responses-cosmetic cover for flail arm

responses-cosmetic cover for flail arm

zach harvey

5/17/2005

There were some great responses to my inquiry about
experience with improving the appearance of a flail
arm. From what I've gathered, there are some
different options for cosmetic restoration, aside from
amputation. The Wilmer carrying orthosis, available
through Becker was a nice find for functional support
of a subluxing shoulder.
Thanks to all who responded! Zach Harvey, CPO
===========================================
I have done a couple of cosmetic restorations for
atrophied arms, but nothing that supported the
shoulder...........
......I used Otto Bock semi-rigid foam. I used a
reversed copy method to duplicate the opposite side,
much of it hand sculpting. I produced a two part shell
that I filled with the foam to make the
prosthesis................
..........How did you reverse the impression on the
other arm?

It was done by eyeball and surform file. Touchy feely
to the cast of the sound side was helpful. It was all
done by hand sculpturing rigid foam. I then made a
plater wrap model of my sculpture and fit over the
cast of the atrophied side and filled the space with
flex foam.............
.........Did you incorporate a zipper or was the foam
flexible enough to push the hand through?

It was flexible. Not sure Otto Bock still sells the
foam.
========================================
Interesting problem...hmmm....what about using a
zippered lymphedema
sleeve
with a shoulder strap to pull over the shoulder cap.
Fill the sleeve
with a
shell of foam to match the size of the other arm. The
only problem
would be
the hand section - is that also atrophied? In that
case probably Juzo
or
Jobst could make an attachable glove piece that you
could also pad................
................Jobst will make the sleeve WITH a
zipper already in it
- you
could probably explain the situation to them and make
your positive
buildup
over her existing arm and then have them make the
garment over the foam
shell (or whatever you make it from).
==========================================
Please check the Becker Orthopedic web-site
[www.beckerorthopedic.com] for the WILMER carrying
orthoses. This orthosis effectively neutralizes a
shoulder subluxation.
Additional info can be found on the WILMER web-site:
mms.tudelft.nl/wilmer
 =========================================
Otto bock silicone house has worked with us on a lower
extremity
restoration
very similar to this. Try calling them
==========================================
You could contact Smooth-On at www.smooth-on.com . It
would be fairly
simple to duplicate one arm to make a latex sleeve for
another arm
.Latex is cheaper & easier to work with than silicone
. The subluxation
would have to be controlled with an elastic strap
system probably separate
from the sleeve . Good Luck . .............
.......No I cannot attest to the products from
experience . I spent
some time at their booth at a national O & P meeting
in Chicago a
couple years back and was very impressed with the
possibilities of some of
their products .I have been looking for a good project
to try them out
and thought something like your case might work well
.Their Dragon Skin
is especially interesting . Silicone products tend
to be more
expensive and geared toward specialty companies
whereas these products are
more for do it yourselfers .Once you have the mold A
sleeve could be
produced fairly easily & inexpensively
==========================================
Not uncommon with flail arms is amputation at a
transhumeral level and
fusion of the shoulder joint. (Is it too much to
assume this is a flail
situation-brachial plexus related injury? If not, then
ignore the rest
and
have a great weekend.) This prevents shoulder
subluxation and allows
for a
prosthetic restoration that can be aesthetic at a
minimum and in most
cases,
some functional benefits are attained such as using
the prosthesis to
stabilize and balance items that are being manipulated
by the sound
side.

I have worked with a number of individuals that are
just not open to
amputation even though they have lived with an
insensate flail arm for
years
and have sustained numerous injuries (one I recall had
burnt his arm 3
times
on heaters or grills). It is a very difficult
decision to make.

A good resource for this individual would be talking
to someone who has
had
the fusion/amputation after flail arm as they have
real experience.

Hope this helps.
=======================================
HAVE YOU CONSIDERED THE WILMER CARRYING ORTHOSIS FROM
RSL STEEPER?

IT PROPOSES TO REDUCE SUBLUXATION AND CAR BE WORN
UNDER CLOTHING, WITH OR WITHOUT A HAND SUPPORT.






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