AOPA Annual Meeting in Reno, Nevada

This year's AOPA meeting was well attended but there was no special "buzz" regarding any particular aspect of the program or the exhibit hall. Although I sat in on as many scientific sessions as possible, none that I heard were particularly noteworthy. There were several clever new products on display, but most I had already seen in Iceland, and they have been highlighted earlier in this Corner.

There were a few products that caught my eye in Reno. There seemed to be a lot of interest in the new adjustable heel-height foot being shown by Freedom Innovations. What made it unique was the integrated "slide-n-rotate" mechanism that kept the length of the anterior lever arm nearly constant, from a flat heel to a 2 inch [50 mm] height. Since it is combined with a carbon fiber keel, this should result in a foot that is dynamically responsive regardless of the footwear chosen.

The New Generation is one of my "can't miss" exhibitors because they always have some new and clever, timesaving tool or product that other practitioners have found useful. This meeting, they were showing the Drill-Out ® power extractors. The M-10 size would be perfect for drilling out that stubborn, salt-stained foot bolt that has rusted in place even though the prosthesis "has never been anywhere near the ocean"! The Drill-Out ® is a left-hand bit combined with an extractor on the same shaft, made by a company called Alden Corporation.

For the larger sizes, the bit and extractor are machined in series, so you simply chuck the tool in the chuck of a drill that is slowly running in reverse and start drilling. Once the bit has penetrated a few millimeters, the extractor will grab the broken bolt and back it out.

You can contact TNG at 800-327-3036 or fax them at 301-587-2750 for more details, or go online to the Alden Corporation site at www.aldn.com/index.htm . Alden also makes an equally useful tool to remove screws with stripped heads call X-Out™. Click here to download a video clip showing how this works, or visit the Alden web site.

Scott Orthotic Labs was showing a couple of clever modifications to familiar orthoses. One was a leather, prefabricated calf corset attached to a rocker boot they call Zero-G™, intended to partially un-weight the at-risk foot. The patient inserts a 12 mm "donning pad" inside the foot section and then uses hook and loop closures to snug up the calf corset. When the "donning pad" is removed, the foot is partially un-weighted and the padded foot cover is wrapped over the dorsum of the foot.

They also have modified the traditional hyperextension orthosis by adding ratcheting one-way hinges at the lateral midlines. This allows the patient to fasten the lumbar strap easily, even while seated, with the trunk in a slightly flexed position. The patient then pushes gently on the sternal and pubic pads, and the orthosis clicks into progressively more extension and holds the spine in the corrected position.

Reader Comments: Read all user comments ertl procedure Please help! After 3 failed total ankle replacement surgeries (along with a subtalar fusion) I am exploring the option of a bka in the hope of getting on with my life. I have been trying to do as much research and be as informed as possib... read more - robyn hanek   9/13/2004 Need referral I need a referral to a doctor that performs the ertl procedure in either Kern County, Tulare County, or Kings County. Bakersfield, Porterville, Visalia or Fresno. Please respond. Thanks, Sharon LaScala (559) 784-3604 - Sharon LaScala   1/13/2004 Re: Need referral I think the most updated source for such information is the Ertl web site at www.ertlreconstruction.com. Since Dr. Jan Ertl is in Sacramento, you may wish to speak with him. --John Michael CPO - John Michael   1/13/2004 Need to find out about limb extention    I have not heard from any doctor yet, so I am going to put my self out on all the medical sites I can find, and maybe just maybe, I can get someone who will be willing to help me reach my goal.  I can wear my leg to do stuff around th... read more - George L. Velazquez   1/10/2004 Re: Need to find out about limb extention If I understand correctly, you are interested in learning whether you are a candidate for surgical limb lengthening. You will need to meet with an orthopedic surgeon with experience in this technique. I'm not aware of any lengthenings for... read more - John Michael   1/10/2004 Feliz Navidad y Prospero Año Nuevo 2004. Ciudad de Mexico 24 de Diciembre, 2003. Estimado John Michael, CPO: le enviamos un afectuoso saludo con motivo de esta Navidad y le deseamos lo mejor para el proximo año 2004. Muchas gracias por su arduo trabajo de informacion, en favor de... read more - Alberto E. Castillo Moreno O.P.   12/23/2003 Re: Feliz Navidad y Prospero Año Nuevo 2004. Thank you, Sr. Castillo, for these kind words of encouragement. Despite the ongoing work required to keep this forum timely, I am honored by the scope of readers worldwide who share my passion for P&O information. As we end another year, ... read more - John Michael   12/24/2003 The Ertle Procedure As a physical therapist and athletic trainer, who has focused on comprehensive rehabilitation following limb amputation, I find this interaction regarding surgical technique very exciting. I have had the privilage of training Paralympic at... read more - David A. Lawrence   12/9/2003 ertl controversy Greetings; in my exploration of the Ertl Procedure, I've found much positive commentary on the results. However, on a few occasions I've seen reference to a controversy around the procedure, although there was no information regarding said... read more - Robert Mercereau   12/6/2003 Re: ertl controversy Robert, I know all the ins and outs of the Ertl because I'm an Ertl amputee myself. My surgery was 6/3/03 in Columbus, Ohio so it's all still very fresh in my mind. The pros for me were (and still are) numerous--I can walk, jump, jog, bike,... read more - AJ Johnson   12/9/2003 Re: Re: ertl controversy AJ....I posted a message on this site but have not gotten any feedback yet so I'm hoping you have some info on my questions about the ertl procedure...1) why aren't there more surgeons who perform it since it seems to be a better amp proced... read more - robyn hanek   9/14/2004 Re: ertl controversy Why the use of the word controversy? Before John Michael’s columns the only other place I could find the word used in connection with the Ertl Procedure was for presentations at the annual meeting of the American Academy of Orthopedic Surge... read more - Vicki Anderson   12/9/2003 Re: ertl controversy The previous Corners on this topic are archived and represent my best effort to present the available information without either excessive hype or blatant prejudice. The Drs. Ertl's clarifications and comments are posted this month. Start... read more - John Michael   12/6/2003 Re: ertl controversy Robert, you can get a lengthy review at the newly launched Ertl website www.ertlreconstruction.com . I agree, you are certainly entitled to look at ALL available options. In my mind, having personally witnessed the procedure performed in ... read more - Anthony T. Barr / President of the Barr Foundation   12/6/2003 REQUESTING ADVISE DRs, BOTH OF MY SHOES HAVE SHOWN SIGNS OF UNEVEN/EXCESSIVE WEAR ON THE OURSIDE OF THE HEEL--MY FEET BEND OUTWARD. I HAVE TRIED TO CORRECT THE MISALIGNMENT PROBLEM BY WEARING A PRODUCT CALLED "PHASE 4 ORTHOTICS." I HAVE LITERALLY BROKEN... read more - RONALD BIDERMAN, MS, LADC, ICADC   12/3/2003 Re: REQUESTING ADVISE Thank you for this question. You don't need a different product until you are evaluated by someone who knows something about the biomechanics of foot orthoses. Once an office exam has established the biomechanical reason why your shoes we... read more - John Michael   12/6/2003