Browsing by Author "Lipe, Del"
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Item Open Access Angulation Osteotomy to Improve Function in Transhumeral Amputee Rehabilitation(2008) Farnsworth, Troy; Lipe, Del; Fergason, John; Granville, Robert; Menetrez, Jennifer; Hillard, AmyRegardless of prosthetic design, there exist inherent limitations which adversely affect the functionality of transhumeral prostheses. Loss of voluntary humeral rotational control, limitations in prosthetic suspension and decreased range of motion limit the user’s acceptance and functional use of a prosthesis. Various techniques have been discussed in the medical literature to compensate for these shortcomings. These include socket design techniques, harness techniques, and surgical techniques. Marquette introduced the concept of humeral angulation osteotomy to resolve these issues. By surgically angling the distal humerus the amputee can be fit with a self-suspending prosthesis that enables voluntary rotational control without restrictions to range of motion. Although this technique is discussed in various prosthetic text books, very few cases have been reported. Case studies will be presented showing surgical, rehabilitation, and prosthetic considerations.Item Open Access CLINICAL EXPERIENCE AND REHABILITATION OF AMPUTEE MILITARY SERVICE MEMBERS AT THE CENTER FOR THE INTREPID AT BROOKE ARMY MEDICAL CENTER (BAMC): PART 1 – OCCUPATIONAL THERAPY REHABILITATION SERVICES(2008) Ebner, Christopher; Farnsworth, Troy; Lipe, Del; Fergason, John; Menetrez, JenniferThis lecture will discuss the clinical experiences and provision of rehabilitation services for amputee military service members at the Center For the Intrepid located at Brooke Army Medical Center (BAMC) Fort Sam Houston, Texas. This is part one of a series illustrating the prosthetic services, rehabilitation and research currently underway at BAMC. Case presentations will be utilized to illustrate the team approach to provide clinically appropriate amputee rehabilitation. This cohesive effort includes surgical considerations, early prosthetic fittings, long-term prosthetic care, rehabilitation services, case management, physiological and social support services. Protocols for advanced prosthetic training will be presented with emphasis on various prosthetic componentry. Advancements in the rehabilitation of the military amputee at the Center For the Intrepid will be discussed in detail to include functional capacity evaluations, drivers training, and firearms training simulator. A case study that involves an individual who sustained a dominant upper extremity transhumeral amputation with total loss of vision will also be discussed. In addition, current and future clinical research studies that involve individuals who have sustained upper extremity loss and who are undergoing rehabilitation at the Center For the Intrepid will be highlighted.Item Open Access Clinical Experience of Fitting Amputee Soldiers at the Center for the Intrepid at Brooke Army Medical Center (BAMC): Part 2 – Prosthetic Services(2008) Farnsworth, Troy; Lipe, Del; Ebner, Christopher; Fergason, John; Menetrez, JenniferThis lecture will discuss the experiences at the Center for Intrepid located at Brooke Army Medical Center (BAMC) providing rehabilitation of amputee soldiers. This is part two of a series illustrating the prosthetic services, rehabilitation and research currently underway at BAMC. Case presentations will be utilized to illustrate the team approach to provide clinically appropriate amputee rehabilitation. This cohesive effort includes surgical considerations, early prosthetic fittings, long-term prosthetic care, rehabilitation services, case management, physiological and social support services. Prosthetic considerations will be presented, including combining the use of technology and basic prosthetic principles. Special attention will focus on unique requirements of traumatic amputations resulting from blast, gunshot, burn injuries, and high demands of the young active users. All advanced systems have been fit at various levels of amputation including fittings with patients who have undergone targeted muscle reinnervation surgery. In addition to being one of the three primary prosthetic amputee care centers, BAMC serves as the primary burn center for the Army worldwide.Item Open Access Enhanced Functional Outcomes with Elective UE Amputations(2008) Farnsworth, Troy; Lipe, Del; Petersen, Branden; Mandacina, Steve; Ebner, ChristopherWith modern limb salvage procedures, successful reconstruction is not always achieved. This lecture will utilize case presentations to show increased functional benefit in patients who underwent elective amputation surgeries. Neurological damage, severe burn, and brachial plexus injuries are common occurrences that lead to a nonfunctional problematic reconstructed limb. Typically considered failures by the surgical team, potential prosthetic users need to be made aware of the positive benefits of elective surgeries. Preliminary outcomes measures will be presented including South Hampton Hand Test and Functional Capacity Evaluations.