STRIVE FOR BETTER.

Summer 2019

Welcome to our Summer 2019 Newsletter!

In this issue we highlight the Arctic One Tri & Para-Tri which was enjoyed by both patients and staff, where lots of hard work, fun and laughter were had by all.

We follow Alex Paterson’s journey as he adds to his incredible story of Osseointergration with a detachable silicone hand and we introduce you to our lovely patient Josephine Bridges. We hope you enjoy these and the other stories within.

The Dorset Orthopaedic Team

NEWSLETTER

Staff members teamed up with our amazing patients to tackle open water swimming, cycling and running. Patients, ambassadors, friends and family travelled from across the UK to be part of this wonderful event in support of The Arctic One Foundation. Arctic One was launched in 2011 and believes that sport should be accessible to all. It aims to provide disabled people, groups and clubs, the opportunity to get involved in sport and become more active.

The Tri and Para Tri events, took place on the Bank Holiday Monday at the end of May and conditions were almost perfect for the day, although a strong headwind presented a challenge at times. The events comprised several different challenges suited to all standards of competition. To begin with, the sprint event (750m swim, 20km cycle, 5km run), was represented in the swim by clinical services director Matt Hughes, Dorset ambassador Grum Leesmith and SAFO specialist Ben Cunningham.

The cycling part of the race was competed in by orthotist Kim Pickering, silicone specialist Anne-Marie Kersse and ambassador Malcolm Hingle, with the 5km run achieved by Dorset ambassador Dave Henson and physiotherapist Mary Tebb.

ARCTIC ONE ROUND UPIn May 2019, Dorset Orthopaedic once again proudly sponsored the popular Arctic ONE Tri and Para Tri event at Eton Dorney Lake for the 3rd year running.

Next up was the super sprint event (400m swim, 10km cycle, 2.5km run) and swimming for their teams were world para-triathlon champion Hannah Moore, SAFO wearer Denise Park and amputee Josephine Bridges. Midlands clinic manager Moose Baxter competed in the 10km cycle race with Dorset ambassador Colin Edwards running 2.5km for his team.

Additionally, Dorset’s own Rio Woolf took part in the children’s fun run event at the end, giving his new running blade a try for the first time. Everyone involved in the Arctic One event had a fantastic time and all the money raised on the day at Arctic ONE goes towards the organisation’s Forward Motion grant programme.

After a series of discussions, Alex opted for a bespoke silicone hand for his existing arm prosthesis. Handmade, colour-matched silicone prostheses is something Dorset Orthopaedic are renowned for globally. We have many years of experience making everything from fingertips to full-length transfemoral leg covers for clinics all over the world.

Colour Match: The first stage in any silicone prosthesis is a colour-match appointment. We start by taking an impression of the sound side hand or foot we will be replicating. In the case of upper limb amputees, this gives us all the information we need about the shape and length of the client’s fingers, the dimensions of their hand and what level of creases, wrinkles and veins to apply. Next we make notes on details such as hair, follicles, freckles and nail colour. We try to match as many details as are evident on the client, as all of these add levels of depth and realism to the final product. Finally, we custom match the client's skin tones as closely as possible which is often a challenging task as hands change colour with blood flow and temperature more than you would realise.

ALEX PATERSON’S BESPOKE SILICONE HANDDorset ambassador Alex Paterson, who was the first person io undergo upper limb osseointegration surgery in the UK, has decided to use a cosmetic hand to be worn on special occasions.

Manufacturing the silicone prosthesis: We tend to use an off-the-shelf prosthetic hand to form an understructure for our work. Using the client’s hand cast as a guide, we manipulate this to give the correct position and curvature of the fingers. We reduce the hand to create a scaled down version and the coloured silicones we add on top will bring it up to the correct size.

Flesh tones: The silicone is added in layers, colours being added in the position noted down in the client’s colour match appointment. The product looks very rough at this stage, as we are simply building up the shapes and the colours will be carefully blended together later. The nails, which have been created separately, are then added at the correct point on the fingers.

When everything is in the correct place, we can add skin details. For Alex’s hand, there are some raised veins on the top of the hand and at the top of the fingers. We also added some light freckling in this area. Once the colours have been blended and we are happy with the shape and bulk, the product is smoothed to prepare it for the next stage.

Pinks: All of the pink on the knuckles and the colours inside the palm are applied next. This is done by applying thin layers of colour onto the flesh colour underneath. We blend the layers out to make them look natural. The pinks have been noted down in the colour match appointment, so we know how much to apply and where.

This stage really starts to bring the product to life! Once these colours have been applied, we can add details such as the lines on the knuckles and the creases on the palm. The hand is checked over again to make sure the dimensions are still correct and we neaten up areas such as around the edges of the nails.

Cosmetic check: The level of detail in a silicone prosthesis means there is no substitute for seeing it in person. For silicone clients at our Southern and Midlands clinics, we offer the opportunity for them to come in and see the silicone prosthesis before we complete the manufacturing process. We can then make small tweaks and adjustments with the client present.

This gives us the best chance of matching them as closely as possible and creating something that is exactly what they want. In the case of Alex's hand, we added some hair to the back of the hand and a little to the fingers as well.

Delivery: Once the silicone has been hardened, it can be made ready for the client by neatly trimming any edges and smoothing the inside of the product. Alex attended the Midlands clinic to receive the finished arm, the fitting was performed by Alex’s prosthetist James Buckett.

The silicone hand is detachable, meaning the same arm can be used for different functions as desired. Alex was very satisfied with the final outcome and we wish him well with using it in the future.

At the age of 17, I was diagnosed with terminal bone cancer in my left tibia and had major surgery to save the leg and my life. After a remarkably successful trial treatment I defied my diagnosis and walked out of the hospital nine months later; however after 11 years and five failed surgeries to salvage my leg, I chose to have my leg amputated above the knee.

Even prior to my amputation I was in communication with Dorset Orthopaedic, arranging a visit to the Midlands clinic in Burton-upon-Trent to discuss prosthetic options, get advice on life after an amputation and in all truth, decide if I really felt ready to do this.

They were lovely, showing me what's on the market, answering my myriad of questions and letting me know about possible physio options going forward. However, more importantly than all of this, they were honest. They told me openly how hard it might be, the difficulties I might face and what problems may occur. It was this information that was most valuable to me and in truth helped me make my final decision to amputate.

After watching many videos of various prosthetics online I knew there was a chance to do more, to not have to stop along the adventure when everyone else is carrying on. So I set up Positive Bones online, firstly to help guide other people possibly making the same decision or just going through a tough period in their life and secondly as a platform for fundraising.

MEET OUR PATIENT JOSEPHINE BRIDGESHi! My name is Josephine, I’m 29 and I had my left leg amputated above knee in October last year.

I would like to highlight at this point that this isn’t just about me. Once we have fundraised for my leg, we have plans to start a charity for others in a similar situation and motivate people who just want the opportunity to continue their hobbies. When we get to the point of making it a charity, the first gift I would like to give an amputee is the same gift I was given in the start of my prosthetics journey at Dorset Orthopaedic.

Before the NHS were considering a leg for me, before they were getting me upright, I was already walking through the park at the end of my physio week with the amazing Beth Langley. At six weeks post-op, the incredible staff at Dorset got me up and not just moving but walking, going up ramps and climbing stairs. That's the gift I would give because it gave me hope, it showed me a future of possibility, a future of saying yes. To read the full story plece click here.

The hip is one of the biggest weight bearing joints in the body, so naturally is prone to wear and tear. So regardless of the level of your amputation, taking care of your hips is very important. The hip is a ball and socket joint, which allows for big ranges of movement in several different directions. It is held together by ligaments and muscles and a clever ring of cartilage inside the joint which acts as suction to reduce the risk of dislocation.

Sometimes, tissues which are normally stretchy become stiff and fibrous. When tendons and ligaments surrounding the joints in the body shorten, a joint contracture can develop and this can reduce the movement of the joint. This is a common problem in people who sit down for long periods of time as they experience shortening in the hip flexor muscles (a muscle group at the front of the hip/thigh). If this shortening occurs, it can be very difficult to push your thigh back so it is straight underneath you and you feel a pull at the front of your hip. It can also be tricky to stand up straight because subsequently your pelvis tilts forwards, creating an inward curve in your lower back. Over time, this could cause pain in the lower back due to muscle imbalances and misalignment.

In the clinic, we use the ‘Thomas Test’ to assess how tight your hip flexor muscles are. This involves sitting on the edge of a physio plinth, hugging one knee in to your chest and lying back – if your hip flexors are tight, the relaxed leg or stump will lift off the plinth. We take a measurement of the angle and the prosthetists will then use the same angle to accommodate any hip flexion in the socket of your prosthetic limb.

Although hip flexion can be accommodated in your prosthetic socket, the bigger the angle is, the more impact it can have on walking. A ‘normal’ walking pattern requires one foot to stretch back underneath you so you can push off your toes to lift the leg forwards. If your hip flexors are tight, you may find it more difficult to swing the leg through in front of you. To read the full story plece click here.

PHYSIO BLOG - THE HIP BY EMILY BRADERThe hip is one of the biggest weight bearing joints in the body, so naturally is prone to wear and tear. So regardless of the level of your amputation, taking care of your hips is very important.

The technology, which is a first for Europe, contains sensors which pair with Ottobock myo-electric hands including bebionic, learns and remembers movements from its user to activate hand grips and actions.

Conventionally, myoelectric arms contain one or twospecific sensors to pick up muscle contractions, which then in turn operate grip patterns in a myoelectric hand. The wearer has to think and contract these specific muscles in order to activate the hand.

In contrast, Myo Plus contains a network of sensors which learn the movements of the person operating it and remember it for the next time an action is repeated.This means they won’t always have to think about contracting specific muscles as the hand will do it automatically.This artificial intelligence means when an amputee repeatedly performs an action like tying shoelaces, lifting a cup of tea or turning a doorknob,

the Myo Plus remembers the action and automaticallyactivates the correct grip pattern.

A Myo Plus app is available for wearers to train with and the app visualises the movement patterns so they can see where they’re strongest and where they need more practice. For more information on Myo Plus or to arrange a consultation click here.

THE NEW MYO PLUSDorset Orthopaedic is now offering the very latest ‘pattern recognition’ technology for below elbow amputees, Ottobock’s Myo Plus.

STELA’S HIGH-HEELED AMBITION A STEP CLOSER Dorset Orthopaedic is helping Romanian social media star Stela Bizdu achieve her big dream of wearing her favourite platform shoes again.Stela, who lives in Romania with her husband, Mihail and young son George Ianis, lost her leg below the knee around a year ago in a road traffic accident. In Romania, services for amputees are very limited and often the prosthetics issued to amputees are ill-fitting and painful to wear. Determined not to see his wife restricted by her limb loss, Mihail researched the internet to find a solution and discovered Dorset Orthopaedic. They visited for the first time late last year, driving across Europe for three days for the month-long stay and haven’t looked back.

Stela now has a prosthesis with an adjustable ankle so she can wear heels of up to 7cm in height, attends regular rehabilitation sessions with physiotherapist Mary Tebb and eventually intends to have a leg for every occasion.She said: “In the end I hope to have my every day leg, a regular high heeled leg, a leg for very high heels as well a waterproof leg and a silicone leg for weddings and parties. I have some shoes at home with a 20cm heel and a 7cm platform and I will walk in them one day, I am determined!

“We are so glad we found Dorset Orthopaedic. Everyone here treats me as if I am normal and they always have a smile. They always seem to know what you need and what you want without asking!”

Stela, who owns an agricultural farming business, said she is now looking forward to the future and a normal life with her family. She charts her progress and her adventures on her Instagram page, stepsbystela and she’s featured on a number of high-profile Romanian TV programmes. “I don’t see my leg as a problem, I am alive and I am healthy,” she said. “Coming here, I feel healthier, more positive and so much better.”

REVOLUTIONARY SAFOS HELP LONDON PARA-THROWERS WITH TOKYO TRAININGTwo para-throwers with their eyes firmly set on representing GB at the Tokyo Paralympics next year are being helped along the way by Dorset Orthopaedic’s revolutionary silicone ankle foot orthosis.

Michael Nicholls (known as Taz), and Nessa Wallace, throw discus and shot put respectively and require their SAFOs for different reasons. Both have seen huge improvements in their overall function and training performance while wearing them.

Taz, 31 from Barnet, wears his SAFO after the nerve which lifts the foot when walking was badly damaged during surgery to repair a broken leg. The former footballer had fractured his tibia and fibula in a pre-season friendly in 2013. Coming to terms with never playing football again was tough but after encouragement to try something different he got in touch with Alison O’Riordan, a para throws specialist coach and discovered a new passion for throwing.

Now a classified F44 athlete, Taz’s personal best in the discus is 48.70m. He got his SAFO thanks to a donation from the Matt Hampson Foundation and he said the difference it’s made has been incredible. “I had a rigid throwing brace initially but I found myself relying on it too much and the top of my leg was getting lazy,” he said. “With the SAFO it gives me the support I need but engages the rest of my leg so I am fitter, more functional and able to get more propulsion. While I don’t compete with it, it’s the perfect training aid for me, as when I am back in my rigid brace for competition I will be much stronger overall and I’ll be able to get better results.” To read the full story click here.

CONTACT US

Southern Clinic - Unit 11 Headlands Business Park, Salisbury Road, Ringwood BH24 3PBMidlands Clinic - Bretby Business Park, Ashby Road, Burton upon Trent DE15 0YZ

enquiries@dorset-ortho.com | www.dorset-ortho.com | 0800 433 2239

A FEARLESS LINDA TAKES ON EPIC RACE ACROSS AMERICA A Worcester woman who lost her leg below the knee more than 20 years ago has embarked on an epic challenge by cycling across America.

Linda Chen, a patient at Dorset Orthopaedic, is one member of ‘Mind over Matter’, the first British female adaptive team to enter the gruelling Race Across America, raising awareness of both physical and mental health challenges along the way.

All the women involved, four military (both serving and veterans) and four civilians have an injury or impairment of some kind, with Linda being the only amputee in the group. Linda set off on June 15th and the team has ridden in squads of four, for nine hours at a time to finish the race, which began in Oceanside, California and ends 3,000 miles away in Annapolis, Maryland.

All those taking part must finish the distance, covering 12 states and more than 170,000ft in total, within nine days. Linda, who lost her leg when she was hit by a car 22 years ago, has been a patient at Dorset Orthopaedic for two decades, was assisted ahead of the race by her prosthetist Moose Baxter, to ensure she’s as comfortable as she can be on the ride, including new liners for her residual limb and adjustments to her socket.

Speaking ahead of her trip, she said: “It’s very exciting, and even though it’s going to be really tough going I’m looking forward to it. As a team we’ve been training together quite a lot and it’s nice because everyone totally understands one another; we don’t have to explain ourselves as to why we can’t do something or that we have to do it differently. We’re all accepted. “We’re the first all-female adaptive team to take part, so the pressure’s on to do well! We’ll certainly do our best!”