than down
on the residual limb. 

 

The most recent addition to my suspension is the Limb Logic VS computerized
elevated vacuum system. This is a beauty of a unit that sits in-line under
the socket and combined with a suspension sleeve will put 20 lbs. of added
suction by the vacuum sucking the air out of the socket. It allows for zero
pistoning, alleviates most of the sweating in the liner and spreads out the
pressure of support up on the thigh as well as over the whole residual limb,
not just the bottom like the pin. The weak spot is the sleeve. You get a
hole in it and it makes the pump run too much and it errors out. But when it
is working properly it is pretty amazing.

 

My point is that every patient I see each day may require something
different. What works best for me may not work best for someone else. Many
of the manufacturers of prosthetic components allow at least a 30 day trial
period. If you are not comfortable in your socket and how it stays attached
to you, you need to try something different. There are some pin components
out now that allow you to interchange the component at the bottom of the
socket to be Pin, Suction, or Lanyard (an attachment that has a string that
you screw into the bottom of a liner and pull yourself into the socket
rather that having to push a pin into the hole) There is so much more
information out there than when I lost my leg. EVERY AMPUTEE needs to be
their own advocate. If you can go into your doctors and prosthetists offices
armed with information and knowledge the better care and outcomes you will
have.

 

Just My Opinion

 

Jeff A. Zeller, CP

Spectrum Prosthetics & Orthotics

Redding , CA

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