Follow upTwister Cables
AIMEE KEITH SMITH
Description
Collection
Title:
Follow upTwister Cables
Creator:
AIMEE KEITH SMITH
Date:
6/18/2009
Text:
Original Question: Wondering what the latest thought on twister cables is in relation to preventing internal rotation of the legs in patients with Cerebral Palsy. I haven't used any in a while and was wondering first thoughts on this and second if their are any studies that show the pros and cons of them. Second, are there other options that are being implemented for the prevention of this rotation?
Responses:
ELASTICS CAN BE USED
I Have used Twister Cables though out my O&P career and found them to be successful most of the time. Compliance, as with many devices, are the driving factor for success. I have also used UCB's with the forefoot section cut at metatarsal heads angled to extend beyond the distal tip of the 5th toe. Hence, it creates an external rotation moment in order to get heel off and toes off during gait. Finally, I have used torque heels with some success. These devices were often use and worked well for some patients more than others. good luck
I share your question with regards to this matter. I have only one physician who still orders these . It seems to me that they place more torque on the knee than they do on the hip but that is just my impression.
We use them in some cases. I would not suggest for low tone, as risk of
spinning BK on Tibial plat., derotation straps work well.
Also I find on the more severe rotators, the twisters start to buckle and
cause knee flexion and pressure on the posterior pelvis.
Nothing like a good pair of HKAFOs with single lateral uprights,free hip
joints, 180 stop knee joints.
I've run into this
problem as well. What I've been doing is cutting the trimline at the base
of the foot from distal to the 5th met head to proximal to the first met
head, this helps decrease the toe in to a degree.
I’m sure you're already aware of this, but the big issue is potential
transverse plane stress on soft tissue in the knee. Twister cables would
seem to me to be contraindicated if there is fixed tibial torsion or femoral
anteversion, so should only be used in conjunction with dynamic medial hip
rotation.
Keith M. Smith
You don't stop laughing because you grow old, you grow old because you stop laughing.
The materials in this email are private and may contain Protected Health Information. If you are not the intended recipient, be advised that any unauthorized use, disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this email in error, please immediately notify the sender via a return email.
Responses:
ELASTICS CAN BE USED
I Have used Twister Cables though out my O&P career and found them to be successful most of the time. Compliance, as with many devices, are the driving factor for success. I have also used UCB's with the forefoot section cut at metatarsal heads angled to extend beyond the distal tip of the 5th toe. Hence, it creates an external rotation moment in order to get heel off and toes off during gait. Finally, I have used torque heels with some success. These devices were often use and worked well for some patients more than others. good luck
I share your question with regards to this matter. I have only one physician who still orders these . It seems to me that they place more torque on the knee than they do on the hip but that is just my impression.
We use them in some cases. I would not suggest for low tone, as risk of
spinning BK on Tibial plat., derotation straps work well.
Also I find on the more severe rotators, the twisters start to buckle and
cause knee flexion and pressure on the posterior pelvis.
Nothing like a good pair of HKAFOs with single lateral uprights,free hip
joints, 180 stop knee joints.
I've run into this
problem as well. What I've been doing is cutting the trimline at the base
of the foot from distal to the 5th met head to proximal to the first met
head, this helps decrease the toe in to a degree.
I’m sure you're already aware of this, but the big issue is potential
transverse plane stress on soft tissue in the knee. Twister cables would
seem to me to be contraindicated if there is fixed tibial torsion or femoral
anteversion, so should only be used in conjunction with dynamic medial hip
rotation.
Keith M. Smith
You don't stop laughing because you grow old, you grow old because you stop laughing.
The materials in this email are private and may contain Protected Health Information. If you are not the intended recipient, be advised that any unauthorized use, disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this email in error, please immediately notify the sender via a return email.
Citation
AIMEE KEITH SMITH, “Follow upTwister Cables,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/230380.
