Dr. Nuzzo AFO Replies

Dr. Nuzzo AFO Replies

Derek Kozar, M.Sc., C.O.(c)

2/12/2018

Below is original post.

 

I have a client (9 year old male, average height and weight, spastic quad

CP) that had SPML surgery with Dr. Nuzzo. Parents want the AFO's that he
prescribes following surgery. Here is the You tube link

 

www.youtube.com/watch?v=j3DAViw1XHg

 

I am not opposed to doing this for the family, but am interested in your
feedback if you have worked with Dr. Nuzzo.

 

He is talking about a polyethylene, but I just can't see how that would
stand up? What have you used for materials???

 

 

Here are the replies..

 

 

 

I've always used 3/32 copoly with elastic velcro straps.

 

--------------------------------------- My guess is that he means copolymer.
What was the surgery for and what kind was it? Is the kid ambulatory?
Spastic quad? Mild, I hope.

I made one for an ambulatory child at the parents insistence. I watched
over for about 5 years as the child's feet collapsed into deformity, worst I
have ever had to work with. Eventually the pt lost the ability to walk
through out the day. He is now in a wc full time. It was horrible.

 

Please avoid doing this, and please leave my name off any response to the
list.

Thanks Derek for sharing this video. The idea intrigues me, but I too do not
know how polyethylene will hold up. I am not sure of the term fatigue
resistant PE. Also the motion of the brace will be very different when it is
on the patient due to the strapping.

Alex

Oh God please, this will be a disaster. All that flexibility is going to let
that kid do whatever he wants - where is the control ?? I'm all for dynamics
but at the same time you have to maintain skeletal alignment and that is
just not going to do it on a 9 year old CP. Of course the parents will love
it because the kid will seem quick and mobile, until his calluses get so out
of hand that he can't even wear the brace.

 

I happen to be at an adult clinic right now as I type this and all I see are
adults either wheelchair bound or in horrible alignment with terrible lack
of mobility and it's all because they started out with little or very poor
management when they were children.

 

AND .... A WELL CONTROLLING ORTHOSIS DOES NOT = A HEAVY ORTHOSIS !!! I am so
damn tired of well fitted controlling braces with the appropriate balance of
rigidity and flexibility getting the reputation of being heavy. That comes
from idiots who never knew how to design a proper brace to begin with nor
with an understanding of the properties of materials available to our
profession.

 

And as for allowing the patient to feel the floor ?? What a load of shit ! I
guarantee that 9 year old only wants to get from point A to point B and
doesn't care how it happens. How about allowing him to live a life when he
is skeletally mature pain free and mobile. I'd rather see that happen.

 

Sorry, you caught me with time on my hands. I've been specializing in Peds
bracing for 36 years, seeing patients in prominent rehab centers throughout
NYC, Westchester County and North and I am busier than ever due to
attrition; because morons who don't know what they are doing are creating
problems that I am called to fix. Only problem is due to cuts in codes, I'm
busy with more of what we can't get paid for. I don't CFab. I do all custom
in house, as it should be. CFab is another topic for discussion that in many
cases leads to further disaster.

 

Thanks and have a great day,

I have seen several of Dr Nuzzo's patient. He is a very good doctor and I
have seen good results from kiddos that I have seen that have travelled to
see him for various surgeries. I had one patient with a severe scoliosis
that no one else would do surgery for due to cardiac issues. He did a muscle
release and saved her life. Her cardiologist was amazed at how well she was
breathing afterwards.

 

We have had SureStep make them out of a thin copoly and they have held up
very well.

That seems to me to be counterintuitive but he's the physician. I'm open to
trying anything reasonable but I'm curious the feedback you will receive. My
first thought is 1/8 or 5/32 MPE not LDPE.

 

 

Thanks to all

 

 

 

Derek Kozar M.Sc., C.O.(c)

Certified Orthotist

Clinical Orthotic Consultants of Windsor, Inc.

316-3200 Deziel Dr.

Windsor, ON

N8W 5K8

519-944-8340 (office)

519-944-8360 (fax)

519-982-1747 (cell)

 


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