Re: UE prosth challenge
JTAndrew
Description
Collection
Title:
Re: UE prosth challenge
Creator:
JTAndrew
Text:
In a message dated 4/7/98 9:31:16 PM, <Email Address Redacted> wrote:
<<Dear Colleagues:
I am part of the Limb Enhancement clinic in my that state that is currently
seeing a young boy who is 3.5 y.o. He suffers from Cornelia-Delange
syndrome. While the text book description escape me the net result is that
his UE have congenital anomolies. For the sake of brevity, his limbs are AE
levels, atrophied musculature, good skin coverage, voluntary motor control on
the Rt, lesser on the Lt, SENS intact, STR is hard to determine at
ultimate, Cognitive and developmental delays plus many other issues. He is
learning to stand with assistive device.
QUESTION: The clinic physician would like add some voluntary control to
operate a TD of rudimentary function. The goal would be to determine if the
child can learn the principle of cause and effect and then manipulate toys,
etc. The child cuurently has a shortened prosth that ends 2 dist to the end
of the residuum. It has a surface for very small objects for him to look at
or move about in space.
I am all ears,
Pat Peick CPO>>
Pat--
I have successfuly fit three Cornelia de Lange kids over the past few years.
Most have been a bit older when the attempt was made--the youngest being about
5 years.
The first was a bialteral BE (In WY) with forearms tapering to single digits.
Hermetically sealed switches were used to actuate cookie crusher enabled
VASI 2-6 hands. Measured IQ of 7. Originally fit at about age 12 and as far
as I know, the first CdL to attempt electric prosthetic fitting. Training
began by using a microswitch operated fan--(she liked the fan to blow on her
face) until she understood cause and effect. Once the arms were fit, her
favorite food (french fries!) was inserted to demonstrate the hand's
usfulness.
She is now about 22 years and wears the arms all day. In fact, she gets quite
upset when they are missing. If we have to keep them for repairs, she ends up
wearing slippers on her arms or she's not happy. We presented this case at
ACPOC a few years ago w/ video.
#2 was a bilateral AE (In NY)--short right/ very long left (a skinny stick
basically). Measured IQ--I don't remember; however, greater than patient #1.
We fit with a cookie crusher enables single electrode and a VASI 0-3 hand
mounted on a modified Otto Bock ball & socket wrist which was itself mounted
at almost 90° to the axis of the humerus on the anteromedial corner of the
distal humerus, i.e., No Forearm. A so-called Mommy swtich was installed so
the OT & Mom couild open the hand esternally to insert objects. Training was
basically accidental discovery of the hand.
#3 is a bialteral BE with chicken wing appearing arms. He is being fit with
our collaboration in TX. The fit presently is unilateral, BE, with a
microswitch/cookie crusher actuated w/ Mommy switch and VASI 0-3 hand--similar
to the first case.
Dexterity of the digit is questionable. The switch is being incorporated into
an electric toy for training. Final result is pending.
I'd be happy to consult in the case if you have the need.
I can be contacted at this eMail address or at <Email Address Redacted>
otherwise, call 801-328-9728.
J. Thomas Andrew, CP
Ability Prosthetic Systems, Inc.
<<Dear Colleagues:
I am part of the Limb Enhancement clinic in my that state that is currently
seeing a young boy who is 3.5 y.o. He suffers from Cornelia-Delange
syndrome. While the text book description escape me the net result is that
his UE have congenital anomolies. For the sake of brevity, his limbs are AE
levels, atrophied musculature, good skin coverage, voluntary motor control on
the Rt, lesser on the Lt, SENS intact, STR is hard to determine at
ultimate, Cognitive and developmental delays plus many other issues. He is
learning to stand with assistive device.
QUESTION: The clinic physician would like add some voluntary control to
operate a TD of rudimentary function. The goal would be to determine if the
child can learn the principle of cause and effect and then manipulate toys,
etc. The child cuurently has a shortened prosth that ends 2 dist to the end
of the residuum. It has a surface for very small objects for him to look at
or move about in space.
I am all ears,
Pat Peick CPO>>
Pat--
I have successfuly fit three Cornelia de Lange kids over the past few years.
Most have been a bit older when the attempt was made--the youngest being about
5 years.
The first was a bialteral BE (In WY) with forearms tapering to single digits.
Hermetically sealed switches were used to actuate cookie crusher enabled
VASI 2-6 hands. Measured IQ of 7. Originally fit at about age 12 and as far
as I know, the first CdL to attempt electric prosthetic fitting. Training
began by using a microswitch operated fan--(she liked the fan to blow on her
face) until she understood cause and effect. Once the arms were fit, her
favorite food (french fries!) was inserted to demonstrate the hand's
usfulness.
She is now about 22 years and wears the arms all day. In fact, she gets quite
upset when they are missing. If we have to keep them for repairs, she ends up
wearing slippers on her arms or she's not happy. We presented this case at
ACPOC a few years ago w/ video.
#2 was a bilateral AE (In NY)--short right/ very long left (a skinny stick
basically). Measured IQ--I don't remember; however, greater than patient #1.
We fit with a cookie crusher enables single electrode and a VASI 0-3 hand
mounted on a modified Otto Bock ball & socket wrist which was itself mounted
at almost 90° to the axis of the humerus on the anteromedial corner of the
distal humerus, i.e., No Forearm. A so-called Mommy swtich was installed so
the OT & Mom couild open the hand esternally to insert objects. Training was
basically accidental discovery of the hand.
#3 is a bialteral BE with chicken wing appearing arms. He is being fit with
our collaboration in TX. The fit presently is unilateral, BE, with a
microswitch/cookie crusher actuated w/ Mommy switch and VASI 0-3 hand--similar
to the first case.
Dexterity of the digit is questionable. The switch is being incorporated into
an electric toy for training. Final result is pending.
I'd be happy to consult in the case if you have the need.
I can be contacted at this eMail address or at <Email Address Redacted>
otherwise, call 801-328-9728.
J. Thomas Andrew, CP
Ability Prosthetic Systems, Inc.
Citation
JTAndrew, “Re: UE prosth challenge,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/210295.
