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The Southlands Temporary Walking Aid

During the last 18 months 15 temporary walking aids have been made in the occupational therapy department at Southlands Hospital; Shoreham-by-Sea, Sussex, and great success has been achieved in the rehabilitation of lower limb amputees. Up to May 1969 patients were generally referred to the Limb Fitting Centre in Brighton for the fitting of temporary and permanent prostheses. A waiting period of several weeks was inevitable, a critical factor in the mobilization of the older patient. This delay is eliminated when the temporary walking aid is made on the spot. The purpose of this paper is to describe in some detail the construction and use of the temporary walking aid which has been based on ideas devised by Sidney J. Lock, M.A.O.T., and developed in the occupational therapy department at Southlands by Hilary Gillott, M.A.O.T. With four exceptions the 15 patients concerned were over 70 years of age and were suffering from peripheral vascular disease, one of the most common conditions necessitating amputation of the lower limb (See Table). Some had previously had sympathectomies and vascular reconstruction in order to try to preserve the limb and there were often associated cardiac and anaemic conditions. The majority of the amputations in this series were of the Gritti-Stoke types in which the articular surface of the patella is removed and the femur is divided above the condyles while the patella is anchored at the distal end. There is a long anterior and short posterior flap which frequently heals very satisfactorily, but the suture line must be carefully inspected by the therapist at the . beginning of each treatment session. Work is started on the temporary walking aid, at the surgeon's discretion, after the removal of the sutures eight to ten days after the operation. The wound is protected with a dry dressing and where the stump is of an awkward, bulbous shape discrepancies are accommodated by padding out with foam plastic. The stump is covered with stockinet. Half-inch Plastazote is moulded round the stump to form the lining of the bucket. When cutting the Plastazote six inches are added to the circumference of the stump to facilitate handling. The length should be the distance from the groin to the inferior surface of the patella. The Plastazote has to be carefully