Young Patient's Search for Comfort and Mobility Brought Him to SPOT

Dane T. was not willing to succumb to pain and sacrifice his active lifestyle, even though it meant a go-round with his insurance provider to approve his request to change prosthetists.

When Dane, 23, became an amputee in 2002, he knew nothing about prosthetics, but he soon learned that the right socket makes all the difference. Dane found comfort and mobility at Specialized Prosthetic & Orthotic Technologies.

"After my amputation, I remember hearing from others that SPOT was one of the best, but for insurance reasons, I had to get my care from another clinic," he said.

Dane's amputation resulted when a sore on his foot, most likely due to poor circulation, became infected. Dr. Timothy Beals at the University of Utah Hospital performed the amputation, because if the infection moved to the bone, it would be fatal.

Dane also has a birth condition, KTS, which makes one leg grow faster than the other. Since birth, he has had 20 surgeries, including one to get his leg lengthened.

Dr. Beals performed the Ertl Procedure on Dane - a surgical technique that creates a bony bridge between the tibia and fibula and covers it with a protective layer of muscle. This helps amputees put greater pressure on their residual limbs without pain.

According to Dr. Beals, Dane was a good candidate for the Ertl Procedure because of his underlying condition that makes the tissue prone to hypersensitivity.

"Linking the bones through the Ertl Procedure minimized the sources of soft tissue irritation, which we knew would be a problem for Dane," Dr. Beals said.

However, a successful outcome still requires the proper fitting prosthesis since the socket design must be in accord with weight bearing on the end of the prosthesis.

In Dane's case, his first prosthesis wasn't an optimal fitting one, which was a source not only of pain for him, but frustration as well. He wanted to get back to his pre-amputation condition that allowed him to enjoy snowboarding, basketball, working out and playing varsity golf for his high school team.

"I'm not into lying down on the bed and relaxing, but my first prosthesis didn't allow me to do what I needed to do," he said. "It also damaged my leg further. I was having growth issues. I was out of alignment and I was in so much pain. I could barely walk, or when I did walk, I could only do it for a very limited time."

After three years, Dane had enough of the care he was receiving, and decided to call Jim Liston, CP, FAAOP, at SPOT to discuss his situation. Eventually, his primary insurance carrier agreed he could receive his treatment from SPOT.

"When Dane first came to see me, he was in a pin system and having problems due to distal distraction occurring at the end of his residual limb," Jim said.

"The fit seemed to be sufficient, although the suspension allowed movement and subsequent irritation," Jim explained further. "There was micro movement with each step, which collectively over time, resulted in macro discomfort. In addition, the KTS coupled with the pin suspension resulted in significant volume fluctuation and inconsistency of fit.

"He was very frustrated," Jim continued. "He did have a poorly aligned prosthesis, but the greater issue was the suspension."

It's not uncommon for the prosthetic limb to piston, chafe, rub, and even ulcerate the skin. And, Dane experienced a problem that many amputees have when the prosthesis doesn't fit right - mobility is limited to only a few steps at a time before the pain becomes unbearable.

After Jim evaluated Dane's condition and discussed Dane's needs and goals, Jim recommended the Harmony® System with VASS - Vacuum Assisted Socket System.

The Harmony System addresses the issue of volume changes causing the residual limb to be a different size and shape and therefore affecting the fit of the prosthesis. It reduces variations in limb volume through a total surface weight-bearing socket; a mechanical pump that draws air out of the system during normal walking; a sealing sleeve that makes an air-tight seal with the user's liner and body; an adjustable shock absorber; and a torsion adapter to increase walking comfort and relieve the strain on joints and the spine.

The components work together to create an elevated vacuum environment. The result for the user is that the liner is drawn completely into the socket for a more intimate fit, allowing fluids to be more easily drawn back into the leg during each swing phase. This increases healthy fluid flow and maintains consistent limb volume to reduce forces on the limb.

"The vacuum promotes consistency in fit through residual limb volume stabilization and enhanced suspension," said Jim. "Lack of residual limb movement within the socket brings consistency to the socket fit all day long. With vacuum, Dane for the first time could sit through a movie without removing his prosthesis. And, the fit felt the same from morning to night."

Dr. Beals agrees the Harmony was the best choice for Dane.

"I would say that the Harmony System appears to minimize the stimulus to the soft tissues of the limb, and that is of particular advantage to amputees who have an underlying condition that makes the tissue prone to hypersensitivity, which describes Dane's situation. It is the same logic we used in terms of doing an Ertl Procedure on Dane."

The new comfortable fitting socket has made a world of difference to Dane.

"Jim did a trial period with the socket to make sure it was right for me. He didn't settle; he did everything to make sure I had a comfortable fit," Dane said.

"I was skeptical about the Harmony System at first, but now I wear it all day long. I didn't realize you could have it so much better. With Harmony, I can pivot, twist, turn, drive in and jump and not suffer pain. I play basketball and golf, and work out two to three times per week."

Dane is a student at Salt Lake Community College who aims for a career as a nurse anesthetist - a choice influenced by the care he received from male nurses as he recovered from many surgeries resulting from the KTS.

"I was inspired by male nurses and the care they gave me, plus I think there is a need for male nurses," Dane said.

In addition to his studies, Dane works as a therapy aid in the hand clinic at the University of Utah Orthopaedic Center, assisting with rehabilitation services to those who have suffered hand injuries.

Newly married, Dane lives in Taylorsville with his wife, Marion, an elementary school teacher.

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