Re: Arthrogryposis, pediatric
DeboraLee Davis
Description
Collection
Title:
Re: Arthrogryposis, pediatric
Creator:
DeboraLee Davis
Date:
2/24/2000
Text:
I'm interested in developing a Patient Satisfaction Survey for our new O & P
program. Without violating any copyright laws, would someone please share a
sample of your survey? All responses will be greatly appreciated. Thank
you.
DeboraLee Davis, Director
Wuesthoff Home Medical Equipment
Rockledge, Florida
<Email Address Redacted>
-----Original Message-----
From: Troy Fink, C.O. < <Email Address Redacted> >
To: <Email Address Redacted> < <Email Address Redacted> >
Date: Sunday, May 04, 2036 6:10 AM
Subject: Arthrogryposis, pediatric
>I have a patient, a 6 month old girl with a diagnosis of arthrogryposis. I
>have been treating her for the past 4 months. I have provided KOs, EOs and
>WHFOs for her. Her mother and PT have been very aggressive with stretching.
I
>have re-fabricated and adjusted the systems several times to accommodate
for
>growth and increased ROM. I have been using low-temp plastic and molding
>directly to the patient. This has been working reasonably well, but it has
>its limitations. Also, we (mother, PT, MD & myself) have elected not to
>treat the ankles orthotically -- as she has an extreme equiinovarus
deformity
>bilaterally. The MD states that ankle correction is the first surgery he
will
>perform.
>
>It is now time to replace the EO and WHFO. The mother states the pt.
>tolerates both systems throughout the night. Unfortunately, she cannot wear
>them both (EO & WHFO) at the same time, as they both cover the lower arm.
>
>My goal is to provide EWHFOs. Part of the challenge is the trim lines. The
>WHFO section should cover the Palmer region to provide extension forces at
>the wrist and MCP joints. But with the wrist at neutral in the transverse
>plane, as the trimlines approach the elbow, the plastic will cover the
medial
>portion of the lower arm. The trimlines are at the center of the anterior
and
>posterior aspects of the lower arm. Now, if I haven't lost you, you will
see
>the challenge arises as I integrate this into the elbow portion. At the
elbow
>I need to prevent extension, so the plastic should be either anterior or
>posterior with the trimlines medial and lateral. Perhaps it could be more
>simply stated: the WHFO portion is rotated ninety degrees relative to the
EO
>portion.
>
>Any suggestions on how to accomplish this while maintaining maximal lever
>arms and still practical and possible to don?
>
>The other part of the challenge is I believe I could provide a better
>orthosis if I could mold to a positive model. Any tips for casting an
infant?
>she is tiny!
>
>Thanks for taking the time to read this. Any and all replies would be
greatly
>appreciated. In fact, any comment regarding pediatric arthrogryposis would
be
>great.
>
>Sincerely,
>Troy Fink, C.O.
>email: <Email Address Redacted>
>
>
program. Without violating any copyright laws, would someone please share a
sample of your survey? All responses will be greatly appreciated. Thank
you.
DeboraLee Davis, Director
Wuesthoff Home Medical Equipment
Rockledge, Florida
<Email Address Redacted>
-----Original Message-----
From: Troy Fink, C.O. < <Email Address Redacted> >
To: <Email Address Redacted> < <Email Address Redacted> >
Date: Sunday, May 04, 2036 6:10 AM
Subject: Arthrogryposis, pediatric
>I have a patient, a 6 month old girl with a diagnosis of arthrogryposis. I
>have been treating her for the past 4 months. I have provided KOs, EOs and
>WHFOs for her. Her mother and PT have been very aggressive with stretching.
I
>have re-fabricated and adjusted the systems several times to accommodate
for
>growth and increased ROM. I have been using low-temp plastic and molding
>directly to the patient. This has been working reasonably well, but it has
>its limitations. Also, we (mother, PT, MD & myself) have elected not to
>treat the ankles orthotically -- as she has an extreme equiinovarus
deformity
>bilaterally. The MD states that ankle correction is the first surgery he
will
>perform.
>
>It is now time to replace the EO and WHFO. The mother states the pt.
>tolerates both systems throughout the night. Unfortunately, she cannot wear
>them both (EO & WHFO) at the same time, as they both cover the lower arm.
>
>My goal is to provide EWHFOs. Part of the challenge is the trim lines. The
>WHFO section should cover the Palmer region to provide extension forces at
>the wrist and MCP joints. But with the wrist at neutral in the transverse
>plane, as the trimlines approach the elbow, the plastic will cover the
medial
>portion of the lower arm. The trimlines are at the center of the anterior
and
>posterior aspects of the lower arm. Now, if I haven't lost you, you will
see
>the challenge arises as I integrate this into the elbow portion. At the
elbow
>I need to prevent extension, so the plastic should be either anterior or
>posterior with the trimlines medial and lateral. Perhaps it could be more
>simply stated: the WHFO portion is rotated ninety degrees relative to the
EO
>portion.
>
>Any suggestions on how to accomplish this while maintaining maximal lever
>arms and still practical and possible to don?
>
>The other part of the challenge is I believe I could provide a better
>orthosis if I could mold to a positive model. Any tips for casting an
infant?
>she is tiny!
>
>Thanks for taking the time to read this. Any and all replies would be
greatly
>appreciated. In fact, any comment regarding pediatric arthrogryposis would
be
>great.
>
>Sincerely,
>Troy Fink, C.O.
>email: <Email Address Redacted>
>
>
Citation
DeboraLee Davis, “Re: Arthrogryposis, pediatric,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 27, 2024, https://library.drfop.org/items/show/213800.
