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Spring 2015
Prosthetic Care Facility of Virginia
COMPASS
Steering a Course Toward Mobility and Function for Limb-Loss Patients
In Jessie’s case, he had only two inches
of femur on his residual limb as a result
of falling into a grain auger because
someone had forgotten to replace the
cover. That was in 2003 and Jessie spent
39 days in the hospital, not only mending
from his massive, extensive injuries, but
also fighting Mucormycosis, which is
a rare fungal infection. But Jessie has
a remarkable attitude and is a fighter.
“I am happy to be alive,” he said. “It
took about a minute-and-a-half for the
auger to get to the point where it cut
off my leg. I was conscious the whole
time, waiting for more than two hours
for life flight to get to me because of the
weather. Being conscious, I realized I
had to choose whether to live or die; I
chose to live.”
Meet JESSIE:
HE CHOSE TO LIVE
Jessie H. has spent more time than he
cares to remember in a wheelchair, in a
bed, or in a chair. And he didn’t like it
one bit.
Jessie is a hip disarticulation patient and
hip disartics, because of how high the
amputation is, are hard to fit so they
can walk, stand, and sit comfortably.
In addition his accident left him with
a colostomy, which needed to be
accommodated in his socket.
Not only was Jessie’s leg traumatically
amputated, but he also lost his rectum,
suffered a torn prostate and had a radical
prostatectomy, underwent a colostomy
revision, had a partial knee replacement,
four shoulder surgeries, and a nerve
revision on his left arm. Through all of
his surgeries and recovery he had who
he refers to as an angel by his side – his
amazing wife Nora.
Jessie had numerous surgeries but
eventually was fit with a C-Leg,
a
computerized
knee
system.
Unfortunately, his socket was more
low-tech – a pin and lock system that
can work fine for some amputees, but
not all, especially those with a high
amputation. Plus, the best technology
in the world will not do an amputee
any good unless he has a socket (the
component that joins the residual limb
to the prosthetic device) that fits securely
and comfortably.
Continued on next page >>
We Welcome
Darren
Hattingh
to Our Practice
Darren, son of John and Michele
Hattingh, has joined the family practice
as a technician. Darren fabricates and
repairs prostheses according to patient
measurements and casts in compliance
with a physician’s prescription. Darren,
wife Alyssa, and son Liam moved to the
Leesburg area from Seattle last year.
National Limb
Loss Awareness
Month
April is National Limb Loss Awareness
Month, a campaign sponsored by
the Amputee Coalition. More than 2
million Americans live with limb loss
and that number grows by 185,000 each
year, either through trauma, disease,
or birth defect. Returning patients to
a lifestyle they enjoyed prior to losing
a limb is the goal of prosthetists and
prosthetic
companies,
continually
researching and marketing innovative
devices that provide higher levels of
function and mobility.
Still, Jessie gave mobility a good try. But
with the traumatic amputation, debris
and blood loss, he developed heterotypic
ossification, where muscles and tendons
turn to bone, causing fractures and pain.
He tried to put his weight on the right
side (his “good” side) but eventually his
right knee joint gave out. “That is why
I was in a wheelchair; it was the least
amount of harm,” Jessie said. “Even
then, sitting would throw my femur in
an awkward position. I needed a special
cushion because of all the scar tissue and
ossification.
Through networking on Facebook,
Jessie’s plight caught the attention of
Michele Hattingh, administrator of the
Prosthetic Care Facility of Virginia.
Michele knew Jessie could be helped by
her husband, John Hattingh, CP, LPO,
CPO(SA), who specializes in difficult
cases and has helped find a comfortable
fit for dozens of hip disarticulation and
hemi-pelvectomy patients.
Michele made travel arrangements
for Jessie and his wife, Nora, to
“Being conscious, I realized I had to choose
whether to live or die; I chose to live.”
- Jessie Herring
come to Virginia for a consultation
through a special program called
Destination Prosthetics, which provides
rehabilitation care to those who want
to achieve mobility, but are unable to
receive the prosthesis they need in their
own community or from their own
prosthetist. Destination Prosthetics is a
means for them to receive intensive oneon-one treatment with no interruptions,
with travel and accommodations
provided for those who qualify.
style” socket and is contoured to fit the
patient’s body. It effectively captures the
pelvic rotation of the user, providing
greater control. It also was made so that
Jessie could manage his colostomy bag
with ease.
Once John Hattingh reviewed Jessie’s
X-rays, he could see that pin and lock were
not a good match and he recommended
they try what is called a “bikini socket.”
“I went down steps the first day too,” he
said. “John is good, there are no ands,
ifs and buts. He saw my X-ray and he
said he could do it and he did it. Thank
you John, Michele, and also Darren
Hattingh, who helped make the socket.”
The bikini socket is less than half the size
and weight of the traditional “bucket-
“On Sunday John did an evaluation, on
Monday he molded a socket, and late
Tuesday I was walking,” Jessie said. “It
feels good and my weight is distributed
evenly. My old prosthesis, I couldn’t sit
in it. With this, I can sit, drive, and walk.
Bikini Socket Provides Higher Level of Comfort for
Hip Disarticulation and Hemi-Pelvectomy Patients
The most high-tech componentry
available is not going to make any
difference if the most important part of
the prosthesis, the socket (or interface),
which holds the prosthesis to the
residual limb, is not comfortable. The
job of the socket is to support body
weight and hold the residual limb
firmly in the prosthesis.
Patients who are hip disarticulations
or hemi-pelvectomy often have a very
difficult time finding a comfortable
socket fit because of their challenging
level of amputation.
Ischial containment sockets have
been made of flexible thermoplastic
materials contained within a rigid
frame. They are considered more
comfortable than the traditional hard
plastic laminate socket. These have
been called several names including the
Scandinavian Flexible Socket (SFS).
Ischial containment sockets are more
successful on short, fleshy residual
limbs and are better suited for high
activity sports participation.
The Canadian design uses unlocked
hip, knee and ankle joints to achieve
stance-phase stability while permitting
flexion at the hip and knee during swing
phase. A molded plastic socket encloses
the ischial tuberosity for weight bearing,
extends over the crest of the ilium to
provide suspension during swing phase,
and affords excellent mediolateral
trunk stability by fully encasing the
contralateral pelvis. The prosthetic hip
joint is attached to the socket anteriorly,
and this results in excellent stance-phase
stability plus good swing-phase flexion.
More recently, Jay Martin, president and
founder of Martin Bionics Innovations,
designed what he dubbed the “bikini”
socket due to its less than half the size
and weight of the
traditional style socket.
According to Martin,
the design can more
effectively capture the
pelvic rotation of the
user, providing greater
control. Instead of
rigid or semi-flexible
materials, the design
uses a compliant iliac
crest stabilizer for a
more comfortable fit
and can accommodate
the
user’s
weight
fluctuations.
In general, the more
flexible the socket is,
the greater the comfort
level, enabling the
amputee to utilize the
prosthesis fully.
Destination Prosthetics
Since the Prosthetic Care Facility of
Virginia opened for business a little less
than two years ago, we have helped
dozens of patients achieve mobility
again through our unique program –
Destination Prosthetics.
Destination Prosthetics was created
for amputees who wanted to achieve
mobility, but were not finding the help
they needed in their own community or
from their own prosthetist. Destination
Prosthetics provided an option for them
to travel to Leesburg for evaluation and
treatment.
One of our patients was Michelle O.,
from Petaluma, Calif. Michelle lost
her leg through a boating accident and
had been struggling for more than a
year to regain her mobility. But she
had two bad experiences with two
different prosthetists, one of whom said
it would be impossible for her to walk
again because she is non-compliant and
difficult to fit. To make matters worse,
she was more than several thousand
dollars out of pocket with insurance
refusing to investigate the situation.
After talking with Michelle, we found
that she was willing to do anything to
get back to her job and being a “regular”
mom to her young son. John Hattingh,
CP, LPO, CPO(SA), fit her with the
Revolimb system (see story on page 4)
and we can say that Michelle is now
walking for the first time in months – just
in time for Christmas with her family.
Said Michelle O.: “I am so grateful to
this entire (Hattingh) family for helping
me get back to me.”
Another patient is Joy C., who was
improperly fit, making walking a very
uncomfortable, if not impossible task.
“Thanks to John, I’m getting back to the
sports I loved before. I’m also getting a
bike with the left pedal modified so my
prosthetic leg clips into the footholds
so it doesn’t fall off and then I want to
do rock climbing and hiking,” she said
enthusiastically.
“I’m so glad for the Hattinghs … I just
appreciate so much all the work they are
doing to help me.”
John Hattingh has come up with a new
design for hemi-pelvectomy patients
which combines the Scandinavian design
with the Bikini Socket. HPs require more
soft tissue surface bearing because there
is no skeletal ischium for weight bearing
purposes. Therefore the combination still
allows for a smaller and lighter socket
with the adjustability of the Bikini, but
enough surface to allow for soft tissue
weight bearing.
To be considered for Destination
Prosthetics, a patient must live more than
100 miles from Leesburg. We will help
with checking out-of-state and out-ofnetwork insurance. However, we cannot
accept Medicare/Medicaid patients.
With a call to (703) 723-2803 or email
to [email protected], you can
find out if you qualify for this unique
program and assistance with travel and
accommodation expenses.
At
Destination
Prosthetics
We Remember
Mathias!
Our little angel of a patient,
Mathias Giordano, 13, passed
away December 7, 2014.
Diagnosed with osteosarcoma
in 2012, we came to know him
after his leg was amputated. He
never failed to be strong of spirit
and he brought much joy and
appreciation of life to our family.
Rest in Peace Mathias. You are
free of pain now.
in
the
Prosthetic Care Facility of Virginia,
you will receive intensive one-on-one
treatment with no interruptions. When
you come to us for assistance, we will
review your limb-loss history, fit you
with the correct socket and components,
analyze your ability to walk in our Gait
Training Lab, and educate you in the
care and use of the components. We also
offer adjustments as needed.
Hard-to-fit cases are our specialty.
44115 Woodridge Parkway
Suite 180
Leesburg, VA 20176
703.723.2803
Fax: 703.723.2804
www.prostheticcarefacility.com
Get social with us on Facebook:
www.facebook.com/prostheticcarefacility
Revolimb Technology
Available at
Prosthetic Care
Facility
John Hattingh, CP, LPO, CPO(SA), is licensed and trained in
the Revolimb, a micro-adjustable prosthetic limb that allows
you to instantly control the fit of your socket without ever
having to remove it. You can easily customize the fit, feel
and performance of your prosthesis by fine-tuning socket
compression around your limb.
John fabricates the Revolimb by customizing the floating
panels around your limb. Precision placement of these
adjustable panels allows them to flow with your changing
body and your changing needs. The panels are lined with
custom pads for soft, smooth compression and exceptional
comfort. Your ability to tighten or release the contours of
your socket puts you in control of your comfort and fit.
For more information about the Revolimb, contact John
Hattingh at Prosthetic Care Facility of Virginia, (703) 723-2803.