2nd. hyperextension responses

2nd. hyperextension responses

Tania Juden Mrs

Second round..................


Townsend makes a very effective brace. Look at the polio design


Try a Swedish knee cage


Have you considered an AFO with an adjustable PF stop?
Tom Lunsford, MS, CO, LO
Magnolia, Texas

A polyprop AFO masy be sufficient to act against the Hyperext. moment Tania.
Good luck Richard Ziegeler P&O (Aust)

there is a small knee-brace only working with the 3-point-princip
distributed by Basko Healthcare in Europe. It is called swedish Kneebrace.
(item # 8668).
Peter Doppler
CPO / Luxemburg


You might contact Townsend Design in the U.S. (661) 432-3466. They make a
polio KO with a posterior tibial section to limit hyperextension. There is
also a knee orthosis with a single upright extension down to the foot with
an ankle joint and a heel cup... and a double upright premiere KAFO made of
lightweight pre-preg material which weighs about 1.25kg (durable, cosmetic,
lightweight, and fits into a shoe).
Good luck,
Jim Fitzpatrick, CP


You can try the donjoy knee brace. The donjoy brace has a firm posterior
distal calf bar. Townsend also makes a polio brace with a distal calf bar.
Good Luck
Daryl .....Orthotist RI, USA


Although the odds are against you, we had a similar case a couple of weeks
ago. We gave in and made a KO, see below. At our follow-up appointment the
device is being used, although I do not expect full time, to control the
progression and has eliminated the pain during use.

The patient had great recurvatum and good knee extensors(quardiceps)

After much effort, we ended up with a custom KO with thigh and calf shells
and joints that flex freely and are limited to - 10 degrees of extension.
This allowed us to control the amount of extension we got, while that
patient used his quads to stabilize the knee.

He still gets some tibia force from the strap at the distal aspect(It might
be possible to make the calf section rotate on the uprights with a single
attachment point medially and laterally, and have the shell be solid at the
anterior distal area, and the proximal posterior area. This way the rigid
sections would take the majority of force).

We also toyed with putting a popliteal X strap that crosses from the
medial to lateral, distal to prox, and visa versa with a pad at the apex
large enough to distribute the forces.

We got some suspension at the medial femoral condyle, much the same way as a
PTS prosthesis suspends(and the new pads on some of the DonJoy braces.

The device was lined to help distribute the forces at the areas near the
knee.
Good Luck
Mike O'Donnell, CPO



I'm afarid I cannot recommend any particular knee brace that would
successfully stabilise this situation. We have had experience with several
patients which would most probably fall under the same category. One chap in
particular, refused a KAFO for a period of around 18 months. The problem was
not with the joints in this case (Otto Bock 22mm offset, homopolymer draped
over side steels) although the straps regularly broke, almost every few
weeks. He laterly became tired of the comtinous repairs and was therefore
encourage to reconsider the KAFO option. Which he did; the result was far
better, although he still requires the occasional repair or replacement to
the ankle joint. The forces were greatly reduced thereby reducing problems
with the straps. The control appeared generally better and he reported the
KAFO as being more comfortable.

Hope this of some help
Peter Mclachlan



Contact Gilbert & Mellish, they have a good
hyperextension knee brace which is probabaly the most
comfortable that you will find, it's quite slender and
easily worn under most clothing, there's virutally
little distal migration
Sasha


Thanks everyone
Tania.......