Amputee Corner

Neil van der Merwe, in KZN, sent us this story of a plucky young survivor who he helped recently, Sthabiso.

It has been a long road for 22-year-old Sthabiso Ngongoma of Umkomaas, whose life changed forever when he was caught in the crossfire of a shootout on the way home from soccer training in 2004.

A stray bullet lodged in the teenager’s left leg, causing irreparable damage and, because of the severity of Sthabiso’s injury, doctors had to amputate his leg above the knee.

In 2007 a group effort between Vodacom, Netcare and van der Merwe and Uken Inc. made it possible for Sthabiso to receive his first prosthesis, three years after the shooting.

A decision was made to hand cast, using a silicone suspension system with an Anatomical design socket. The socket and prosthesis were a success and Sthabiso walked with this prosthesis for a few years.

But Sthabiso was growing and we realised that he should be remoulded for a new socket as he had outgrown the old socket. Vodacom generously agreed, for a second time, to donate the money for a new prosthesis.

A few months before we started the second prosthesis for Sthabiso, we attended a course on the Otto Bock S.I.T casting method. The new casting technique was extremely impressive and, as a result, we purchased this casting apparatus from Otto Bock.

The S.I.T cast apparatus consists of an adjustable frame with various size ischial containment casting moulds.

After using the apparatus it was clear that this would be the casting method of choice.

The principle behind the S.I.T casting method is hydrostatic pressure with an anti-rotation bony lock of the Ischium and Greater Trochanter.

What this means in layman’s terms is that we were achieving our ultimate goal when manufacturing a prosthesis.

As all Prothetists will know, creating a perfect prosthesis is not an exact science. But since the introduction of the S.I.T casting apparatus it is now possible to have that extra “exactness” that was always lacking with our first prosthetic sockets.

Sthabiso’s residual limb was moulded using the S.I.T method. Sthabiso is an easier candidate (very slim, well defined bony prominencesand athletic) for casting, but we have also found this new casting method successful in our other patients.

We decided to cut a posterior (back) and an anterior (front) window in the hard outer shell which would aid him in sitting on a hard surface like a toilet seat.
After gait analysis and a bit of fine tuning, Sthabiso walked like a pro.Sthabiso is currently studying engineering at university which was sponsored by the Vodacom foundation. I would like to thank Vodacom foundation for digging deep for this patient and fulfilling their promises, as they said they would, to make Sthabiso’s dreams come true.

The proof of the pudding - Sthabiso going up steps...

... and coming down!

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