Browsing by Author "Menetrez, Jennifer"

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Open Access
Angulation Osteotomy to Improve Function in Transhumeral Amputee Rehabilitation
(2008) Farnsworth, Troy; Lipe, Del; Fergason, John; Granville, Robert; Menetrez, Jennifer; Hillard, Amy
Regardless 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.
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, Jennifer
This 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.
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, Jennifer
This 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.
Open Access
Trial Fitting Protocols to Optimize Rehabilitation for Transhumeral Amputee Soldiers
(2008) Farnsworth, Troy; Lipe, D; Fergason, John; Menetrez, Jennifer; Ebner, Christopher
This lecture will discuss the experience at Brook Army Medical Center (BAMC) utilizing trial fitting protocols to optimize rehabilitation of upper limb amputee soldiers. Case presentations will illustrate and focus on the rehabilitation of transhumeral amputee soldiers using trial fitting protocols. Trial fittings were performed to evaluate the clinical appropriateness of fitting electric-powered elbow systems in comparison to cable-operated elbow systems in hybrid designs. Trial fittings were also utilized to optimize socket and harness systems. Through the trial fitting process each amputee was fit and trained with “loaner” systems for a fixed time period. A comprehensive clinical team evaluated the progress of the trials. The amputees were able to use their own experiences gained in the trial fitting process to give valuable input toward definitive prosthetic fittings. This in combination with the experiences gained by the clinical team results in an optimal prosthetic recommendation and design for each patient.