Elevated Vacuum Suspension

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Presentation transcript:

Elevated Vacuum Suspension Comprehensive insight into prosthetic suspension and volume management

What is elevated vacuum Past/present of suspension systems Total contact vs PTB Knee sleeve Why not just pin suspension? Fitting basics of elevated vacuum Swing/stance…………positive/negative

Potential issues with pin suspension History of Pin Swing/stance Volumetric issues Pistoning Shear force vs liner matrix Benefits

Suction vs. Elevated Vacuum Benefits of elevated vacuum in comparison Mm/Hg differences How can I tell which is which?

Indications for Elevated Vacuum Functional level UE mobility/dexterity Compliance

Contraindications Unmanaged medical status Poor compliance Dialysis patients

Elevated Vacuum Pumps Mechanical Electronic User activated Weight activated

Interfaces Polyurethane lines (PUR) Silicone lines Thermoplastic Elastomer liners (TPE) Skin fit

Cold Flow Thermodynamics of PUR Stress ball Total contact Vascular benefits

Which pump is best? Dynamic pumps have been shown clinically to provide superior outcomes.

Casting and Modifying Vacuum Casting ROM considerations Total contact modifications What about bony prominences? Distal reduction

Fitting/alignment protocols Initial contact/heel compression Vertical compression at stance Are the hips level? Torsion What to look for…

Volume Management Vacuum/Suction Pin Suspension Socks = not padding Volumetric changes Minimalist approach to volume management Baby hats TEC Spots Pin Suspension Fitting socks Shrinker Volume changes during activity The Matrix factor

ALL LIMBS ARE NOT CREATED EQUAL Custom liners SPOTS

Sounds perfect but……….. Characteristics which can cause problems Lack of total contact (hyperplasia) How to check for total contact distal Pump maintenance

When to call the prosthetist? Things that are alignment/mechanical related that are causing deviations Common issues lack of suction Socket discomfort

Mechanical System Comparison Knee sleeve vs no sleeve Harmony vs Unity system

Future of vacuum High friction interfaces Weight considerations 3D printing? Why plaster is superior to CAD/CAM Pressure sensitive interfaces?

Questions ?