Prune Belly Syndrome

Prune Belly Syndrome

Bernie Veldman

1/3/2003

Thank you for all of the responses to my question regarding Prune Belly
Syndrome. I apologize for the delay in posting responses.

Here is a review of the responses that I received regarding a teenage
patient with Prune Belly Syndrome.



I have provided 1/8 polyethylene (with aliplast lining) Boston
Overlap style LSO's for doctor's requesting kidney shields or a
modified corset (usually neoprene) with protective front.




Orthomerica makes a nice compression orthosis available in an 8 and 10
fronts. It has great compression. If he needs more of a plastic panel,
the California low profile might serve him well. Call Orthomerica at
800-446-6770 for more information.





I've seen a few individuals over the years with this Dx and they have
done very well with simply a corset.




You can try and put him in a flex foam body jacket





  The first thing that comes to my mind is a clamshell TLSO or LSO. It
would be restrictive but what else would protect the abdominal region?




  The first thing that comes to my mind is a clamshell TLSO or LSO. It
would be restrictive but what else would protect the abdominal region?
  Let me know what you come up with.




I recently consulted on a prune belly case. This 3 or 4 year old, active
boy wore an elastic abdominal binder quite successfully. My only concern
with this would be to avoid roping of the binder in the waist area.




Bernie:

I had a patient with a similar condition a few years ago - also very
active in sports and in need of protection for his abdomen. The doctor
prescribed a flexible LSO - neoprene style. I ordered a custom one
from Benick with a thermoplastic panel inside. It helped protect him
without being too restrictive and also gave him some abdominal support
as well.

Hope I was of help.




I have fit several children with this diagnosis to treat their
scoliosis. I know in some of those cases our treatment was difficult
because no pressure on the abdomen was allowed because abdominal
expansion was needed for full inspiration. I just throw this out as
something to consider early in the design process. Another thing to
consider is what would be allowed by the basketball league.




Bernie -- I have treated a child with the same diagnosis... only
younger. I used a modified Flex-Foam TLSO from Spinal Technology. We
eliminated the normal windows and left the external frame where we
needed protection. You can place the opening anywhere you want... just
talk with the guys at Spinal Tech and tell them what you want. You will
have plenty of padding against the skin and a rigid protection on the
outside. Also, you can remove the frame from the molded liner to make
changes and then easily reattach. If the frame is too stiff for your
liking you can create 'hinges' made from dacron simply by cutting the
frame and riveting strips of dacron across the cut frame. I would
suggest casting the patient with plaster (standing) and then have him
sit with the cast almost dry to create a natural wrinkle above the
thigh. This will be the limit of the foam liners distal trimline. The
frame can be cut back any distance from there that you like. Hope this
helps. Good luck.




Hi Bernie, just wondering if a maternity style elastic corset with an
additional undersling may be sufficient?




Hey Bernie,
I had a little boy with prune belly syndrome that we had to brace with a

scoliosis style TLSO due to a dramatic curvature. The first orthosis
fit
well and did help correct the curve, but the patient could not tolerate
the
compression in the abdominal that we would give with a standard TLSO.
We
had to refabricate with a abdominal releif that did not compress the
stomach. He tolerated it better, but we did lose some control.

It does'nt sound like you need correction, but if you use a TLSO for
protection, you may find out how much compression the patient can
tolerate.

Maybe this will help you.

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