Case study

Case study

Scott Yarberry

4/20/2006

I had a family practitioner M.D. stop by with her daughter the other day inquiring about bracing for her toe walker. Normally a standard presentation and treatment BUT, this child is 12 years old, 5'6 and easily 160 lbs. and is autistic. With knee flexed at 90 degrees: 20 degrees PF contracture that I could hardly reduce. She did seem to relax when I wasn't payiing attention to her or testing her ROM. She normally sits in her chair all day and will listen to music. Any past attempts to brace her in night time orthoses, or serial casting and been very frustrating as the child is was very resistive. She got very combative/diificult when they did serial casting and took off night time orthoses. The mother was looking for something that her daughter might not notice or would be much less cumbersome/obvious that would help reduce the PF. I explained the obvious necessity to come above the ankle to gain any kind of leverage or control to reduce. The childs orthopedic Dr wants very much to do an achilles tendon release but again there is the issue of casting to maintain and the need for her to stay in a wheelchair for several weeks. The parents are not excited about that option. I am curious if any of you have had success with tone reducing footplates (only) to manage this kind of presentation. Any ideas?
THANKS
Scott Yarberry

                          ********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.

If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>

OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.

Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.