Fabrication of a ZIP (Zwolle Isala Prosthesis) for transtibial prosthesis users

The Zwolle Isala Prosthesis (ZIP) is supplied as a transtibial prosthesis as the first prosthetic device within the multidisciplinary treatment team at the Isala Hospital in Zwolle, the Netherlands. The ZIP has the characteristics of a full prothesis, with all the features of a regular transtibial prosthesis.

Immediately after amputation, the lower leg is placed in an ORD. A cast is then applied to prevent oedema and the possible development of flexion contracture. Weekly cast changes take place in the plaster room to monitor this process closely, and after five to six weeks the ZIP is applied. The interplay between the plaster technician and the CPO in this process is essential. It is a team effort between two disciplines to deliver a functional lower leg prosthesis in two hours. Therefore, it can be considered a direct fitting method. The ZIP is individually sized and manufactured in the hospital plaster room. The ZIP is made from material that is regularly used in the plaster room (synthetic plaster). Special adapters are used to ensure correct power transmission between the socket and the foot. Major advantages of the ZIP are the short delivery time, lower cost of materials and re-use of the adapters.

In this session we will explain the process of providing ZIP, including a demonstration, and discuss the advantages and disadvantages.