Getting a Good Grasp on Trans Femoral

Starting a new level of amputation means more manual binders full of lectures, articles, and things to be memorized.  This is what I was greeted with bright and early Tuesday morning.  I think we got through about the first three sections by lunch on Tuesday, but there are many more powerpoint presentations and weeks to come in transfemoral.  We learned that the alignment for transfemoral is typically the least of the issues you have when making a prosthesis for someone - it is typically in making a great fitting socket.  Because you are essentially putting in all of the components of the leg (from the foot and ankle and knee), you do not have to accommodate for as many gait deviations as with a transtibial amputee.  The flip side is that it is much harder to get a transfemoral amputee into a really comfortable fitting socket that they will want to wear all day.  We are creating a socket with a brim on it for them to sit on and that is essentially resting your sitting bones against a hard piece of plastic/laminated carbon fiber for multiple hours a day.  That cannot be nice for anyone.  After a few hours of introduction into transfemoral and a basic rundown of the anatomy and different socket styles we will be making for our future patients, we were able to observe a casting of a patient.

 

In order to cast a person with a transfemoral amputation, you have to put them in these jigs that provide a pre-made brim with which to mold your cast around.  You measure your patient and then find a brim that has been manufactured to that size and have them put their residual limb into the jig.  This allows the patient to already be sitting on the brim while you are casting and to create a better fitting cast because the patient is in the right place and the limb is in the same position it will be when they are wearing their prosthesis.  It is fairly hard to imagine what this feels like and how potentially uncomfortable it may be, but this is school...so we spent the rest of the afternoon putting our own legs in the jigs so we would not have to just imagine it.  You have to get the brim right up under your ischium (the infamous bone that we awkwardly were finding on each other a few weeks ago) and really get up close and personal with this casting.  It is definitely shoving a giant metal thing up further on your leg than one would prefer.  I would have been okay with keeping it in my imagination.

So, we spent the afternoon all trying out jigs and Mike was the guinea pig for the class.  Little did he know that he signed up for a chance for everyone in the class to have to go and find his ischium and see that he was sitting with it right on the top of the brim.  He did not look comfortable...and neither did any of the rest of  us who had to go check out his anatomy.  It did make for an entertaining few moments and a lot of really great pictures.  Potential blackmail??

That was pretty much how the first day of transfemoral went.  The first project is going to be putting all of our classmates into these jigs and making quad castings for them before we tighten any sort of metal contraption onto an actual patient.  I think this was a very smart move on our professors, risking each other's body parts first.  

I am taking a break from school and the blogging world for a few days to attend a wedding in Baton Rouge.  I have gotten the okay from my instructors to miss the rest of the week and I am so looking forward to having a few days off and celebrating with my friends.  I know this means I will show up next week and probably be behind and feeling a little frantic, but I think it is well worth it.  Also, I got to skip out on having to wear bathing suit bottoms and being jigged up and casted by a classmate...not so bad planning on my part :)