John Michael's Corner Welcome to the intersection of orthotics and prosthetics in cyberspace!
This month will highlight the presentations from the "Skin, Sockets, and Interfaces" segment of the International Conference of Advanced Prosthetics, and offer a clinical tip on minimizing the rotary forces on the socket for the short transhumeral amputee who uses externally powered components. The first of a series of reports on the Orthopadie + Reha-Technik World Congress in Leipzig, Germany will also begin this month.

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International Conference of Advanced Prosthetics (ICAP)

The second part of the report from the ICAP meeting follows, covering the "Skin, Sockets, and Interfaces" segment. The final segment will appear in next month's Corner. If you are interested in more information, the entire proceedings will be available on NTSC videotape for purchase from the Flex-Foot site at

  • Skin Problems of the Amputee - William Levy, MD presented an extensive overview of various dermatological problems that can be associated with wearing a prosthesis.
  • The Evolution of Soft Inserts - Terry Supan, CPO presented a nice overview of the evolution of soft inserts from the traditional leather and Kemblo materials, to the polyethylene foams such as PE-lite, to today's elastomeric silicones, polyurethanes, and related materials.
  • Liner Systems - Carl Caspers, CPO summarized some of the basic characteristics of common liner materials.
  • Ischial Containment with Elastomeric Suspension Sleeves - Jan Hattingh, CP reported in detail on his clinical observations combining ischial containment concepts with elastomeric suspension sleeves.
  • Teaching Ischial Containment Principles - Tim Staats, EdD, CP concluded this segment by reviewing the method he uses to teach Ischial Containment principles to the students at California State Domingues Hills University.

Orthopaedie + Reha-Technik World Congress 2000

An estimated 10,000 people attended this triennial congress being held in historic Leipzig, Germany from May 30 - June 2. This is the best opportunity for companies to showcase emerging technology and products to a primarily European audience, so it is often a good place to see for yourself what will be appearing in the USA and elsewhere over the next year or so.

Few of the scientific presentations I attended had anything new or significant to offer. Most of the ten-minute talks were simply highlights of established principles or practices, or thinly veiled spiels for commercial products. Also, there was little scientific substance in most lectures although the widely respected technical skills of the predominantly German speakers was clearly evident and a pleasure to see.

Despite the presence of two large exhibit halls filled with products and technologies, there was not one stunning innovation that stood out as the "buzz" of the meeting. For the most part, all the advances were incremental and most had already been seen at other major meetings in previous years.

I will highlight some of the more intriguing new concepts in this and subsequent Corners, but it is probably significant to note that the most striking novelty discussed by most attendees was the gaggle of male and female models wearing only G-strings and body paint who roamed the exhibit area, courtesy of one of the European distributors, and posed for T&A photos. A number of attendees commented that this created an aura more appropriate to the Reeperbahn sex shops than to a rehabilitation congress.

  • The Future of O&P - a series of speakers presented short papers on differing aspects of the evolution of O&P practices, technology, business, and education
  • Upper Limb Prosthetics - case studies by Wolfgang Bierwirth based on his experience in Switzerland with high level transhumeral amputees.

Clinical Tip - "Balancing the forearm" for short transhumeral residual limbs