Alternative to amputation for many wounded warriors

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Troops coming home with injured legs are requesting those limbs be cut off instead of saved. Advances in prosthetics are a major reason why. But now a breakthrough that some believe could be the most significant orthopedic advancement to come out of the war on terror, has many wounded warriors reconsidering.

Sophisticated prosthetics allow military amputees to run and return to duty. Those whose limbs are salvaged haven't been so lucky.

"Every time I took a step, it felt like walking on a bed of nails," said Sgt. Ammala "al" Louangketh.

That's why he considered having his leg cut off after it was riddled with bullets in combat.

"It's a very difficult decision," said Joseph Robert Hsu, M.D., chief of orthopaedic trauma at SAMMC in San Antonio.

Before wounded warriors make that decision, Dr. Joseph Hsu is offering them another option.

"The IDEO has been a real game changer for us," said Hsu.

"It feels like putting on a new leg," Louangketh said.

It's the return to run program at the center for the intrepid. After surgery and lots of rehab, injured service-members strap into the IDEO. Since his leg was mangled in an IED attack, specialist Caleb Redell has problems walking on his own, but as soon after putting on the IDEO, he can jump!

"It was exciting," said Redell. "I haven't done anything like that since I got hurt."

Captain Victor Munoz struggles to walk since his legs were crushed by a drunk driver, but with two IDEO he can sprint!

"I wear them as much as I can just because I feel much more normal and pain free," said Munoz.

Developer Ryan Blanck says the brace supports the wearer's weight, which can help relieve pain. Struts connect the top and bottom, giving wounded warriors back the ability to thrust their bodies forward. Blanck says while some who try IDEO do decide to go through with amputations, he's seen a lot of people change their minds.

"I may not be back to 100 percent, but I'm going to give 110 percent," Louangketh said.

There are more than 200 wounded warriors using IDEOS in the return to run program. Hsu says he could probably have thousands in it, but right now it's not an officially funded program. He tells us efforts are underway to change that and to eventually make it available to civilians.

Additional Information:

WHAT IS THE IDEO?  The Intrepid Dynamic Exoskeletal Orthosis, or IDEO, was designed by prosthetist Ryan Blanck at the Center for the Intrepid. It is a custom-fit device made from carbon and fiberglass that supports the foot and ankle and resembles an amputee's running prosthetic. The energy-storing orthopedic device, along with an extensive rehabilitation program, is allowing wounded warriors who previously had difficulties walking or standing due to lower leg injuries to run again.

HOW IT WORKS: The IDEO is custom-made using a mold from the warrior's leg. The three piece device fits in shoes and boots. The top piece that is shaped like the top portion of a prosthetic leg is placed just below the knee. Both pieces are held together by a sturdy and flexible support bar. The upper and lower sections are joined by a carbon fiber dynamic response strut system originating from prosthetic technology used with the high-activity amputee population within the Department of Defense.

In order to maximize the full benefits of the IDEO, warriors go through extensive rehab sessions. During the initial sessions, warriors are trained on how to step with the device. As they progress through the rehab, they are introduced to more stringent training that involves running and jumping up and down and side to side. Then weights are introduced into the rehab.

THE STUDY: A study performed at The Center for the Intrepid found that the IDEO improved performance 10 percent to 37 percent when compared with three commercial braces. Performance measurements included walking speed over smooth and rocky terrain, the ability to climb stairs, the 40-yard dash and other tests of speed and agility.

HIGH PRAISE FOR IDEO:  Dr. Michael Bosse, clinical chair of the Major Trauma Extremity Research Consortium and an orthopedic surgeon at the Carolinas Medical Center in N.C., said that the IDEO has the potential to be one of the most significant medical advancements from the wars in Iraq and Afghanistan.

"This will change the game for patients that don't get amputations," said Bosse, who has seen the device in action and has no financial stake in it. "And the long term benefits for society are potentially huge."

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