Arthrogryposis Responses, Part1
Troy Fink, C.O.
Description
Collection
Title:
Arthrogryposis Responses, Part1
Creator:
Troy Fink, C.O.
Text:
Hello list:
First I'd like to thank everybody who took the time to respond to my
question.
Secondly, I apologize for the length of time it has taken for me to post
these responses -- It took less time to cast, fabricate and deliver than it
took to get through to compuserve technical assistance (to instruct me on how
to copy and paste)!
Finally, I did complete the project. I pulled low-temp plastic over a
positive model taken from the patient. WHFO overlaps EO. Positive model is
pronated, but is very easy to supinate the system during donning.
The replies follow, and my original post is at the end.
Thanks again, Troy Fink, C.O.
1)
First I would think about doing a bi-valve type above the wrist. This will
make donning and doffing easier. As for casting it will take two people to
get the best cast. One to hold the fingers stright and the arm. Use 2
casting tape making a thin cast so it sets up quick and is easy to cut off. I
do alot of peds. at Cook Childerns Hospital in Ft. Worth. Call me if you need
to 817-
2)
Make a whfo with the trimlines of your choice-palmer would be most
appropriate-then, placing that back on the mold, vacuum form the proximal
(eo) section over the top of the whfo. The eo will ultimately overlap the
whfo a matter of only a few inches and can be semi-permantely attached with
rivets or whatever. This design can serve many purposes and allow alot of
interchange if desired. Also, it's easier to fabricate another eo section if
growth or anatomical changes should dictate. I have made one and would be
glad to walk you through aspects of the fabrication. At the time I was the
practitioner and the technician and learned alot about all aspects of the
case.
3)
Why not make the WHFO first and then mold the EO portion over the WHFO vs a
one piece system? Good luck.
4)
Troy,
Think of making up a (plastic-covered) three-point wire orthosis for the
w-h-f section and extend it proximally to include an above elbow section.
In this way, you will have minimal skin contact , ease of donning and
cleaning.
Maybe a weird looking device but it works.
A palmar cone or ovoid segment, a webbing/velcro strap over the extensor
surface of wrist and another of these just distal to the elbow crease, with
another on the posterior surface of the upper arm, all joined by 1/8
plastic coated spring wire.
I could try to send a sketch if you wanna see more.
5)
Troy,
Think of making up a (plastic-covered) three-point wire orthosis for the
w-h-f section and extend it proximally to include an above elbow section.
In this way, you will have minimal skin contact , ease of donning and
cleaning.
Maybe a weird looking device but it works.
A palmar cone or ovoid segment, a webbing/velcro strap over the extensor
surface of wrist and another of these just distal to the elbow crease, with
another on the posterior surface of the upper arm, all joined by 1/8
plastic coated spring wire.
I could try to send a sketch if you wanna see more.
6)
Troy,
Think of making up a (plastic-covered) three-point wire orthosis for the
w-h-f section and extend it proximally to include an above elbow section.
In this way, you will have minimal skin contact , ease of donning and
cleaning.
Maybe a weird looking device but it works.
A palmar cone or ovoid segment, a webbing/velcro strap over the extensor
surface of wrist and another of these just distal to the elbow crease, with
another on the posterior surface of the upper arm, all joined by 1/8
plastic coated spring wire.
I could try to send a sketch if you wanna see more.
7)
Troy,
Think of making up a (plastic-covered) three-point wire orthosis for the
w-h-f section and extend it proximally to include an above elbow section.
In this way, you will have minimal skin contact , ease of donning and
cleaning.
Maybe a weird looking device but it works.
A palmar cone or ovoid segment, a webbing/velcro strap over the extensor
surface of wrist and another of these just distal to the elbow crease, with
another on the posterior surface of the upper arm, all joined by 1/8
plastic coated spring wire.
I could try to send a sketch if you wanna see more.
8)
Troy,
Have you thought about keeping it two sections, molding the second orthosis
over
the first completed system. You would first don one, then the second.
Plastizote
and PE / Orthoplast,etc.. Good Luck!
********************
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the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
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OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list.
First I'd like to thank everybody who took the time to respond to my
question.
Secondly, I apologize for the length of time it has taken for me to post
these responses -- It took less time to cast, fabricate and deliver than it
took to get through to compuserve technical assistance (to instruct me on how
to copy and paste)!
Finally, I did complete the project. I pulled low-temp plastic over a
positive model taken from the patient. WHFO overlaps EO. Positive model is
pronated, but is very easy to supinate the system during donning.
The replies follow, and my original post is at the end.
Thanks again, Troy Fink, C.O.
1)
First I would think about doing a bi-valve type above the wrist. This will
make donning and doffing easier. As for casting it will take two people to
get the best cast. One to hold the fingers stright and the arm. Use 2
casting tape making a thin cast so it sets up quick and is easy to cut off. I
do alot of peds. at Cook Childerns Hospital in Ft. Worth. Call me if you need
to 817-
2)
Make a whfo with the trimlines of your choice-palmer would be most
appropriate-then, placing that back on the mold, vacuum form the proximal
(eo) section over the top of the whfo. The eo will ultimately overlap the
whfo a matter of only a few inches and can be semi-permantely attached with
rivets or whatever. This design can serve many purposes and allow alot of
interchange if desired. Also, it's easier to fabricate another eo section if
growth or anatomical changes should dictate. I have made one and would be
glad to walk you through aspects of the fabrication. At the time I was the
practitioner and the technician and learned alot about all aspects of the
case.
3)
Why not make the WHFO first and then mold the EO portion over the WHFO vs a
one piece system? Good luck.
4)
Troy,
Think of making up a (plastic-covered) three-point wire orthosis for the
w-h-f section and extend it proximally to include an above elbow section.
In this way, you will have minimal skin contact , ease of donning and
cleaning.
Maybe a weird looking device but it works.
A palmar cone or ovoid segment, a webbing/velcro strap over the extensor
surface of wrist and another of these just distal to the elbow crease, with
another on the posterior surface of the upper arm, all joined by 1/8
plastic coated spring wire.
I could try to send a sketch if you wanna see more.
5)
Troy,
Think of making up a (plastic-covered) three-point wire orthosis for the
w-h-f section and extend it proximally to include an above elbow section.
In this way, you will have minimal skin contact , ease of donning and
cleaning.
Maybe a weird looking device but it works.
A palmar cone or ovoid segment, a webbing/velcro strap over the extensor
surface of wrist and another of these just distal to the elbow crease, with
another on the posterior surface of the upper arm, all joined by 1/8
plastic coated spring wire.
I could try to send a sketch if you wanna see more.
6)
Troy,
Think of making up a (plastic-covered) three-point wire orthosis for the
w-h-f section and extend it proximally to include an above elbow section.
In this way, you will have minimal skin contact , ease of donning and
cleaning.
Maybe a weird looking device but it works.
A palmar cone or ovoid segment, a webbing/velcro strap over the extensor
surface of wrist and another of these just distal to the elbow crease, with
another on the posterior surface of the upper arm, all joined by 1/8
plastic coated spring wire.
I could try to send a sketch if you wanna see more.
7)
Troy,
Think of making up a (plastic-covered) three-point wire orthosis for the
w-h-f section and extend it proximally to include an above elbow section.
In this way, you will have minimal skin contact , ease of donning and
cleaning.
Maybe a weird looking device but it works.
A palmar cone or ovoid segment, a webbing/velcro strap over the extensor
surface of wrist and another of these just distal to the elbow crease, with
another on the posterior surface of the upper arm, all joined by 1/8
plastic coated spring wire.
I could try to send a sketch if you wanna see more.
8)
Troy,
Have you thought about keeping it two sections, molding the second orthosis
over
the first completed system. You would first don one, then the second.
Plastizote
and PE / Orthoplast,etc.. Good Luck!
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list.
Citation
Troy Fink, C.O., “Arthrogryposis Responses, Part1,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 7, 2024, https://library.drfop.org/items/show/214177.
