Casting a Plaster Model

In my fourth mentor visit, Mr. Wilson and I continued to work through the details for my Final Product by listing out all the possible options for the prosthetic leg. We started with the category of suspension systems, so I chose a variety of designs that could each be specialized for specific patient characteristics and the most valuable systems that I've learned about so far. I decided to include a suction, electronic vacuum, suspension sleeve, shuttle lock with a clear test socket, and a lanyard. 

To read my analysis, click here.

Assembling My Final Product

This week in ISM, I updated my portfolio and assembled the majority of both prosthetic legs during my mentor visit. First, I had to decide the approximate height and foot size of my patient, so that I could get the appropriate parts. I decided that the individual would be just over 6 feet with a 27 cm foot, and then my mentor and I used this information to select several models of foot attachments and other connecting pieces for the legs. As I built the first device, Mr. Wilson allowed me to first try and figure out which pieces were needed by myself before he gave me more information to lead me to the correct parts. In this way, I was able to really understand each step and incorporate critical thinking skills to build the legs by myself under my mentor's guidance. For the foot attachment, I selected a low-energy transfer model for the shuttle lock system and one more suitable for an active lifestyle for the vacuum, since the patient would need about a year to adjust to the amputation before returning fully to his prior activities. Then, I started to put each leg together, working from the foot attachment to the socket, since this method gave me a solid foundation to build upon. Lastly, I adjusted the foot on each socket to angle slightly outward, because Mr. Wilson told me that most people walk with their toes pointing outward. Through this entire process, I realized that the generic template for both the temporary and finalized prosthesis was essentially the same. The main differences were the type of suspension system used and style of connecting parts, since I did have to modify the lengths of pylons to maintain the same distance from the bottom of the foot to the knee on both devices. This upcoming week, I will create my FPN guest list and write another Evidence of Learning.

3D Printing Prosthetics

This week in ISM, I had another phone call meeting with my mentor and created the rough draft of my FPN program brochure. In the phone call, my mentor and I discussed possible changes that could be made to the prosthetic legs after we finished putting them together and the future of this field. We decided that the biggest changes would be made to the foot attachments, pylon, and socket, since these can vary based off the patient's height, weight, and activity level. Also, we'll most likely add minor details to our current patient description, so that specific aspects of each leg are justified by patient characteristics. Another important topic we covered in this meeting was the role of 3D printing and osseointegration in the future. I learned that the greatest weakness for 3D printing prosthetic legs is currently the reduced durability of the materials. As a result, each device must be replaced more frequently and even though the cost per leg is cheaper, having to get a new prosthesis more often significantly impairs the purpose behind 3D printing. In regards to osseointegration, it appears that its implementation within the United States is still in its initial phases. This is most likely due to the fact that this procedure is limited to a very specific patient type, because patients must have strong bones and be willing to undergo surgery as well. However, as this technique is researched in greater depth and fine-tuned, I believe that osseointegration has the potential to become the standard for prosthetic devices, rendering the use of a socket obsolete. This upcoming week, I have scheduled a mentor visit at UT Southwestern, and I plan on assembling both prosthetic legs for my Final Product.

Product Progress Report

This week in ISM, I wrote an Evidence of Learning, had a phone call meeting with my mentor, and completed a Product Progress report. During my phone call meeting with Mr. Wilson, we discussed the estimated costs of a shuttle lock system vs. an electronic vacuum and the role of insurance in helping patients cover these costs. I realized that a complete prosthesis with a vacuum is approximately three times more expensive than a temporary one with a shuttle lock, and this difference is most likely due to the amount of technology in a vacuum that supports a higher activity level for the patient. A complete prosthesis includes the prosthetic leg, any adjustments that are made, and all patient visits under that single device, so the price seems much more reasonable for a final vacuum because these legs can typically last about five years before they need replacement. Also, some patients are able to use the same socket when transitioning from a temporary prosthesis to their final device, so this will significantly decrease the overall cost. In my Product Progress report, I described everything I have accomplished so far in regards to my Final Product and what else I have left to complete before Final Presentation Night. As of right now, my mentor and I are ahead of the deadlines on my Final Product Calendar, so I can spend more time testing out various combinations before I choose the best version for my finished product. I'm planning on fully finishing both prosthetic legs by May 8th, which will ensure that I have enough time to account for any potential setbacks while I'm building my Final Product and focus on other aspects of Final Presentation Night as well. This upcoming week, I have scheduled another phone call with my mentor, and I will draft out the information for my FPN program brochure.

Information about FPN

This week in ISM, we discussed the different components of Final Presentation Night and a general to-do list before the actual event. So far, I've been focusing exclusively on developing my Final Product and updating my portfolio every few weeks, but there are several other tasks I need to complete as well, such as creating invitations and door signs, making a program brochure, coming up with a guest list, choosing a classroom, and starting to draft my 30-35 minute speech outlining my ISM experience and Final Product. Even though FPN is still two months away, I know that time will fly by, so staying organized and ahead of schedule will definitely ensure that I'm fully prepared by May 20th. I also had a mentor visit this week, and during this visit, Mr. Wilson and I pulled a clear test socket for my Final Product and decided on the majority of the patient's characteristics. Because we are going to be building two separate prosthetic legs for this individual, we talked about why we chose the specific suspension systems and what reasons could justify different design elements of the prosthesis in regards to the patient. Pulling the test socket was really interesting, and I was surprised by how quickly the plastic cooled and molded to the plaster model. I was also able to see how small changes could be made later to the socket by heating a small section of the plastic and pushing on it to reduce pressure on specific areas of the patient's leg. This upcoming week, I will write another Evidence of Learning and read through notes my mentor sent to me about types of suspension systems for specific patient types.

Choosing a Patient

This week in ISM, I had a phone call meeting with my mentor, updated my blog, and discussed my Original Work with classmates. During our phone call, mentor and I revised our previous idea of designing two prosthetic legs: one for an above the knee patient and another for a below the knee patient. Because an above knee device is significantly different from a below knee, building this product would essentially mean that I'll have to create two patients, instead of one. As a result, the purpose behind having an above knee and below knee device would be lost, because each prosthesis wouldn't be fundamentally identical, despite the use of the same suspension system. And since I was initially trying to compare a single suspension system within the category of type of prosthesis, I would no longer be able to draw as strong of a conclusion at the end. Therefore, my mentor and I decided to create a single patient with specific characteristics and then design two prosthetic legs for that individual: one immediately following surgery and another approximately a year later, when the leg has stabilized and is no longer rapidly losing muscle mass. I think this idea will allow me to not only incorporate different suspension systems but also practice a realistic approach to treating a patient. Furthermore, I will choose this patient by looking through several links my mentor sent me describing actual patient experiences, so I can either base the patient for whom I'm designing this prosthesis off a real individual or through compiling various characteristics from several people. This upcoming week, I have scheduled a mentor visit, so I plan on finalizing the details for my patient and pulling the sockets for my final product.

Mentor Visit #3

During my third mentor visit with Mr. Wilson, we tested out several ideas for my Final Product and discussed the socket making process. The previous week, we had scheduled a phone call, and through this phone call, my mentor and I brainstormed several different options and types of products. Therefore, we were able to determine the feasibility of each idea and also had the ability to determine what materials, parts, and tools were available to us at UT Southwestern, so that we would be able to understand how realistic each option was.

To read my analysis, click here.