Toppie Gray lost his leg above-the-knee and was left with a short residual limb with a very short femur at the end of his stump. This left it with a lot of soft tissue. Jaco Deist loves a challenge and when he met with Toppie Gray in June of 2018 he said, “What a challenge! It has been a while since I was tested in my skills like this!”
Deist does not shy away from a challenge but rather applies and develops his skills to deliver the best service possible so that he can improve the quality of life for any and all amputees. Toppie is a very active person and is not content with sitting behind a desk and only making use of his prosthesis moderately throughout the day.
Toppie Gray is a hardworking individual who puts his prosthesis on in the early hours of the morning and only takes it off late in the evening. He walks thousands of steps in a day for his work on uneven terrain which presented Deist with the challenge of fitting an exceedingly comfortable prosthesis for Toppie.
“I had to think way outside the box, and I was reminded, strongly, that no amputee is the same. When one has such a short residual limb, stability and comfort in the prosthesis is very important, but very challenging.”
Ordinarily, longer residual limbs still have many of the muscles responsible for stability (adductors) intact. However, in shorter residual limbs, more often than not, all or most of the adductor muscles are lost.
In order to compensate for Toppie’s shorter stump Deist needed to make a custom liner and build an elevated vacuum system with an inner socket and expulsion valve. This is then fitted inside a socket that is locked with a pin to keep the two sockets securely attached.
The process was long and daunting but after six or seven sockets Deist and his team achieved a fit that provides Toppie with the stability and comfort he needs. Deist comments, “I was reminded of the importance of socket design and the stability provided by containing the Ischium (sit bone) deeply and efficiently enough. If it is done effectively the patient should have the stability to be able to give a proper step on his prosthesis.”
What Deist had to say about the challenge Toppie presented him with rings true and could effectively act as the moto for everything Deist and Associates does:
“We are faced with lots of challenges and I have learned the importance of meeting every patient’s needs or expectations and to keep on going, until it is achieved.”
Deist addresses Toppie personally with gratitude for the professional challenge he presented him with:
“Toppie, thanks for all your patience and what I have learned from you in this experience! Happy walking days for you!”
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