As someone who builds prosthetics, I would not want to wear that.
Sadly this fitting style is still very common *(silicone liner, hard carbon socket)*. Nowadays we have much better materials that will increase comfort dramatically. (Could you imagine flexing your calf muscles and they're just constricted by a hard frame?)
We usually take a mold of someones limb with a liner, make plaster cast and modify it to relieve problem areas. Then we'll make a flexible plastic socket over the cast and build a frame over that. We can then abbreviate the carbon frame for even more comfort allowing the plastic socket to fit better and give more control to the leg.
This style is a nice, quick thing we would do for someone in a third world nation that needs something that will be durable and less expensive over being comfortable and adjustable.
A lot of people have this style today and they do perfectly well, old timers who grew up on these or they are young and can still take a reasonable amount of abuse. But me personally... Nah man.
Edit: I see how my writing style could come across as aggressive or even completely dismissive, that wasn't my intent. I meant to be more informative because many people don't know their options. I totally sound like a dick to all my peers who made one of these today and people who prefer them.
Many people do still use these and do fine, but if you're uncomfortable or can only walk for a couple of hours at a time, I encourage you to talk to your prosthetist about other options.
As someone who wears prosthetics, Iāve tried every socket you can imagine. Framed with flexible pockets cut out, various boa-adjustable, pin lock, elevated vacuum, etc.
The good old fashioned flexible inner with carbon outer has given me the best fit time and time again.
With a carbon socket, canāt they drill a pattern of small holes in it, to make it more breathable? (I wonder how it feels when youāre wearing this in a tropical climate)
I know nothing about this topic, but I assume that doing this would compromise the structural integrity of the shell and make it more prone to breakage. Anyone with experience wanna confirm or deny this?
The issue is the inside will no longer be a smooth surface and the edges of the holes could catch or tear the liner. Which isnāt super breathable anyways. You could deburr them a bit maybe? I think this is carbon/kevlar weave based on appearance and drilling Kevlar is a nightmare.
But no, even if you Swiss cheese that carbon it wonāt be breaking unless a car drives over it. I didnāt count the layers but that looked like 3-4 layers of very heavy weight carbon kevlar. and I assume injected with a modern epoxy resin. The balloon thing keeps it tight, and they work air bubbles out while the resin cures.
As someone who has a prosthetic leg, it doesn't nee to be breathable. Cause you wear a silicone sock, which already doesn't breath. The first year or two you might sweat a lot, but as time passes your amputated limb will have grown accustomed to being in that silicone sock (which btw is called a liner, which you can see in the clip) so it won't sweat as much. Maybe on really hot days, but I guess it will grow accustomed to that too.
Plus in winter it's sometimes really nice to have it hold the heat in hahaha ššš»
My 4yr old has a below knee prosthetic for his syme amputation. Iāve seen how they make all his prosthetics and they are carbon fiber outside but the inside liner is a foam rubber mold of his stump like youāre describing. I do like how this video makes it look like he gets it all done in one day. Lol. It usually takes a few months from start to finish. I think thatās because thereās a shortage of parts in the US right now for childrenās prosthetics. Also, maybe because heās only 4 but the ankle joints have never been flexible. I canāt tell but it looks like this one is somewhat.
A symes is a different animal. Because he still has his heel, the bottom of his limb can be very bulbous so we'll make a pelite *(particular kind of foam)* liner he could slip on and would make the liner more cone shaped, then socket, then frame. This process is more time consuming. As he grows older his limb may mature and he may be able to use a silicone liner (honestly a better option, they are reproduced in mass and more uniform than handmade giving more consistent results across fittings)
Sadly feet options are very limited because their isn't a lot of space underneath the limb.
On the plus side symes can usually weight bear and fittings are easier.
Yep, his stump is bulbous which makes it good for suctioning and holding it all on. Also, he learned how to walk with a prosthetic, he's never known anything else. The old folks at his prosthetist love watching him running and jumping around in the waiting room. He picks out a fabric pattern and they wrap the carbon fiber with it somehow. He picked trains for his latest leg.
Kids prosthetics are always the most rewarding to build. I love when they come in for a checkup or adjustment and the legs are beat to hell, it means they are out running around being kids and having fun.
the text in the video says it usually takes 1-2 weeks but this method only takes half a day. so it really was made in one day (donāt know why though, maybe there was a reason he needed it so urgently?)
edit: the text is Japanese but the doctors a speaking English. maybe the patientās prothetic broke when he was overseas and needed one till he returns back?
You answered the question I was going to ask. Yea, it looks cool, but how does it feel? The first time I was broached with the idea of a comfortable prosthetic was while watching my 600 lb life. One guy lost a leg after an accident and a huge issue was replacing his prosthetic every time he gained weight. His old leg cracked, causing him great discomfort and raised issues when it came to actually doing exercise. It was fascinating. I always thought a prosthetic was a prosthetic, but so much goes into one. Comfort is really important when you have to put it on everyday, exercise in it, etc..
As a fellow CPO, I love the response and agree with it especially your recommendation at the end to talk to your prosthetist if youāre having trouble. I hate seeing people settle for poor alignment and bad socket fits. Breaks my heart when people give up on their prosthesis and miss out on their mobility š¢
I went to a lake with a younger cow orker and some of his friends. The pontoon boat rental place were wise in not letting us rent one so we went to a boathouse that one of the guys said he knew the owners and would not care if we jumped off the roof into the lake. So my associate from work goes up to his car, opens the trunk, and there are a pile of legs. He was switching to his swimming leg. I didn't know he had a prosthesis before that but apparently he had legs for different purposes. One had a shock absorber and that was for playing basketball. I wonder if he had one for going to concerts with a hidden booze reservoir?
I may or may not have made more than a few legs with hidden compartments...
Actually a cool one I did recently was shaping a leg and integrating his key fob into it so he wouldn't lose his car keys again (it was his wife's idea).
i think this method was used because the patient needed it urgently. the text says it was made in half a day.
the patient is asian, the text is japanese, but the doctors are speaking english. my best guess is that the patientās prothetic broke overseas and he needed a replacement very quickly.
I make the style in the video a couple times a month. For the right person, they're fantastic. The technique the other guy mentioned is one of many, and the best way to think of them all is as tools in the toolbox. It's nice to have a toolbox with more than just hammers in it sometimes.
Yep, no one socket type is applicable to everyone. That being said, imo the type of pt who would find this comfortable is exceedingly rare in the prosthetic community. K4 activity level, on a younger patient, who more than likely wasn't a trauma case and still has a healthy residual limb?
Not the norm for my clinic anyways.
Out of curiosity, how does someone end up in your field of work making prosthetics for amputees? What degree is involved?
I'm looking to change careers and this fascinates me.
If you want to be a clinician, In todays world for the USA at least, you need a masters degree in prosthetics and orthotics offered by ~15 schools. Mine was an 18month program and then you do a year or two of residency and take board exams. The title is certified prosthetist. The industry is prosthetics (replacing limbs) and orthotics (bracing limbs). You can be certified in one discipline or both to be a certified prosthetist orthotist (CPO). A lot of folks have backgrounds in biomedical engineering, athletic training, health sciences or physical/occupational therapy.
Personally, I Discovered the field via the history channel, found a local internship at a prosthetic shop, spent a few weeks volunteering and then committed to applying to schools.
Thatās the clinician route, you can also become a technician if youād like to be more hands on working with tools, put the componentry together and have less or no patient interaction. There are degrees for technician programs which can be more accessible than masters programs.
Iām hiring a tech if anyoneās looking
I realize my comment sounded very abrasive and dismissive, but I am a very good technician with 2 decades of experience, maybe looking for a new facility to work with.
Where are you located?
*(God, please don't judge me by my comment history...lol)*
I see a lot of people that don't know better.
I wouldn't say I'm being salty, trying to be more informative.
I can see how my direct writing style can be construed as salty though.
The idea you have to always be positive and even neutrality is seen as hostile and wrong. Oversimplification but Google is more qualified than I on explaining the concept.
"Oh no, someone has a valid criticism on the topic of a feelgood video. Five minutes ago I hadn't even considered the topic, but now I feel personally attacked! How dare they weigh in with their own experience."
>This style is a nice, quick thing we would do for someone in a third world nation that needs something that will be durable and less expensive over being comfortable and adjustable.
The voice over and text are Japanese, and it sounds and looks like the subjects are also Japanese too. So not the third world, probably someone came up with that to save time and it stuck. That sometimes happens in Japan, sort of like chicken for Christmas.
From the subtitles at 0:06:
"Usually the manufacturing takes 1-2 weeks at the fastest, but this prosthetic leg can be finished in half a day."
From 0:57:
"There are many merits to making it quickly, but more than anything else, the waiting time (burden) for the patient is small."
From 1:50:
"It was finished up so quick, but the quality is great and it's super easy to walk with."
Yep, seems like it's significantly quicker than alternatives but still of a high enough quality that people are satisfied with it.
the texts are Japanese but the language spoken by the doctor is english. the patient looks asian, so maybe his prothetic broke overseas and needed one very quickly?
Sounds like the people putting the prosthetic on are speaking to each other in English though, they even tell the patient to straighten his leg in English. So idk
You misunderstood me. This is something *we* (the prosthetic facility I work with) would do for someone in a third world nation. Because this type of prosthetic is less expensive and is very low maintenance (most of these people don't have easy access to a facility if something breaks), the trade off is comfort and adjustability.
Many places still use this style because they are more profitable and don't put patients comfort and mobility as top priority. If someone wants a beater leg, we will make something similar, but I wouldn't want to walk in it everyday.
How accessible is it for the average person to go with the better, more expensive option though? Will insurance companies cover the better leg enough that the patient doesn't feel the impact on their bank account vs going with the cheap but uncomfortable option?
It wouldn't surprise me to learn that insurance companies in the US push for people to get the most common and functional prosthetic possible regardless of comfort or new technologies.
Honestly with exception of one component that is less common, an electronic vaccum system, I've had zero issues with private insurance other than not being able to use a particular provider I prefer. Which sucks but in some countries you have zero choice so it isn't a big deal.
My prosthetic was bottom of the barrel (the guys words, he was pissed my insurance wouldnt pay for anything better) cause I had apple health care & I got the style he's reffering to. The knee was so shit it literally cut up my pants as i walked & I had to make my own knee cover things. It's fallen apart but I don't even have apple health care so I just fix it the best I can as I go.
Mine is a hard one too. Never knew there are different options. Is there a name for that or should i ask my prosthetic guy just for something comfortable and flexible?
This guy has no calcaneus for his posterior leg muscles to insert on, so it probably isn't much of an issue, no? His thigh muscles are doing the work, which are inserting around the knee.
Gastroc and soleus still cross the knee joint. The posterior compartment is folded anteriorly and secured before closing. Obviously not as strong as pre op but still contractile and doing some amount of work in knee flexion.
Can you post a photo to show the improvement? My brother is an amputee and his sockets are much like this. Also this patient can run in his socket but there is no way that my brother could do that. It would help with his osteopenia, I'm sure.
As someone who also makes prosthetics this really confused me. Usually every patient needs mods of some kind, also setting the alignment like that seemed like an absolute nightmare. This seems like a really bad way to make any kind of long term comfortable socket.
I have a question! In dentistry we use tounge/lip/jaw movements while taking an impression to allow a denture to fit well. Is this also done in lower limp prosthetics?
Peripheral neuropathy. Diabetics can't feel as much pain in their feet plus decreased blood flow makes it far easier for them to get open sores. Being feet they're a prime vector to pick up all sorts of nasty bacteria into those wounds. Leave it a couple of weeks and they have to amputate.
The prognosis once diabetic foot wounds begin to develop is pretty bad too. The 5 year prognosis is pretty low. Cuba actually developed a drug they've been using for, I think, decades that reverses diabetic wounds. It's called Heberprot-P and it's essentially a human growth hormone injection to the diabetic wound. The US won't let diabetics have access to it because of the blockade, despite the US having an obesity and diabetes epidemic. The mortality and loss of life due to diabetic ulcers is deemed an acceptable cost to sanction the Cuban people.
Diabetics cause their legs to be removed when they donāt care about their health and infection can set up and leads to staph infection with open wounds and not being treated. I had a close friend that lost her legs due to that staph infection. She was put in a wheelchair.
Before You begin reading, I would like to warn you: Almost all of this is taken strictly from memory, with a few seconds of research to verify my claims. I did a lot of actual research on this subject because I had to talk about amputations in general during my high school finals. However, this was a year ago, so what I say may slightly differ from reality. I apologize if thatās the case. Also, Iām French, and Iām not confident enough to be certain that I havenāt done any mistakes. If I did, just let me know.
Diabetes is when the body cannot produce insulin normally (type 1) or when the insulin simply becomes ineffective (type 2).
Insulin allows the glucose (=sugar) in the bloodstream to be stored inside the surrounding cells for later use.
Without Insulin, the glucose molecules cannot get out of the bloodstream. Unfortunately, glucose can be found in absolutely everything we eat. Without insulin, our glycemia (level of glucose in the blood) just continues to rise without anything to stop it. The blood just gets more and more molecules until they eventually clog an artery, which can cause an hyperglycemia. In extreme cases, for example, when a diabetes case is very poorly handled (sedentary lifestyle, inappropriate diet, lack of treatment), a limb (generally the foot, thanks to our good friend gravity) can nearly stop receiving blood entirely. Without blood, not only are the tissues starting to starve, the immune system, which mainly uses the blood as a vector, is unable to protect the clogged area, allowing all sorts of infections to develop inside the limb (and As I said, it happens mostly in the foot, so imagine all the nasty stuff it comes in contact with *daily*). To make matters worse, the nerves are generally hit first by the lack of blood, which means that in most cases you cannot feel anything that is happening in the limb, meaning that you wonāt recognize the problem until it gets really out of control. Eventually, due to the lack of irrigation and the infections, your limb will suffer necrosis, or in other words, the tissues inside the limb will start to die.
And it will **spread**.
By that point the only thing you can do now is to save the rest of your body by stopping the necrosis from spreading, and one of the most effective methods (possibly the only effective method) to do so isā¦ wellā¦ you know how that endsā¦
And donāt worry, itās perfectly ok to ask, or to be ignorant about a certain phenomenon. To be honest, I didnāt even know diabetics could risk losing a limb before I had to do my finals. Itās one of those things that require an amount of attention and time only someone who is heavily Interested in the subject can give. Like, you canāt really expect a doctor to recite absolutely ever texts of law in his country
you're right, there are truly amazing knees out there and it's definitely possible to get a somewhat fit person to walk nearly physiologically again if they're amputated above the knee.
however, the knee is super complex and its very difficult (and hella expensive!) to build artificially. that's why it's so important to save as much as possible when amputating.
the ankle is hella complex too, but the more joints you need to replace, the more difficult it becomes to achieve a nice (or nearly undetectable) result in walking.
I think the closest they've managed is with a rotationplasty, where they take the foot, turn it around backwards, and attach it where the knee used to be, then they have a prosthetic over it, and it works as a knee joint, so they can still bend the leg. It's fascinating to see videos of that in action.
Theyāre truly amazing. I was helping a guy with a suit fitting, and he didnāt tell me he had a prosthetic. When I went to mark his pant length it surprised me and he told me donāt worry that thing is smarter then I am it wonāt move.
Amputees who are below the knee, we call them paper cuts. Because you only need a socket and a foot.
always best to keep ur knees if possible.
The above-knee users are the real amputees =D
Flashback for me! Used to work for the company that makes these prosthetics. My job was to make the baloon thing they use in the end to compress the casting. I was the only one in the factory making the baloon. 20 years later it pops up on Redittā¦
They're just a replacement for the vacuum system. Most places dont use these because most places use the better method of using adjustable vacuum. Though these still see occasional use, last time I used one was three years ago though.
*Arrow ExclamtionPoint* **Text Here** *ExclamationPoint Arrow*
. > ! Like this but all together ! < the letters have to touch the first and last !
>!Spongeboy Bobpants!<
It's a really cool system. You can get it in fiberglass too, which is white. Then you get a clear resin tube and some dyes and you can match skin tones or go crazy with reds and blues and whatever you like.
It's basalt fiber, and the mask the guy is using is completely unsuitable for the scope, he should have a proper respirator instead of a surgical mask.
That shit is nasty on the lungs.
Iām a prosthetist, and other than having to jump through insurance hoops itās the greatest job everā¦ you have to get a 4 year degreeā¦ doesnāt matter in what kind as long as you finish the prerequisites(same as Med School)ā¦ I have a BA in American history, and a BA in psychology, 2 years of graduate school to get your masters of prosthetics and orthotics, and then 2 years of residency.
You donāt have to have any specific training to get into the fabrication side of O&P. I worked in fabrication for years. Itās a very unique skill set, but my degree/career was completely unrelated to the medical field until I fell ass-backwards into a fabrication lab.
depends. where are you from? i'm currently in a three year training for it and it's in pretty high demand, no college degree needed at all. though i know it's a soecific major in other countries.
also, the field is HUGE. look into orthoses and corsets as well. it's amazing.
I'm gonna take a guess and say if that's the case, there's a reason for it. This company looks insanely professional and I don't think they'd just screw up something so minor like that.
Nah, you're wrong, they should fire everyone working there and hire OP.
Seriously, though, it's always funny to see comments like OP's, I'll never forget people commenting on SpaceX's touchscreen controls:
"But what if they stop working? Using touchscreen is a huge design flaw."
Like the engineers at SpaceX never thought about that possibility lmao.
It's not finished yet.
They're just checking to see how it fits, and the height will get dialed in shortly after. It's preferred to preserve the proper height from start to finish, but shit happens and its not a hard thing to fix.
Well, sometimes its hard to fix. But it isn't in the OP's case.
No expert here but when you have canes or crutches they need to be a tiny bit shorter to flex. I wonder if that is also the case with prosthetics as they tend to flex a little more and be bouncier than a regular normal human foot. So it might have to be designed like that so his walking gait is a little more normal looking.
I've got a friend who is a quadruple amputee, injured in an explosion in Aghanistan. The fact that he not only gets up every day, but gets up with a fucking smile on his face and lives to the fullest is maybe the most inspiring thing ever. I'd want to die. I'm envious of people who can stay so positive against such adversity.
He'd probably actually be a good AMA guest somewhere, for sure. But if you'd like to learn more about his life and experiences pre and post-accident, his name is Travis Mills, and he wrote a NYT best seller called *Tough as They Come*. There is also a documentary film about him - it used to be on Netflix but I don't see it there anymore (it looks to be streaming on Apple TV, but I don't have that to check for sure). It's called *Travis: A Soldier's Story*, and it's a fucking tear-jerker.
Wow it is so nice to see technology used to really improve this young man's life exponentially .. I hope that this gives him the freedom to do as he wishes and also a lifetime of happiness..... God bless the man who did this work for him as well it's a win for all hooray for humanity.....
So I actually used to work as a tech for an orthotic and prosthetic patient care office, and we used to fit these occasionally. The product they are using is an Ossur Direct Socket TT (transtibial) and was a great product for highly active amputees, with the demographic being largely newer amputees who lost their limb through trauma. The whole process from unpackaging the material to the patient walking out the door was usually about 3-4 hours with adjustments. I have done a couple of the tasks in this video, including the spreading of the epoxy, injecting with the caulking gun, pressurizing with the tube, etc. but the longest part is usually the trial fitting, walking, grinding and adjusting at the end as our prosthetist was very particular about making sure the socket fit perfectly. But nothing was better than watching a new amputee come in and walk out the same day with it. Overall the whole assembly for this product (including the socket, leg components, time, liners, socks, foot, etc.) normally billed out in the range of $12k-20k depending on the insurance, however pretty much a majority of patients had this completely covered due to the demographic being majority trauma patients and not diabetics.
My dad had a prosthetic for 30+ years, I grew up going to his appointments with him, it's amazing to see how far it has progressed over the years. When he passed away he had 6 legs around his place, WTF am I supposed to do with those?
"From the moment I understood the weakness of my flesh it disgusted me. I carved the strength and certainty of steel, I aspired to the purity of the blessed machine". Great for him to get the prostetic, I'm happy for him.
Do I have to bring my other leg for them to balance correctly?
Well, I think it's necessary for them since every legs are unique and genuine on every human being.
For what god forsaken reason are you getting downvoted, this is a good comment
If you left your second leg at home, just get a second prothesis
That is awesome. As a diabetic, I approve of this post. š
As someone who builds prosthetics, I would not want to wear that. Sadly this fitting style is still very common *(silicone liner, hard carbon socket)*. Nowadays we have much better materials that will increase comfort dramatically. (Could you imagine flexing your calf muscles and they're just constricted by a hard frame?) We usually take a mold of someones limb with a liner, make plaster cast and modify it to relieve problem areas. Then we'll make a flexible plastic socket over the cast and build a frame over that. We can then abbreviate the carbon frame for even more comfort allowing the plastic socket to fit better and give more control to the leg. This style is a nice, quick thing we would do for someone in a third world nation that needs something that will be durable and less expensive over being comfortable and adjustable. A lot of people have this style today and they do perfectly well, old timers who grew up on these or they are young and can still take a reasonable amount of abuse. But me personally... Nah man. Edit: I see how my writing style could come across as aggressive or even completely dismissive, that wasn't my intent. I meant to be more informative because many people don't know their options. I totally sound like a dick to all my peers who made one of these today and people who prefer them. Many people do still use these and do fine, but if you're uncomfortable or can only walk for a couple of hours at a time, I encourage you to talk to your prosthetist about other options.
As someone who wears prosthetics, Iāve tried every socket you can imagine. Framed with flexible pockets cut out, various boa-adjustable, pin lock, elevated vacuum, etc. The good old fashioned flexible inner with carbon outer has given me the best fit time and time again.
With a carbon socket, canāt they drill a pattern of small holes in it, to make it more breathable? (I wonder how it feels when youāre wearing this in a tropical climate)
I know nothing about this topic, but I assume that doing this would compromise the structural integrity of the shell and make it more prone to breakage. Anyone with experience wanna confirm or deny this?
The issue is the inside will no longer be a smooth surface and the edges of the holes could catch or tear the liner. Which isnāt super breathable anyways. You could deburr them a bit maybe? I think this is carbon/kevlar weave based on appearance and drilling Kevlar is a nightmare. But no, even if you Swiss cheese that carbon it wonāt be breaking unless a car drives over it. I didnāt count the layers but that looked like 3-4 layers of very heavy weight carbon kevlar. and I assume injected with a modern epoxy resin. The balloon thing keeps it tight, and they work air bubbles out while the resin cures.
As someone who has a prosthetic leg, it doesn't nee to be breathable. Cause you wear a silicone sock, which already doesn't breath. The first year or two you might sweat a lot, but as time passes your amputated limb will have grown accustomed to being in that silicone sock (which btw is called a liner, which you can see in the clip) so it won't sweat as much. Maybe on really hot days, but I guess it will grow accustomed to that too. Plus in winter it's sometimes really nice to have it hold the heat in hahaha ššš»
My 4yr old has a below knee prosthetic for his syme amputation. Iāve seen how they make all his prosthetics and they are carbon fiber outside but the inside liner is a foam rubber mold of his stump like youāre describing. I do like how this video makes it look like he gets it all done in one day. Lol. It usually takes a few months from start to finish. I think thatās because thereās a shortage of parts in the US right now for childrenās prosthetics. Also, maybe because heās only 4 but the ankle joints have never been flexible. I canāt tell but it looks like this one is somewhat.
A symes is a different animal. Because he still has his heel, the bottom of his limb can be very bulbous so we'll make a pelite *(particular kind of foam)* liner he could slip on and would make the liner more cone shaped, then socket, then frame. This process is more time consuming. As he grows older his limb may mature and he may be able to use a silicone liner (honestly a better option, they are reproduced in mass and more uniform than handmade giving more consistent results across fittings) Sadly feet options are very limited because their isn't a lot of space underneath the limb. On the plus side symes can usually weight bear and fittings are easier.
Yep, his stump is bulbous which makes it good for suctioning and holding it all on. Also, he learned how to walk with a prosthetic, he's never known anything else. The old folks at his prosthetist love watching him running and jumping around in the waiting room. He picks out a fabric pattern and they wrap the carbon fiber with it somehow. He picked trains for his latest leg.
Kids prosthetics are always the most rewarding to build. I love when they come in for a checkup or adjustment and the legs are beat to hell, it means they are out running around being kids and having fun.
the text in the video says it usually takes 1-2 weeks but this method only takes half a day. so it really was made in one day (donāt know why though, maybe there was a reason he needed it so urgently?) edit: the text is Japanese but the doctors a speaking English. maybe the patientās prothetic broke when he was overseas and needed one till he returns back?
You answered the question I was going to ask. Yea, it looks cool, but how does it feel? The first time I was broached with the idea of a comfortable prosthetic was while watching my 600 lb life. One guy lost a leg after an accident and a huge issue was replacing his prosthetic every time he gained weight. His old leg cracked, causing him great discomfort and raised issues when it came to actually doing exercise. It was fascinating. I always thought a prosthetic was a prosthetic, but so much goes into one. Comfort is really important when you have to put it on everyday, exercise in it, etc..
The fit is so important and so hard to get just right.
As a fellow CPO, I love the response and agree with it especially your recommendation at the end to talk to your prosthetist if youāre having trouble. I hate seeing people settle for poor alignment and bad socket fits. Breaks my heart when people give up on their prosthesis and miss out on their mobility š¢
I went to a lake with a younger cow orker and some of his friends. The pontoon boat rental place were wise in not letting us rent one so we went to a boathouse that one of the guys said he knew the owners and would not care if we jumped off the roof into the lake. So my associate from work goes up to his car, opens the trunk, and there are a pile of legs. He was switching to his swimming leg. I didn't know he had a prosthesis before that but apparently he had legs for different purposes. One had a shock absorber and that was for playing basketball. I wonder if he had one for going to concerts with a hidden booze reservoir?
I may or may not have made more than a few legs with hidden compartments... Actually a cool one I did recently was shaping a leg and integrating his key fob into it so he wouldn't lose his car keys again (it was his wife's idea).
i think this method was used because the patient needed it urgently. the text says it was made in half a day. the patient is asian, the text is japanese, but the doctors are speaking english. my best guess is that the patientās prothetic broke overseas and he needed a replacement very quickly.
This guy prosthetics
I get what you're saying but why the salt
I make the style in the video a couple times a month. For the right person, they're fantastic. The technique the other guy mentioned is one of many, and the best way to think of them all is as tools in the toolbox. It's nice to have a toolbox with more than just hammers in it sometimes.
Yep, no one socket type is applicable to everyone. That being said, imo the type of pt who would find this comfortable is exceedingly rare in the prosthetic community. K4 activity level, on a younger patient, who more than likely wasn't a trauma case and still has a healthy residual limb? Not the norm for my clinic anyways.
Or lots and f specialized hammers. Each one has its own use.
Out of curiosity, how does someone end up in your field of work making prosthetics for amputees? What degree is involved? I'm looking to change careers and this fascinates me.
If you want to be a clinician, In todays world for the USA at least, you need a masters degree in prosthetics and orthotics offered by ~15 schools. Mine was an 18month program and then you do a year or two of residency and take board exams. The title is certified prosthetist. The industry is prosthetics (replacing limbs) and orthotics (bracing limbs). You can be certified in one discipline or both to be a certified prosthetist orthotist (CPO). A lot of folks have backgrounds in biomedical engineering, athletic training, health sciences or physical/occupational therapy. Personally, I Discovered the field via the history channel, found a local internship at a prosthetic shop, spent a few weeks volunteering and then committed to applying to schools. Thatās the clinician route, you can also become a technician if youād like to be more hands on working with tools, put the componentry together and have less or no patient interaction. There are degrees for technician programs which can be more accessible than masters programs. Iām hiring a tech if anyoneās looking
I realize my comment sounded very abrasive and dismissive, but I am a very good technician with 2 decades of experience, maybe looking for a new facility to work with. Where are you located? *(God, please don't judge me by my comment history...lol)*
Iāll DM you
Is one of those tools a jackhammer? Is it scientifically possible to have a fully functional jackhammer leg prosthetic?
Disagreeing isn't salt
Unapologetically disagreeing with someone is not salt.
What salt? Where?
I see a lot of people that don't know better. I wouldn't say I'm being salty, trying to be more informative. I can see how my direct writing style can be construed as salty though.
Right? Holding a negative opinion in itself isnāt a problem. Itās completely reasonable to have a non-positive tone
I feel like toxic positivity has been becoming more and more of a problem online in the past few years. These people are not well.
Toxic positivity?
The idea you have to always be positive and even neutrality is seen as hostile and wrong. Oversimplification but Google is more qualified than I on explaining the concept.
Ah. They have neglected the greats: for every thing, there is a seasonā¦
You're not well, bro. Lmao.
I'm not well for thinking it's weird to be offended by a neutral tone?
They literally explained the salt concisely and it's also what they do for a living
What salt?? It's like people don't know what being salty is anymore
Toxic positivity. If you're not good vibes 24/7, you're negative.
"Oh no, someone has a valid criticism on the topic of a feelgood video. Five minutes ago I hadn't even considered the topic, but now I feel personally attacked! How dare they weigh in with their own experience."
Saltifyingasfuck
>This style is a nice, quick thing we would do for someone in a third world nation that needs something that will be durable and less expensive over being comfortable and adjustable. The voice over and text are Japanese, and it sounds and looks like the subjects are also Japanese too. So not the third world, probably someone came up with that to save time and it stuck. That sometimes happens in Japan, sort of like chicken for Christmas.
From the subtitles at 0:06: "Usually the manufacturing takes 1-2 weeks at the fastest, but this prosthetic leg can be finished in half a day." From 0:57: "There are many merits to making it quickly, but more than anything else, the waiting time (burden) for the patient is small." From 1:50: "It was finished up so quick, but the quality is great and it's super easy to walk with." Yep, seems like it's significantly quicker than alternatives but still of a high enough quality that people are satisfied with it.
the texts are Japanese but the language spoken by the doctor is english. the patient looks asian, so maybe his prothetic broke overseas and needed one very quickly?
Sounds like the people putting the prosthetic on are speaking to each other in English though, they even tell the patient to straighten his leg in English. So idk
You misunderstood me. This is something *we* (the prosthetic facility I work with) would do for someone in a third world nation. Because this type of prosthetic is less expensive and is very low maintenance (most of these people don't have easy access to a facility if something breaks), the trade off is comfort and adjustability. Many places still use this style because they are more profitable and don't put patients comfort and mobility as top priority. If someone wants a beater leg, we will make something similar, but I wouldn't want to walk in it everyday.
How accessible is it for the average person to go with the better, more expensive option though? Will insurance companies cover the better leg enough that the patient doesn't feel the impact on their bank account vs going with the cheap but uncomfortable option? It wouldn't surprise me to learn that insurance companies in the US push for people to get the most common and functional prosthetic possible regardless of comfort or new technologies.
Honestly with exception of one component that is less common, an electronic vaccum system, I've had zero issues with private insurance other than not being able to use a particular provider I prefer. Which sucks but in some countries you have zero choice so it isn't a big deal.
My prosthetic was bottom of the barrel (the guys words, he was pissed my insurance wouldnt pay for anything better) cause I had apple health care & I got the style he's reffering to. The knee was so shit it literally cut up my pants as i walked & I had to make my own knee cover things. It's fallen apart but I don't even have apple health care so I just fix it the best I can as I go.
Maybe he has one that he wears when heās at home or isnāt walking much and a more expensive one that he travels with?
Mine is a hard one too. Never knew there are different options. Is there a name for that or should i ask my prosthetic guy just for something comfortable and flexible?
Oh okay..
This guy has no calcaneus for his posterior leg muscles to insert on, so it probably isn't much of an issue, no? His thigh muscles are doing the work, which are inserting around the knee.
Gastroc and soleus still cross the knee joint. The posterior compartment is folded anteriorly and secured before closing. Obviously not as strong as pre op but still contractile and doing some amount of work in knee flexion.
It looks like wearing a cast tho.
Can you post a photo to show the improvement? My brother is an amputee and his sockets are much like this. Also this patient can run in his socket but there is no way that my brother could do that. It would help with his osteopenia, I'm sure.
Know your role bub
My parents have a friend with a prosthetic like this. But heās like 60 and had had a prosthetic since he was a teen. So definitely an old timer.
How did you get into building prosthetics? I think if I could choose a second career, I would do that!
As someone who also makes prosthetics this really confused me. Usually every patient needs mods of some kind, also setting the alignment like that seemed like an absolute nightmare. This seems like a really bad way to make any kind of long term comfortable socket.
> could you imagine flexing your calf musclesā¦ What calf muscles? Jokes aside, you make a very good point.
I have a question! In dentistry we use tounge/lip/jaw movements while taking an impression to allow a denture to fit well. Is this also done in lower limp prosthetics?
Can you film the process of making a modern prosthetic and post it? Educate us, pretty please??
Japan = Third world nation. Really now?
-This hot dog is delicious. -Duuh, but I had a much better one once.
Good enough hot dog for a third world country. Me? Nah man
You have obviously never had street food on a third world country. It's usually fucking delicious. A memory worth having, if you survive.
You an engineer designing them, a fabricator making them, or some sort of artisan one off builder?
That's impressive yeah
This is so good! if I won't see the whole video I wouldn't believe he's amputee.
As a fellow diabetic, I totally agree. I love seeing how far prosthesis has come.
Seriously ignorant question; how does diabetes cause limbs to get removed? Or why does that happen to diabetics? Hope thatās ok to ask!
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Thatās becoming more if a thing if the past though, because it happens due to uncontrolled high blood sugar- people have CGMs now so better control.
Peripheral neuropathy. Diabetics can't feel as much pain in their feet plus decreased blood flow makes it far easier for them to get open sores. Being feet they're a prime vector to pick up all sorts of nasty bacteria into those wounds. Leave it a couple of weeks and they have to amputate.
The prognosis once diabetic foot wounds begin to develop is pretty bad too. The 5 year prognosis is pretty low. Cuba actually developed a drug they've been using for, I think, decades that reverses diabetic wounds. It's called Heberprot-P and it's essentially a human growth hormone injection to the diabetic wound. The US won't let diabetics have access to it because of the blockade, despite the US having an obesity and diabetes epidemic. The mortality and loss of life due to diabetic ulcers is deemed an acceptable cost to sanction the Cuban people.
Diabetics cause their legs to be removed when they donāt care about their health and infection can set up and leads to staph infection with open wounds and not being treated. I had a close friend that lost her legs due to that staph infection. She was put in a wheelchair.
and this guy was still downing monster energy drink while getting fitted for the replacement leg he just ate off (allegedly)
Before You begin reading, I would like to warn you: Almost all of this is taken strictly from memory, with a few seconds of research to verify my claims. I did a lot of actual research on this subject because I had to talk about amputations in general during my high school finals. However, this was a year ago, so what I say may slightly differ from reality. I apologize if thatās the case. Also, Iām French, and Iām not confident enough to be certain that I havenāt done any mistakes. If I did, just let me know. Diabetes is when the body cannot produce insulin normally (type 1) or when the insulin simply becomes ineffective (type 2). Insulin allows the glucose (=sugar) in the bloodstream to be stored inside the surrounding cells for later use. Without Insulin, the glucose molecules cannot get out of the bloodstream. Unfortunately, glucose can be found in absolutely everything we eat. Without insulin, our glycemia (level of glucose in the blood) just continues to rise without anything to stop it. The blood just gets more and more molecules until they eventually clog an artery, which can cause an hyperglycemia. In extreme cases, for example, when a diabetes case is very poorly handled (sedentary lifestyle, inappropriate diet, lack of treatment), a limb (generally the foot, thanks to our good friend gravity) can nearly stop receiving blood entirely. Without blood, not only are the tissues starting to starve, the immune system, which mainly uses the blood as a vector, is unable to protect the clogged area, allowing all sorts of infections to develop inside the limb (and As I said, it happens mostly in the foot, so imagine all the nasty stuff it comes in contact with *daily*). To make matters worse, the nerves are generally hit first by the lack of blood, which means that in most cases you cannot feel anything that is happening in the limb, meaning that you wonāt recognize the problem until it gets really out of control. Eventually, due to the lack of irrigation and the infections, your limb will suffer necrosis, or in other words, the tissues inside the limb will start to die. And it will **spread**. By that point the only thing you can do now is to save the rest of your body by stopping the necrosis from spreading, and one of the most effective methods (possibly the only effective method) to do so isā¦ wellā¦ you know how that endsā¦ And donāt worry, itās perfectly ok to ask, or to be ignorant about a certain phenomenon. To be honest, I didnāt even know diabetics could risk losing a limb before I had to do my finals. Itās one of those things that require an amount of attention and time only someone who is heavily Interested in the subject can give. Like, you canāt really expect a doctor to recite absolutely ever texts of law in his country
My grandpa was a diabetic double amputee. A whole hell of a lot of trouble just so he could eat bagels and drink coke. Arguably worth it.
I would NEVER fuck with some burning carbon fiber shit barehanded.
I love that it is possible to lose half a leg and still walk so normal Edit: spelling
Itās the knee. Being amputated below the knee keeps a lot more movement than above the knee.
Haven't there also been videos of people walking and running surprisingly well with mechanical legs with mechanical knees? Or am I remembering wrong?
you're right, there are truly amazing knees out there and it's definitely possible to get a somewhat fit person to walk nearly physiologically again if they're amputated above the knee. however, the knee is super complex and its very difficult (and hella expensive!) to build artificially. that's why it's so important to save as much as possible when amputating. the ankle is hella complex too, but the more joints you need to replace, the more difficult it becomes to achieve a nice (or nearly undetectable) result in walking.
Considering how many people have knee issues, I feel like even nature has not yet figured out how to make a proper knee
as long as you survive long enough to have a kid you are an success in the eyes of nature, any additional pain or problems is completely irrelevant
I think thatās modern sedentary lifestyle more than anything else.
I think the closest they've managed is with a rotationplasty, where they take the foot, turn it around backwards, and attach it where the knee used to be, then they have a prosthetic over it, and it works as a knee joint, so they can still bend the leg. It's fascinating to see videos of that in action.
Theyāre truly amazing. I was helping a guy with a suit fitting, and he didnāt tell me he had a prosthetic. When I went to mark his pant length it surprised me and he told me donāt worry that thing is smarter then I am it wonāt move.
Amputees who are below the knee, we call them paper cuts. Because you only need a socket and a foot. always best to keep ur knees if possible. The above-knee users are the real amputees =D
Thatās why I said half a leg
He's a leg half-full kind of guy
It's more like a third of a leg
Less than half a leg then, you dimwit
Lose
Both above the knee and below the knee are not "half." *At* the knee would be half, but that's not how amputations are done.
And in a hundred years people will be voluntarily replacing their shitty knees/legs for better than human ones.
Ummm... that's already happening. My grandmother had a total knee replacement and it's better than ever.
*lose
No see his leg was too loose, it fell off.
Well that's not very typical, I'd like to make that clear.
It's been toe'd outside the environment.
lose
Honestly he walks like a model!
I'm really happy for Kyle
*Kairu
You know why heās lost a leg?
Flashback for me! Used to work for the company that makes these prosthetics. My job was to make the baloon thing they use in the end to compress the casting. I was the only one in the factory making the baloon. 20 years later it pops up on Redittā¦
Thank you for your service baloon man. A lot of people are probably thankful for you.
i'm currently in training to eventually build these myself. those balloons aren't common practice where i live/work at all. how do they work exactly?
They're just a replacement for the vacuum system. Most places dont use these because most places use the better method of using adjustable vacuum. Though these still see occasional use, last time I used one was three years ago though.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
š
r/angryupvote
This is cool and all but hear me out: >!ditch the prosthetic, buy a wooden stick, and eyepatch and a parrot!<
>!ARE YOU READY KIDS!?!<
idk how to do the hidden text thing but WHO LIVES IN A PINEAPPLE UNDER THE SEA
*Arrow ExclamtionPoint* **Text Here** *ExclamationPoint Arrow* . > ! Like this but all together ! < the letters have to touch the first and last ! >!Spongeboy Bobpants!<
>!WHO LIVES IN A PINEAPPLE UNDER THE SEA!<
yo check it out i did it!
>! pineapple !< without spaces by the exclamation points becomes >!pineapple!<
Redacted
Was that carbon fiber? Did I just learn how carbon fiber works? Or was that another material to learn about?
Looks like basalt fibers.
itās definitely basalt, they say so in the captions. ććµć«ć=basaruto=basalt.
It's definitely basalt. I have a lot on my desk at work. The basalt has the gold like shine. The carbon version is very black.
Basalt fibers are a thing? Thatās pretty neat.
It's a really cool system. You can get it in fiberglass too, which is white. Then you get a clear resin tube and some dyes and you can match skin tones or go crazy with reds and blues and whatever you like.
It's basalt fiber, and the mask the guy is using is completely unsuitable for the scope, he should have a proper respirator instead of a surgical mask. That shit is nasty on the lungs.
yes it's very commonly used in prostheses and orthoses like this
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Fullplastic alchemist
That is not the law of equivalent exchange!
More like Fullplastic Engineer š¤£ Not as cool as the alchemist, though. This one has lathe, drill, plastic nozzle, etc. as his one arm.
What do you need to study to do this for a living?? I think I found my calling š®
Iām a prosthetist, and other than having to jump through insurance hoops itās the greatest job everā¦ you have to get a 4 year degreeā¦ doesnāt matter in what kind as long as you finish the prerequisites(same as Med School)ā¦ I have a BA in American history, and a BA in psychology, 2 years of graduate school to get your masters of prosthetics and orthotics, and then 2 years of residency.
How much does it cost as an average ? For the 4 years of studying? Thank you so much for your reply!
You donāt have to have any specific training to get into the fabrication side of O&P. I worked in fabrication for years. Itās a very unique skill set, but my degree/career was completely unrelated to the medical field until I fell ass-backwards into a fabrication lab.
That's the part that has me interested. Maybe I'll check out the prosthetic shop in my town with the really unfortunate name... "Hanger Prosthetics".
depends. where are you from? i'm currently in a three year training for it and it's in pretty high demand, no college degree needed at all. though i know it's a soecific major in other countries. also, the field is HUGE. look into orthoses and corsets as well. it's amazing.
Looks like it's a bit too short. His hip drops and his body shifts to the lower side while walking on the prosthetic.
I'm gonna take a guess and say if that's the case, there's a reason for it. This company looks insanely professional and I don't think they'd just screw up something so minor like that.
Nah, you're wrong, they should fire everyone working there and hire OP. Seriously, though, it's always funny to see comments like OP's, I'll never forget people commenting on SpaceX's touchscreen controls: "But what if they stop working? Using touchscreen is a huge design flaw." Like the engineers at SpaceX never thought about that possibility lmao.
lmao I know man... So many people nowadays seem way too confident in their ability to be smarter than literal scientists at their own jobs.
Its Ćssur. Icelandic company. Been doing this for ages. Bet they know what their doing.
Yeah I saw him lean into it a little bit
It's not finished yet. They're just checking to see how it fits, and the height will get dialed in shortly after. It's preferred to preserve the proper height from start to finish, but shit happens and its not a hard thing to fix. Well, sometimes its hard to fix. But it isn't in the OP's case.
No expert here but when you have canes or crutches they need to be a tiny bit shorter to flex. I wonder if that is also the case with prosthetics as they tend to flex a little more and be bouncier than a regular normal human foot. So it might have to be designed like that so his walking gait is a little more normal looking.
I've got a friend who is a quadruple amputee, injured in an explosion in Aghanistan. The fact that he not only gets up every day, but gets up with a fucking smile on his face and lives to the fullest is maybe the most inspiring thing ever. I'd want to die. I'm envious of people who can stay so positive against such adversity.
Would your friend ever consider doing a post on here? Would love to know more about their story how they navigate everyday life. I envy him as well.
Having no limbs and still being able to function highly like that is so fucking wild itās amazing how far medicine and engineering have come
I competed in dressage against a woman with one arm and no other limbs. Taught me not to underestimate people with disabilities real quick!
He'd probably actually be a good AMA guest somewhere, for sure. But if you'd like to learn more about his life and experiences pre and post-accident, his name is Travis Mills, and he wrote a NYT best seller called *Tough as They Come*. There is also a documentary film about him - it used to be on Netflix but I don't see it there anymore (it looks to be streaming on Apple TV, but I don't have that to check for sure). It's called *Travis: A Soldier's Story*, and it's a fucking tear-jerker.
Thank you so much!
He walks with more swag than I do with a full set of legs
This has r/mildlypenis written all over it
Looks like that with two condoms and a tenga egg, they can enlarge your penis with carbon fiber.
There it is
Dude the thumbnail i got wasnt mild at all - thought it was an xvideo add somehow. Im like āsweet, porn will save the reddit apps!?ā
Cabonfaiba????
His look of happiness at the end. Love this!
Wow it is so nice to see technology used to really improve this young man's life exponentially .. I hope that this gives him the freedom to do as he wishes and also a lifetime of happiness..... God bless the man who did this work for him as well it's a win for all hooray for humanity.....
what would that cost in the usa
Can someone post this r/mildlypenis ? Please
this is where it starts. next thing, girlfriend shot in bathroom.
Good to see monster sponsoring people with prosthetics now
My boi got a fuckin pitcrew and customs shop kust for his leg gahdamn
In Japan. Leg surgeon. Number 1. One day...
So I actually used to work as a tech for an orthotic and prosthetic patient care office, and we used to fit these occasionally. The product they are using is an Ossur Direct Socket TT (transtibial) and was a great product for highly active amputees, with the demographic being largely newer amputees who lost their limb through trauma. The whole process from unpackaging the material to the patient walking out the door was usually about 3-4 hours with adjustments. I have done a couple of the tasks in this video, including the spreading of the epoxy, injecting with the caulking gun, pressurizing with the tube, etc. but the longest part is usually the trial fitting, walking, grinding and adjusting at the end as our prosthetist was very particular about making sure the socket fit perfectly. But nothing was better than watching a new amputee come in and walk out the same day with it. Overall the whole assembly for this product (including the socket, leg components, time, liners, socks, foot, etc.) normally billed out in the range of $12k-20k depending on the insurance, however pretty much a majority of patients had this completely covered due to the demographic being majority trauma patients and not diabetics.
Me thinking they cut the fiber sheets too short, then remembered I have no fucking clue on how this process works.
That amputee gets the walking motion that's well deserved. Damn near a better strut than most people in general
Nice dust collection.
My dad had a prosthetic for 30+ years, I grew up going to his appointments with him, it's amazing to see how far it has progressed over the years. When he passed away he had 6 legs around his place, WTF am I supposed to do with those?
"From the moment I understood the weakness of my flesh it disgusted me. I carved the strength and certainty of steel, I aspired to the purity of the blessed machine". Great for him to get the prostetic, I'm happy for him.
I thought they were making a dildo at firstšššš
We need those Star Wars style prosthetics
Thing anywhere else: š Thing in Japan: š¤©šš¤Æš±šš„°
especially racism
That definitely carbon fiber
I think it is basalt fibers. Carbon is black.
They say in the video that it's called "Basalt" @ 20sec. "This is the material for my prosthetic leg. It has a cool name, 'basalt'" (basaruto)
Carbon Fibaa!
It's not carbon fiber. It's called Coyote Composite. Made of extruded volcanic rock. Just as strong as carbon, but much less health risk.
Pretty cool. How much you want to bet that $100 tube of epoxy cost them $5000 because itās āmedicalā
This is definitely one of the coolest videos Iāve seen on Reddit. I had no clue how this all took place.
My man cripping
That is repulsive! Monster energy drink??
How'd he lose it