Thursday, January 8, 2009

PTB Prosthesis/Minimize Slight Trendelenburg

The patient was seen in the office today for follow-up on his right patella tendon bearing prosthesis. He is doing very well at this time. He has lost volume on his residuum. He is now wearing 6-ply of sock plus a double lined gel liner. He has also grown. We had to increase the height of his prosthesis by Vi inch. We also dynamically aligned him today. All screws were Lok-Tited and torqued to manufacturer's specifications. He continues to walk with a slight Trendelenburg to the right. He has made some marked advances that were noticed today such that he is able to ambulate without the use of assistive devices. The second thing is that he is able to fully bear weight on his prosthesis by standing on his right leg only. He is also walking very well and has gained some confidence in his prosthesis. He still has to gain more confidence in his ability to bear weight through the prosthesis. I think this is the reason why he continues to have this slight Trendelenburg. I have discussed this with his parents. I will followup with him in 3 months. Between today's followup and the 3-month followup, I have asked him to work on 3 goals. One is to gain full knee extension at heel strike. The second is to minimize the Trendelenburg, and the third is to utilize his upper body in a more natural fashion as he is walking with a stiff upper body at this time. His parents have also requested additional socks and a suction suspension sleeve for him and also a double-lined gel liner from Silipos. I will look into this order and have the father pick it up upon approval.