Silicone Feet & Hands

People living with partial hand and foot amputations now have a new option in the Triangle. Surprisingly, not many people realize that custom silicone is an option after partial hand or foot amputation.

Highly realistic silicone devices address physical and emotional needs. For example, a partial hand amputee may be unable to grasp a cup without a partial hand prosthesis. The prosthesis provides passive function, grasp, and extension. In some cases, realistic anatomical restoration is key to the user’s physical and emotional healing.

Whereas some people require realism, others may focus more on function. Or perhaps their funding source will not cover a highly realistic prosthetic design. In these cases, we offer functional custom silicone devices that offer the functional restoration without the focus on realism.

In order to determine the right prosthetic design for the user, we recommending scheduling a free consultation with our team. To schedule a consultation, simply call our office. Our care coordinators are happy to guide you through the process.

3D Print Innovations

3D printing has become more common in orthotics and prosthetics, in part because it enables greater precision and limitless design possibilities. Our on-site fabrication lab includes a 3D printing room dedicated to printing unique orthotic devices for lower limbs.

We designed this brace to fit intimately and naturally around this person’s ankle. Though the brace is a single piece, it includes areas of flexibility and rigidity. That means that the brace is comfortable, yet supportive.

These 3D braces are typically much lighter weight and more streamlined than other types of custom ankle foot orthoses (AFO), such as leather braces. The low profile design also fits much easier into shoes, which improves long term wearing compliance.

We offer many different colors, including grey, black, blue, purple, and pink. Customizing the color of the brace is one way we can address the emotional needs of the person using it.

3D printing may still be relatively new to orthotic and prosthetic practices, but we’ve embraced this technology – a technology that has opened new doors for our patients.

On-Site Fab is Key

Modification of a plaster cast to ensure proper stability and patient comfort

“The biggest benefit to fabricating our devices on-site is that we have the opportunity to manage every step of the process. We can customize out-of-the-box designs, combine different technologies, and make sure that every component is built to our standard. Our technician and I work together to address every detail, from the quality of the cast, the finish of the socket lamination, alignment, height, and the final appearance of the prosthesis. The appearance of the prosthesis is important because we want patients to play a big part in customizing the way their devices look. Each prosthesis is unique and special. 

Experienced technician, Jim Glover, removes a diagnostic socket from the cast

I like providing tours of our Durham fabrication lab because I can show patients that every step of the fabrication process is being managed by me, the person responsible for their care. If I sent the fabrication out to a fabrication company, I wouldn’t have control over the quality of what I’m providing. I know every detail has to be right and, because of our on-site fabrication, we can hold ourselves accountable to that. 

Brian M. Gold, CPO, reviews all measurements for accuracy

My personal favorite part of the fabrication process is the hands-on plaster work, assembling and aligning the components, achieving a great socket fit, and then making sure things look great from an artistic perspective.” 

-Brian M. Gold, CPO, Bio-Tech Prosthetics & Orthotics

The 1st Bio-Tech Adaptive Swim Clinic (BASC) was a success!

August 24th 2019 marked our first Bio-Tech Adaptive Swim Clinic (BASC) event. A HUGE thank you to all the volunteers, participants, and the amazing staff at the Edison Johnson Aquatics Center in Durham! Our goal was to create an opportunity for people living with amputation to gain confidence in the water while surrounded by peers and plenty of support. With the help of US Masters Swimming instructors, therapists, and other medical professionals, we experienced progress, enjoyed emotional connections, and had lots of FUN!

Some participants used prosthetic devices specifically designed for use in the water, while others left their devices on dry land.

Swim instructors from US Masters Swimming, as well as therapists and medical professionals from DukeUNC and Elon partnered with Bio-Tech staff to guide participants through swimming basics.

We all felt the benefit of a team approach, particularly when the transition from swimming with full assistance to swimming independently occurs during a single session!

A sincere shout-out to Dennis Bongiorni, retired Chief of Physical Therapy with the Veterans Administration, Michael Murray, PT, DPT, Aquatic Physical Therapist with Duke Physical Therapy Sports Medicine, and US Masters Swimming for helping us design a unique curriculum that combined adult learn-to-swim instruction, water therapy, and emotional support.

We received very useful feedback from our participants and volunteers and are currently in the process of scheduling our next swimming event.

Future Bio-Tech Adaptive Swim Events (BASC) will be posted soon. If you would like more information about our BASC events, please contact Jennifer Robinson at 919-471-4994 ext 1469, or email

For more information on adaptive sports, check out Disabled Sports USA, which provides opportunities for individuals with disabilities to develop independence, confidence, and fitness through participation in sports.

Photo credit: Heather Davidson, CO, Pediatric Orthotist, Animal Specialist, Bio-Tech

Mr. James Shaw’s Story ​

My Dad left us when I was 12, so I had to go to work, since I was the oldest of the children. I’d sign my paycheck over to my Mom, so my 8 brothers and sisters would have food to eat.

I met my wife in junior high school. We got serious in the 11th grade and got married 2 years after high school.

Mr. James Shaw

Been married 39 years now. We have 9 kids of our own, 5 adopted kids, including 2 sets of twins, 27 grandkids and 2 great grand children.

So, now when I go fishing, I don’t clean the fish, ’cause the kids’d take ’em. I love my kids, but I want my fish for my wife and me to eat.

“I worked for a moving company in New York for 30 years, then worked for Burroughs Wellcome here in Durham and at American Tobacco and the Durham Bulls Athletic Park in security. Had to walk from one end of the park to the other checking locks and such.”

My ankle started hurting really bad, and when my wife said to take my shoe off, we found a big sore on my left foot. I had to start wearing a ‘Frankenstein’ boot, but the sore got worse and gangrene set in.

Mr. Knoop’s Story

“They’re personable and professional at the same time.
I wholeheartedly recommend BioTech to anyone.”

I was an advanced practice nurse, before I retired. In fact, I was a psychiatric mental health clinical nurse specialist. We worked with a lot of soldiers from as far back as Vietnam all the way up to Desert Storm and the current wars.“Four years ago, I was diagnosed with multiple sclerosis, so my goal has become to control the rate and speed of my physical descent as I get older. My right ankle was also destabilized, which made it very difficult to walk.

At first, I tried to make my own orthosis, but it didn’t work well. My internist recommended Bio-Tech, and I was pleasantly surprised the first time I met Michael .

They took a great deal of history on me, as far as what I’ve done that was helpful or not. They talked about my options and seemed to know as much about the muscles and bones in the foot as the doctors I’ve worked with.  So I was impressed by their expertise.

Once I showed them the problem with my ankle inversion and eversion, because of the destabilization, we discussed the advantages and disadvantages of using an existing orthosis versus a custom-made one.

They took a cast of my ankle to be able to create a custom fit. The first orthosis Michael gave me rubbed on my ankle and created a sore, so I went back, and they fixed it. Now my ambulation and gate are much better. Without the orthosis, walking causes a lot of strain on my knee, hip and ankle. But with the orthosis, there’s no pain when I’m up and walking.

“The team at Bio-Tech is very patient driven and quite knowledgeable. They’re another set of healthcare providers who help me manage as much functionality as possible, dealing with my MS.”

The way my ‘gizmo’, as I call it, works is to stabilize my foot to the baseline, it gives the starboard side lift that I needed, and it protects my knee from stress. I can’t drive with the gizmo on, but it’s a lot easier to walk.

Another thing that impressed me about Michael and his team is that they were teaching advanced students about orthoses and prostheses. That really keeps them on their toes, because Bio-Tech’s staff has to keep up with continuing education — those students asked a lot of tough questions.

It was nice to see that Michael was giving back by helping out the students. I was even more impressed after that experience with them.

The team at Bio-Tech is very patient driven and quite knowledgeable. They’re another set of healthcare providers who help me manage as much functionality as possible, dealing with my MS.

When I have an appointment to check on things with Michael, I don’t mind waiting a bit, because I know he’s going to spend as much time as necessary with me.

They’re personable and professional at the same time. I wholeheartedly recommend Bio-Tech to anyone.

Catherine’s Story

“Recovery happens in stages.”

In 2014, Catherine went on sabbatical from her career as a psychotherapist to try her hand at real estate. The day before her recently flipped house’s first showing, as her final task, Catherine climbed up a ladder to clean the exterior windows, really wanting to make the house shine before its debut. Her hard work and courage had finally culminated into this moment. The next thing Catherine remembers, though, is lying on a pile of dirt and mulch, having fallen off the ladder and severely breaking her ankle, though she didn’t yet know how severe her injury was. In the ambulance, she says, she gabbed about her kids and cracked jokes with the EMTs and genuinely thought she’d be back home later that evening. It wasn’t until they wheeled her into pre-op of the Emergency Department, in front of a large team of physicians and nurses, that she realized the gravity of her situation.

Catherine’s great recovery

The next six months included a series of operations in an attempt to save her leg, riddled with infection, the bones too stubborn to heal properly. Luckily, she had an amazing medical team, supportive friends and family, and was able to speak with Duke amputee nurse Nancy Payne and Mike, the owner of Bio-Tech. With their guidance and support, Catherine knew the best thing for her was a below-the-knee amputation, which she elected to have in February 2015. The healing from the amputation, she says, took about 2-3 months. She explains, “I gained 40-50 lbs. in that wheelchair! Now it’s the body image that bothers me most…not the leg! But, you see, it’s important to recognize that it’s a process. Recovery happens in stages. I had countless setbacks, but I knew that this would get better. I mean, it’s difficult at first and it will get better. This too shall pass. I just wanted to get out of that chair! I just wanted to move!”

“Things improved a lot after getting the leg. I saw this interview with one of the Boston Marathon victims and she said, ‘It’s just my leg. It’s not my whole life.’ And that resonated with me. I realized that there’s no right or wrong way; it’s what works for you.”

When Catherine received her first prosthesis, what she calls her “beginner leg”, she presumed she’d put it on and simply walk away. For her this was not the case, she explains. “I could not walk on it. I had difficulty adapting.” But the Bio-Tech crew was patient and accommodating that May in 2015 as she transitioned, ensuring her comfort with every step, just as they are now as she transitions into her next, second socket, having outgrown her training wheels. She elaborates with a sigh of contentedness, “Things improved a lot after getting the leg. I saw this interview with one of the Boston Marathon victims and she said, ‘It’s just my leg. It’s not my whole life.’ And that resonated with me. I realized that there’s no right or wrong way; it’s what works for you.”

When asked what she was like before her accident, she describes herself as very active and totally ambulatory. But when asked to describe herself now, she pauses to think, finally answering, “Well really, I’m a busy and active person now. Planning for my days was different when I had all my limbs; now I have to think about my activities for the day ahead of me and think through it more, strategize what I’ll need to take care of my leg.” Otherwise, the amputation hasn’t slowed her down at all, she claims. “You absolutely can return to a high-functioning, very active life. I never would have called myself ‘strong’ before my accident. But it took something major like this to make me look at myself and say, ‘Whoa! You’ve got strength in there to pull this off! You can and will move forward!’”

Valentine’s Day Prep: Healthy & Happy Hearts!

Whether we’re celebrating a close family member, a great friendship, or a romantic partner, here are some simple ways to fill our hearts with joy and health!

1. Switch out candies for exotic fruit.

This is a health no-brainer, plus fruit displays can light up a room with eye catching color.

2.Opt for dark chocolate.

It’s a healthier alternative to milk chocolate, yet still satisfies the sweet tooth. 

3. Create one-of-a-kind cards.

We don’t have to spend a lot to make a big impression: hand written notes of appreciation go a long way.

4. Don’t stress over the plans.

Sometimes the most meaningful act is shared relaxation. 

5. Home cooked dinners can be win-win.

Cooking dinner at home allows for more personal dish choices, lower cost, and better portion control. And no reservations or waiting required!

Foot Care After Toe Amputation

I am diabetic and recently had my toe amputated. I have been fit with a custom shoe insert with a ‘toe filler’, which I wear with my diabetic shoes.What can I do to protect my remaining toes?

People living with sensory diabetic neuropathy may not be able to feel pain, cold, or heat in their feet. For this reason, daily self-examination is essential in preserving health and mobility.

How Often Should I Check My Feet?

Feet should be examined daily.

What am I Looking for?

  • Cuts, scratches, blisters, or any other skin irritation.
  • Discoloration, redness.
  • Excessive warmth or pain to touch. 
  • Ingrown toenails, calluses, corns.

What Else Can I Do?

  • Wear socks and properly fitting shoes.
  • Keep feet clean and moisturized.
  • Ensure toenails are appropriately trimmed and shaped.
  • Following up regularly with a dedicated healthcare team can help keep blood glucose within range. Healthcare team members will also perform foot examinations. 

Contact your doctor if you notice any skin irritation during your daily check. If you experience problems with the fit of your custom insert, contact your orthotist to schedule a follow-up appointment. 

To learn more about living with diabetes, check out The American Diabetes Association.

The contents of this article are for informational purposes only and do not constitute medical advice. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. In the event of a medical emergency, call a doctor or 911 immediately. 

5 Tips for Orthotic & Prosthetic

Users Who Need to Get Things Done Despite Snow.

#1 Traction, Traction, Traction

Snow and ice are slippery and uneven, which can be a recipe for disaster for someone using a brace or artificial limb. Removable shoe, crutch, and cane spikes dig into the ground so people, and devices, stay put.

#2 Stay Updated on Weather Forecasts

Whether watching our favorite weather forecaster on TV, tuning in to the radio, or using an app on our phone, keeping our eyes on current and projected storms can help us prepare and avoid problems. 

If a storm looks particularly worrisome, it’s time to kick the preparations into high gear.

#3 Stock Up

The Red Cross provides recommendations on how to prepare an emergency kit of supplies, water and canned goods, in addition to creating an evacuation plan and staying connected with friends, family, and neighbors. 

#4 Drive-Through Grocery Pick-Up

For a small fee, stores like Harris Teeter allow shoppers to order online for drive-through pick up.

​It takes several hours between the time the online selections are made and when they are ready to be picked up, so this requires planning and time. 

#5 Keep Limbs (and Residual Limbs) Moisturized and Warm 

The winter weather can make sensitive skin dry and more susceptible to breakdown. A skin lotion, recommended by a physician or practitioner, can provide protection, especially when a brace or prosthetic limb is required during the day. At night, many people find that compromised and residual limbs are more sensitive to colder temperatures. Sleeping with socks, and prosthetic socks for amputees, can help keep the limb at a more comfortable temperature. Electric heating pads, though they might sound like a wonderful idea, could cause burns and should not be used at nigh