title: Improvement of the soft socket after rotationplasty: a single case study.
abstract: Rotationplasty is established as a functionally improving and partially ablative method of tumour surgery, but good clinical and functional results do not only depend on a successful surgery. Due to the changed biomechanical situation the activity level is limited by the weight bearing capacity of the rotated foot. Painful blisters and callosities may limit the use of the exo-prosthesis, because the skin is overstressed in the soft socket. A 28-year-old patient with a rotationplasty type A2 suffered from painful callosities of the rotated foot. Capacitive pressure measurements were performed as well as a gait analysis for kinematics and kinetic characteristics. Clinically a decrease of the callosities and a pain relieve was obvious and the patient learned skiing without prior knowledge. Biomechanically a decrease of the peak pressure (from 240.6-135.0 kPa) and the mean pressure (from 83.2-66.2 kPa), was observed with an increased weight bearing area. The study has shown that a modification of the heel bench can considerably improve pressure distribution. An increase of the load bearing area appears to enable the skin to compensate even intensive strain during athletic activities.
authors.affiliation: Department of Orthopaedics, University Hospital, University of Muenster, Muenster, Germany. wessling@uni-muenster.de
authors.forename: Martin
authors.initials: M
authors.lastname: Wessling
authors.forename: Mirko
authors.initials: M
authors.lastname: Aach
authors.forename: Jendrik
authors.initials: J
authors.lastname: Hardes
authors.forename: Elmar
authors.initials: E
authors.lastname: Janssen
authors.forename: Dieter
authors.initials: D
authors.lastname: Rosenbaum
authors.forename: Winfried
authors.initials: W
authors.lastname: Winkelmann
authors.forename: Carsten
authors.initials: C
authors.lastname: Gebert
mesh_terms: D000328:Adult; D001186:Artificial Limbs; D002145:Callosities / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D019637:Orthopedic Procedures; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing