FIELD EXPERIENCE WITH FIELD EXPERIENCE WITH SAND-CASTING AND WU-SAND-CASTING AND WU-

CASTING SYSTEMS IN CASTING SYSTEMS IN VIETNAMVIETNAM

Nguyen H THANH, VIETCOT, HANOI, Nguyen H THANH, VIETCOT, HANOI, VIETNAMVIETNAM

Assessor Team: Assessor Team: P POETSMA, ICRC, HCMC, VIETNAMP POETSMA, ICRC, HCMC, VIETNAM

J STEEN JENSEN, ISPO INT., DENMARKJ STEEN JENSEN, ISPO INT., DENMARK

FIELD EXPERIENCE IN FIELD EXPERIENCE IN VIETNAMVIETNAM

• SAND- CASTING SYSTEM : 2003 - SAND- CASTING SYSTEM : 2003 - 20042004

• WU- CASTING SYSTEM : 2006 -2007WU- CASTING SYSTEM : 2006 -2007

SAND-CASTING OF SAND-CASTING OF SUPRACONDYLAR SUPRACONDYLAR

SOCKETSSOCKETS

IPOS brim Thin stocking or women sockThin stocking or women sockPressure reliefPressure relief

Pressure reliefPressure reliefPositive sand cast.

Socket test.

TUBULAR ENDO-SKELETAL SYSTEM WITH TUBULAR ENDO-SKELETAL SYSTEM WITH PYRAMID SOCKET ALIGNMENT KIT AND PYRAMID SOCKET ALIGNMENT KIT AND

SACH-FOOT (FUJIAN)SACH-FOOT (FUJIAN)

FROM ENDOLITE ASIA , MALAYSIAFROM ENDOLITE ASIA , MALAYSIA

WU-CASTINGWU-CASTING

CastingCasting Apply pressure areasApply pressure areas Negative castNegative cast

Rectification castRectification cast Positive castPositive cast MouldingMoulding

POLYPROPYLENE TRANS-TIBIAL POLYPROPYLENE TRANS-TIBIAL COMPONENT WITH SACH FOOT (EB-I)COMPONENT WITH SACH FOOT (EB-I)

FROM DANANG CENTRE , FROM DANANG CENTRE , VIETNAMVIETNAM

PATIENTSPATIENTS

• FOLLOW-UP 28/34 FOLLOW-UP 28/34 TRANS-TIB. TRANS-TIB. AMPUTEESAMPUTEES

• AGE AT AMP. 22 y (13-AGE AT AMP. 22 y (13-44); NOW 44 y (20-57)44); NOW 44 y (20-57)

• WAR ORDNANCE 13, WAR ORDNANCE 13, TRAUMA 8TRAUMA 8

• IN WORKIN WORK• NO MOBILITY NO MOBILITY

RESTRICTIONSRESTRICTIONS• FOLLOW-UP AFTER 6 FOLLOW-UP AFTER 6

Mo and 11 MoMo and 11 Mo

• FOLLOW-UP 10/10 FOLLOW-UP 10/10 TRANS-TIB. TRANS-TIB. AMPUTEESAMPUTEES

• AGE AT AMP. 25 y (10-AGE AT AMP. 25 y (10-40); NOW 47 y (15-65)40); NOW 47 y (15-65)

• WAR ORDNANCE 3, WAR ORDNANCE 3, TRAUMA 7TRAUMA 7

• IN WORKIN WORK• NO MOBILITY NO MOBILITY

RESTRICTIONSRESTRICTIONS• FOLLOW-UP AFTER 5 FOLLOW-UP AFTER 5

MoMo

Sand-castingSand-casting Wu-castingWu-casting

CLINICAL QUALITY BENCH CLINICAL QUALITY BENCH MARKS FOR DW-COUNTRIESMARKS FOR DW-COUNTRIES

ISPO RECOMMENDATIONISPO RECOMMENDATION

• Patient CompliancePatient Compliance 95% 95% ++ 5%5%

• Not UsedNot Used 5% 5% ++ 5%5%

• Walks > 1kmWalks > 1km 90% 90% ++ 10% 10%• PainPain 10% 10% ++ 10% 10% • DiscomfortDiscomfort 10% 10% ++ 10% 10%• SatisfiedSatisfied 90% 90% ++ 10% 10%

SAND SAND

CASTINCASTINGG

• 89%89%• 11%11%• 79%79%• 36%36%• 32%32%• 89%89%

WU WU

CASTINCASTINGG

• 100%100%• 0%0%• 80%80%• 10%10%• 10%10%• 80%80%

SOCKET FITSOCKET FIT

Sand-casting Sand-casting Wu-castingWu-casting (3 (2-5) SOX) (3 (2-5) SOX) (1 (1

SOCK)SOCK)

GOOD FITGOOD FIT 19 (68%) 19 (68%) 8 (80%)8 (80%)

WIDE FITWIDE FIT 5 5 00

TIGHT FITTIGHT FIT 4 4 22

Circumference Circumference comparisoncomparison

  Patient 08 Patient 07 Patient 02 Patient 06 Patient 01

  Sand Wu Sand Wu Sand Wu Sand Wu Sand Wu

Patella tendon 33

32.9 30.5 29 33

32.7 37 35.5 36.5

37.2

(+4cm) 30 30 2928.

5 30.529.

8 33 33.2 33 33

(+4cm) 28 27 26.325.

8 27.526.

5 31 29 31.5 31

(+4cm) 25.5 24 24.824.

2 24.522.

8 29 27.3 30 29

  Patient 02 Patient 03 Patient 04 Patient 09 Patient 10

  Sand Wu Sand Wu Sand Wu Sand Wu Sand Wu

Patella tendon 32

30.3 34

33.5 33 30 38 36.5 29.5

28.6

(+4cm) 29.829.

4 3231.

4 30.5 28 35.5 35 27.5 27

(+4cm) 2726.

1 29.527.

2 26.5 25 34.5 32.7 25.3 24

(+4cm) 2523.

5 26.524.

6 2423.

5 31 30 24.122.

5

Difference CircumferenceWu < Sand-cast

Median Min Max Students'

TTEST

Patella Tendon 1.3 0.1 3.0 0.001

Patella Tendon + 4 cm 0.5 -0.2 2.5 0.045

Patella Tendon + 8 cm 1.2 0.5 2.3 0.0001

Patella Tendon + 12 cm 1.5 0.5 1.9 0.00002

CONCLUSIONSCONCLUSIONS

• DOES DOES NOTNOT ELIMINATE ELIMINATE INVOLVEMENT OF INVOLVEMENT OF PROFESSIONEL PROSTHETISTPROFESSIONEL PROSTHETIST

• WU-CASTING SYSTEM HAS WU-CASTING SYSTEM HAS GOOD RESULT OF SOCKET GOOD RESULT OF SOCKET FITTING COMPARE WITH SAND-FITTING COMPARE WITH SAND-CASTING SYSTEM.CASTING SYSTEM.

• NEED MORE INVESTIGATION NEED MORE INVESTIGATION ON IT.ON IT.