Shuttle lock release modification of a trans-tibial prosthesis with an obese client

This article describes the procedure taken to modify trans-tibial shuttle lock release mechanisms to decrease standard reach requirements in a case of limited mobility secondary to morbid obesity. The participant was a middle-aged, morbidly obese client with bilateral trans-tibial amputations. The distomedial shuttle lock release buttons were modified to activate with a cable/Dacron pull strap located proximal/lateral. The outcome of the modification was determined by whether or not the client would be able to independently doff the prostheses, if the patient was satisfied with the prostheses and by the condition of the components at the three-month follow-up. The client was independently successful at doffing both prostheses following the modification procedure. The patient expressed satisfaction with operation of the release mechanism but cosmetic covering was an issue. Components were optimally functioning at the three month follow-up. It was concluded that this procedure is a viable option for relocating distomedial release lock buttons more proximally when reach is limited. The procedure is not indicated in every case as gadget tolerance, cosmesis and manufacturer warranty issues must be considered.