Replies: achondroplasia

Replies: achondroplasia

Gary A. Lamb

9/29/2000

Thanks to all, Following are the responses.

You might start with neoprene sleeves with spiral stays or look for the
neoprene wraps that Velcro on (sorry I do
not remember who makes them). Heli Weber is a manufacturer of knee sleeves
among other products. I will be out most
of Monday but if you e-mail my work address I could send you their phone
number.

Regards,


Dan Snelson, CPO, FAAOP
============================================
Contact Innovatiohn SPorts(CTI brace) They manufacture a carbon composit
system specifically sized for kids. Might work out for your needs.

Ralph W Nobbe CPO
===========================================
I remember a knee orthosis from Scott Specialties. It was like their
Stromgren ankle orthosis buy only for the knee. It is a heavy duty elastic
knee sleeve with large wraps the are attached to it that you wrap in a
figure eight around the knee. Patients like it because it did not have a
knee joint nor uprights. They also wore quite well.

Charles Barocas, CO, LO, OT, OAP(C)
==============================================
If you are looking for something simple try a hinged elbow orthosis, if you
need good AP control, a custom device may be necessary. I don't know of any
KO's specifically made for children, but I would consider calling the
orthotists at Shriners hosp. in Tampa.


Gerald L. Martin CPO, FAAOP
=============================================
I've done some custom knee orthoses to address ML instability in
kids with achondroplasia. The most common design I've used can
be described as a custom molded, polypropylene KO with the
plastic extending down for a heel cup extension (PLS type
trimlines) strickly for suspension of the orthosis. I've considered
doing an articulating ankle (for the same concerns about
suspending the orthosis, and in hopes to be sure to not limit ankle
motion as compared to the heel cup extension), thus making it a
true KAFO, but have not done so because of the bulk and haven't
really found the PLS trims to hamper ROM much at all. I've used
3/16 by 1/2 aluminum side-bar, polycentric (free) knee joints. For
varum, usually just a lateral joint. But if that's not strong enough,
have gone double upright, or even a lateral joint with an overlapping
(Oklahoma - Large) ankle joint for the medial side. This plastic
medial articulation is lower weight, lower profile and just as strong
as a medial metal upright (again, in a varum application). What
you lose, however, is adjustability for height (knee center raises
due to growth). That really shouldn't be much of a concern for a 14
y/o boy with Achondroplasia, though.

Hope this helps, and good luck!

-Don K. CO
==========================================================
Bauerfeind has a relatively new stabilizing brace on the market called
SofTec. It provides both a compressional support along with A/P laxity
control. It also has M/L hinges for control there too. Might be worth a
shot!
Jeff
======================================================
Not sure if these will help but thought I would throw them out anyway. A
company named Scott Orthotic Labs represents a product line called New
Options, they make all kind of neoprene sleeve, with and without joints and
stays, etc. I had a very small and difficult child that they helped me on.
I told them all the dimensions and circumfrences and they manufactured a
custom sleeve in 48 hours. In my case it ended up fitting very well.

Option two may be to talk to Carl at Scott Orthotic Labs, they have been
known to fabricate very custom and odd orthoses for me at there Lab. They
have a line of K.O.'s, and may be able to manufacture a custom combined
instability functional knee orthosis for you. Their number is
1-800-821-5795.

Hope this helps,
Jason L. Bradshaw Director
Shands Hospital O & P Dept.
=========================================================
Does he hyperextend, or fall into flexion? Irrespective of the answer to
these questions I would recommend a KO, custom molded, with suspension over
the femoral condyles and just above the patella. When molding do a two part
mold indenting the area above his condyles and his patella hold then place
knee in desired poition and continue to wrap distally. When modifying mold
accentuate indentations over condyles and patella. When vacumforming fill
cavity above condyles and patella with aliplast.Trim out with anterior thigh
and posterior calf sections. Use Becker c size posteriorly offset knee
joints. This should suspend reasonably well but you could also get a very
thin 1/8 neoprene sleeve made for him by Benik (1-800-442-8910) this might
also reduce irritation since it needs to be worn all day long. AP and ML
stability should be very good. Well, that's my $0.02. Tom D
===================================================

Again I thank you for the collective wisdom,
Gary A. Lamb C.O.,F.A.A.O.P.

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