One of the most dangerous farm machines is the hay baler, a tractor accessory that ties and bundles hay into bales. Every year, hundreds are injured as a result of being crushed or pulled into a baler. Such is the case with Sampson's patient David S., who lost his leg in a nasty baler accident in the early 1970s. David doesn't talk about it much. Ask him how he is doing and you're likely to get a plain and simple answer – good and fine. He is not one to dwell on his accident; he has other things to do. As owner of DW Body Shop in Esperence, N.Y., for 35 years, he spends his days working with his son, Jeremy, at the family business. His shop is always overbooked and the schedule is extremely busy because of the quality craftsmanship that the firm offers.
David, 66, is not shy about giving credit for his high level of mobility to the service and care of Bill Sampson, CP, his prosthetist for more than 14 years. "Bill's expertise and techniques are letting me walk today!" he said. "Bill is so good at what he does. He takes the time he needs to help me and he does what he says he will. I couldn't ask for better advice and attention."
David and Bill began working together in 1998 when David needed a new prosthesis and was experiencing some issues with range of motion and difficulty in donning and doffing his prosthesis. Bill was able to fit him with a locking liner for more secure suspension; the silicone liner also aided in making it easier for David to don and doff his prosthesis. A new dynamic response foot provided the good energy return, comfort and responsiveness David needed for his active lifestyle.
That solution worked for David until he had a second accident in 2009 that further injured his residual limb. His left knee was broken when he fell from a vehicle and was pinned under a piece of metal. Rushed to the hospital, he underwent emergency treatment. Surgeons used pins and screws to put his tibia and medial lateral knee joint back together, but post-surgery, his range of motion was severely limited (just 35 degrees) due to swelling. Pain during ambulation was a huge problem and David was unable to tolerate torques placed on his knee joint from his previous prosthesis.
When the doctor suggested that David consider an above-knee amputation, David sought Bill's advice.
"David didn't want the second amputation and I agreed that we should first try a more conservative approach," Bill said. "We started by fitting him with a shrinker to diminish the soft tissue swelling. Next, we worked on eliminating pain and stabilizing the knee. One of the causes of his pain was the pistoning in his previous socket, caused by volume fluctuation and putting pressure points on his limb. To address this, I fit him with the Harmony® P3 system and a custom removable knee orthosis, pinned on with a flip pin, to stabilize the joint."
The Harmony System is an active volume management suspension system that optimizes the limb/socket environment. It creates a sub-atmospheric environment by incorporating a Total Surface Weight Bearing socket, a liner, a vacuum pump that draws air out of the system, and a sealing sleeve that makes an air-tight seal with the user's liner and body.
The key to the system is the pump, which draws the entire surface of the liner onto the socket, relieving pressure from the residual limb and allowing fluids to be more easily drawn back into the leg during swing phase. This increases healthy fluid flow and maintains consistent volume to reduce forces on the limb.
"One of the keys to successful ambulation is the socket choice. No one socket is right for every patient. In David's case, sub-atmospheric technology offers substantial benefits," Bill said. "Harmony P3 creates an optimal limb environment, with volume management, excellent suspension, plus internal and external rotation for easier maneuvering and shock absorption.
"Now David is able to walk without a cane or crutches," Bill said. "Time and healing improved his range of motion. His knee extension improved from 35 to 8 degrees and his knee flexion from 5 to 100 degrees. David is highly-motivated to be active," Bill said. "He was in so much pain after the accident but he didn't let it hold him down."
Keeping busy isn't difficult for David. When he's not working at the shop, he can be found helping Jeremy build his home or volunteering in his community helping neighbors affected by severe flooding last year. He also enjoys splitting firewood for exercise and spending time with his nine-year-old granddaughter. David and his wife, Barbara, also enjoy cruise vacations.
"There's life after amputation," he said. "A whole lot of life. It goes on and it's good!"
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