Houdini with neurofibromatosis
Mark Seibel
Description
Collection
Title:
Houdini with neurofibromatosis
Creator:
Mark Seibel
Date:
8/18/2005
Text:
I have a 15 month old patient with a diagnosis of Type 1
neurofibromatosis. He has a pseudoarthrosis of the tibia near the
midway point. Pt has good ROM at the knee and ankle with no muscle
tightness. The orthopedist has ordered a jointed, custom molded kafo
with a PTB type anterior tibial shell.
This is the second kafo I have made for this pt. He was fit with the
initial orthosis at the age of 5 months. This orthosis was a one-piece,
plastic, posterior kafo with an overlapping, one-piece, full length,
foam-lined, anterior shell(including the foot). This worked fine for
about a month and then as pt became more active, he began sliding his
heel out of the orthosis. This quickly got to the point where he was
able to slide it completely off. I added a posterior aliplast foam
inverted U above the heel. This helped, but did not stop the problem. I
finally added a distal velcro ankle strap just proximal to the ankle.
This strap entered the posterior shell through a slot posteriorly and
looped around the ankle and exited from the same slot. It was then
attached to the outside of the shell with self adhesive velcro. It was
long enough so that when applying the posterior section, it could be
loosened to allow the foot to be slid through the strap without needing
to thread the strap into the slot each time. This worked fairly well,
but the pt. still managed to slide his heel up. It did, however, prevent
him from sliding it all the way off!
Before I begin this second version, I thought I'd bring this to you all
for suggestions. Does anyone out there have experience with this type
of patient? If so, I'd love to hear from you. I am requesting ideas on
brace design(anterior shell over posterior shell vs. anterior into
posterior, length of the anterior shell, foam lined vs non lined, type
and thickness of plastic, joint type, etc.) and suggestions for keeping
the heel in place.
Thanks in advance for sharing your knowledge.
Mark Seibel CPO
IMPORTANT WARNING: The information in this message (and the documents attached to it, if any) is confidential and may be legally privileged. It is intended solely for the addressee. Access to this message by anyone else is unauthorized. If you are not the intended recipient, any disclosure, copying, distribution or any action taken, or omitted to be taken, in reliance on it is prohibited and may be unlawful. If you have received this message in error, please delete all electronic copies of this message (and the documents attached to it, if any), destroy any hard copies you may have created and notify me immediately by replying to this email. Thank you.
neurofibromatosis. He has a pseudoarthrosis of the tibia near the
midway point. Pt has good ROM at the knee and ankle with no muscle
tightness. The orthopedist has ordered a jointed, custom molded kafo
with a PTB type anterior tibial shell.
This is the second kafo I have made for this pt. He was fit with the
initial orthosis at the age of 5 months. This orthosis was a one-piece,
plastic, posterior kafo with an overlapping, one-piece, full length,
foam-lined, anterior shell(including the foot). This worked fine for
about a month and then as pt became more active, he began sliding his
heel out of the orthosis. This quickly got to the point where he was
able to slide it completely off. I added a posterior aliplast foam
inverted U above the heel. This helped, but did not stop the problem. I
finally added a distal velcro ankle strap just proximal to the ankle.
This strap entered the posterior shell through a slot posteriorly and
looped around the ankle and exited from the same slot. It was then
attached to the outside of the shell with self adhesive velcro. It was
long enough so that when applying the posterior section, it could be
loosened to allow the foot to be slid through the strap without needing
to thread the strap into the slot each time. This worked fairly well,
but the pt. still managed to slide his heel up. It did, however, prevent
him from sliding it all the way off!
Before I begin this second version, I thought I'd bring this to you all
for suggestions. Does anyone out there have experience with this type
of patient? If so, I'd love to hear from you. I am requesting ideas on
brace design(anterior shell over posterior shell vs. anterior into
posterior, length of the anterior shell, foam lined vs non lined, type
and thickness of plastic, joint type, etc.) and suggestions for keeping
the heel in place.
Thanks in advance for sharing your knowledge.
Mark Seibel CPO
IMPORTANT WARNING: The information in this message (and the documents attached to it, if any) is confidential and may be legally privileged. It is intended solely for the addressee. Access to this message by anyone else is unauthorized. If you are not the intended recipient, any disclosure, copying, distribution or any action taken, or omitted to be taken, in reliance on it is prohibited and may be unlawful. If you have received this message in error, please delete all electronic copies of this message (and the documents attached to it, if any), destroy any hard copies you may have created and notify me immediately by replying to this email. Thank you.
Citation
Mark Seibel, “Houdini with neurofibromatosis,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/225266.
