ירון דוזטס - אמנות בשיקום אורטופדי

The rehabilitation of a rehabilitation product requires three main features:

Professionalism, patience and integrity !

Professionalism: How much is your prosthetic technician professional? , How many repetitions or fittings                                    are required? , How much he  knows how to overcome problems and mishaps? , How                                      much do you know to choose components that suit you  personally ?? How updated your                                prosthetist in the latest innovations and solutions? How updated is it in terms of                                                courses and continuing education?

Patience: How patient is your  prosthetist about troubleshooting prosthesis \prostheses problems? How free                   is the prostheses  technician available to serve you?

Integrity: The ability to choose the components that suit you personally and not for the needs or needs of                       the system? How honest is it  with you to find out issues that may not be comfortable for an                             immediate solution? How much the price level is
                 Consistent with his professionalism?
 

The fitting of a rehabilitative product has several partners: The first is the client, who is required by the new or old rehabilitation event. The second is the rehabilitation doctor, who in his decision involves medical considerations and functional aspects. The third is the professional, an expert in the field of adapting a rehabilitative device, whether manufactured according to mesure or required to adapt a shelf product. There are quite a number of areas including; Prosthetic technicians whose art is the production of artificial limbs - dentures to the right. Orthopedic technician whose art is the production of orthopedic support equipment - Orthopedic saddles and belts. An orthopedic shoemaker whose art is producing orthopedic shoes for people with disabilities and those who do not have shelf shoes for them in the free market. Physical therapists and / or occupational therapists are trained in the practice and training of the patient. Some of the physiotherapists are also qualified in the field of wheelchairs. We also mention the field of custom-made seat cushions, which sharpens the extra support required for a passive or active person.

 

To what extent can product adaptation such as prosthesis affect the patient's life and how does it affect the life of his family, environment and country?

Loss of limb is caused by several reasons; Illness, accidents to death, wars and birth defects. Each amputation event is traumatic for the amputation and for the environment. There is no amputee who can not remember the time when he lost his limbs. His life is divided into two at that moment; Before amputation and after amputation. The psychological effect is enormous mainly because of the change in the image of the body. The physical effect is equally great due to the loss of basic functions and due to the formation of phantom pain. At this stage, the rehabilitation process is critical and the rehabilitation of its essence is the best return of the patient to his pre-amputation life as a productive person who does not constitute a burden on his family.

After recovery of the stump, the doctor authorized to order prosthesis will approve the prosthesis. The surgeon is an expert in life saving and a prostheses specialist in saving life, in terms of both technical and psychological aspects, specializing in science, medicine, art and a lot of personal capital .

 

Here are some of the highlights of the technician's choice:

1 - Professional studies and training - ask to see a certificate issued by the Ministry of Labor and / or an academic institution .A qualified technician studied anatomy, physiology, kinesiology, dermatology, strength of materials and metallurgy, chemistry, technical English, etc. In Israel there is no law and actual regulation In any case, anyone can claim a professional.

2 - Think about your technician! A good technician is like MacGyver - the same television character who knew improvising improvisingly and finding solutions to every problem. A skilled technician in the field of leg prostheses and hand prostheses can combine the variety of components, technologies and professional knowledge of hand prosthesis or leg prosthesis. There are not many such professionals in the world, and in Israel, very few are.

3 - It is important to check how well your expert maintains his professionalism and participates in conferences, exhibitions and professional training.

As there are no two identical stumps, it is very difficult to estimate a precise degree of pressure or freedom at the level of a millimeter in a particular place for that cutoff. To sharpen the issue, it says that even for a specific single amputation, 500 technicians will produce 500 different prostheses. They may look similar from the outside, but the interior design of the stump which is the most critical factor for a successful prothesis will be different, the selection of components will be different, as is the level of fit and finishing

A successful prostheses expert will stand as far as possible on your lifestyle. This stage is very important for selecting the components and materials from which the prosthesis will be produced. Share your expert with a lot of information about your occupation, your hobby, and especially your expectations. For example, there are over 1500 energy-holding feet, about 1000 artificial knees and more than 1,000 hand components. All of these can be divided into smaller categories, but the selection is enormous. For example, choosing a foot to store energy to interrupt a slow walk is unacceptable. Choosing a knee with a spring hinge for a person with varying walking speeds is also wrong. Choosing a foot that is not multi-axial for a person living in a mountain environment is a mistake. Also, choosing a functional / electronic / bionic handheld for a person with a very short stump will make it difficult for him to use it. There are many examples and it is important to understand that the benefit of the cut is at the top of the ladder, and we must isolate the improper modern considerations of combining a necessarily expensive component, due to considerations of hidden financial gain

5 - Patience is an essential factor. Do not put a prosthesis and the hocus pocus all the pix although sometimes it also happens. The optimal stump adjustment should be performed and it takes time. Specific directions should be made specifically for you. It is clarified that both directions and adjustments are for this moment and that future changes may occur as a result of physiological changes of the amputation, which sometimes necessitates the replacement of the components accordingly.

6 - that all versus emotion - or a gut feeling versus a thought; You were at your prosthesis - fitting specialist. As much as he tries to fit you a good prosthesis (according to the specification of course), there is no success. You come to the Institute on a daily basis for repeated adjustments. The prosthetic technician is very nice and sympathetic ... but the match does not cross. Many amputees stand in such a situation whether they waste precious time or waste other energies. You've reached such a situation - it's time to change "hands", the prosthetist that take care about you . Ask the institute manager to replace your prosthetics technician and you will likely feel the difference. If this is not possible or not, it is time to move to another Orthopeadic institute, with all the sorrow.

7 - The time of the prostheses technician is a precious commodity. You have a queue - you will arrive on time. With the exception of the status of determining the problem as widely as possible. This will allow the technician to estimate the time of your treatment. If the queue is set by a secretary, it is sometimes advisable to talk directly with the prosthetics technician to identify the problem and provide a telephone solution, if possible.

8 - The Orthopedic Institute and the experts are often found between the hammer and anvil while the fragment receives funding from an institution. In the State of Israel, it is no surprise that the institutions raise difficulties. Often, the expert on the prosthesis stands

9- 11- For customers who receive a prosthetic limb financing from abroad / insurance / external parties: work in close cooperation with the technician / the workshop, in order to promote actual payment

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A selection of tricks by prosthetic technicians in a nutshell:

1 - Tempting the client to get to the Institute and there will receive it a senior C.P.O prostheses technician, but in practice the senior technician will not actually perform the work for you.

2 - Client seduction with gifts such as free upgrades, promise to produce a carbon fiber socket , use of sales representatives, promise of luxury items and more:

3 - upgrades are usually prohibited by the Israeli funding institutions. In addition, sometimes the word "titanium" is thrown into the air, which is composed of identical components of lighter weight. Not necessarily the total components will result in a lighter weight of the prosthesis that is felt by the stump, since optimizing the prosthesis makes the stump feel that the prosthesis is light and is part of it.

4 - Carbon fiber: is an advanced fabric incorporated in the prosthesis as raw material. A common trap that is mainly an illusion that the amputee will receive a prosthesis from the high-tech section and light weight as a feather. Carbon fibers do cause prosthesis to be lighter but not necessarily in all manufacturing technologies. What is more, the conclusions of professional studies point to the fact that the use of prothesis with carbon fibers increase phantom pains because they are attractive and lead to electromagnetic radiation! Does your technician know about this factual detail? If you have an electronic prosthesis and the sensors are placed in a carbon fiber environment, do not be surprised if the prosthesis sometimes responds independently without giving you an command.

5 - Components: I have often been asked, for example, "Do you have a knee type XXX"? Well, every prosthetics institute - even at the tip of Antarctica can order any component from any manufacturer of prosthetic components across the globe. No prostheses institute has stock of all the knees, all hands and feet, etc. Moreover, the world market has recently moved to a minimum stock that is produced according to economic forecasts, and therefore it is sometimes necessary to order components for more than one month, even if it Otto bock, Ossur, Blatchford Endolite, Touch Bionics, Steeper, Freedom Innovations, Ohio Willow wood, Alps, Fillauer, Proteor, etc....

6 - Do not forget for a moment that the most important component in the prosthesis is the stump house !!!! Without a well-adapted stump, no component is essential enough to satisfy your needs. What is a bionic prosthesis worth if it is not convenient for the user ?! What is the value of a prosthesis with a 7-axis knee when the center of gravity is not properly fitted?! ... It is like driving a luxury car luxuriously on a long drive - only the driver's seat is a stool.

 

Yaron Dozetas is a 35 year prostheses specialist C.P.O. , producing all kind of prosthesis in Israel and is a founding member of ISPO Israel.

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