The use of the shuttle lock system for problem trans-femoral suspension.

Case 1 MG is a 61 year old arthrosclerotic amputee who, following a right popliteal by-pass graft, required a left auxiliary bifemoral by-pass. Unfortunately there was a problem with healing and the vascular graft became exposed in the left groin. The vascularity of the tissue below the transverse abdominal scar was severely compromised and on surgery, it was found there was no viable rectus muscle remaining. The abdominal skin was utilised as a trans-position flap based on the contralateral superficial inferior epigastric vessel. The wound margin of the flap, however, underwent necrosis and further exposure at the graft and the rectus femoris muscle flap was utilised to cover the vascular implant. The wound at the right leg, however, failed to heal and amputation was required. The result was a very tender heavily scarred abdominal wall which could not tolerate a belt of any sort (Fig. 1). Management was by way of an ICEROSS suspension sleeve with the shuttle lock incorporated within the thigh section of the prosthesis. The prosthesis was a hand wrapped ischial containment type thermoplastic socket attached to a Blatchford semi-automatic knee lock and multiflex foot. The patient found this easy to apply and lock and it also gave excellent suspension and comfort resulting in no pressure on her abdomen and no pain over the grafted scarred abdominal area.