Amputee Corner

Our national soccer team was knocked out of the first round of the 2010 world cup but still, I was mesmerized by that game against France. Despite all odds, our boys never gave up! It must have been only sheer will power that pushed Bafana Bafana to beat that goliath of a team in a 2-1 victory.

Nine year-old Xolisa Sikawu needed all of his will power when he underwent bilateral amputations just a year after the passing of his mother.

Now, six years later, Xolisa is still pursuing a full life and, thanks to the Sabrina Love Foundation, obtaining a prosthetic upgrade.

The Sabrina Love Foundation provides children who have physical disabilities with financial assistance towards equipment, medical treatment and other professional needs.

Chopart, Lizfranc carbon plates and Symes feet were specifically designed for the challenging low build heights found in cases such as mid-foot and ankle disarticulation amputations. We Prosthetists often use these brand names to describe the various types of amputation.

In a chopart (a type of midfoot amputation) there is almost no space underneath the residuum (stump) for a prosthetic foot.

This means that the only options that are available to prosthetists are variations of carbon plates that provide the patient with an energy storing lever to help with propulsion - but with no shock absorption on heel strike.

With the normal ankle still intact in this level of amputation the shock absorption should, theoretically, be accommodated by the mobility of the ankle itself. In reality a large number of these chopart amputations are left with a very rigid ankle in equinus, unable to perform its normal range of motion.

That means, in a normal chopart prosthesis with the chopart carbon plate attached directly to the bottom of the socket, that all the force generated by heel strike is transmitted through the prosthesis into the rigid ankle - resulting in a most unpleasant experience for the patient.

Xolisa is now 16 and an amateur soccer coach. He has a rigid and sensitive left side chopart with very little soft tissue covering the residuum. As he is a bilateral amputee, with a symes amputation on his right side, we could approach this chopart case differently.Lengthening his height by 3cm provided us with enough space to fit components with a slightly higher build height and, more importantly, gave Xoliswa a foot on the chopart side that absorbs the shock of heel strike. The chopart amputation was fitted with one of Ossur’s Flex Symes, complete with an active heel, and the Symes amputation was fitted with Ossur’s low profile Variflex with EVO, providing high energy return and superior flexibility.

The more natural gait provided by the EVO feature reduces fatigue and puts less strain on the lower back and other limb. The chopart prosthesis also incorporated a custom made silicone distal cup for added comfort.

To inject some personality into the prostheses (and in the spirit of the 2010 world cup) the pair were laminated with Xolisa’s favourite team’s logo, Bafana Bafana.
Go Xolisa, Ayoba!

If you would like to submit an article for this column please contact us in order to obtain the criteria and patient indemnity form. The completed form should be emailed, with the story and hi-res pictures of the patient and their prosthesis.

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