Responses: Searching for Low Temp. Thermoplastic

Paul Werner, LPO

Description

Title:

Responses: Searching for Low Temp. Thermoplastic

Creator:

Paul Werner, LPO

Date:

4/29/2013

Text:

Thanks to all that have responded to my post. Lots of good ideas. This
patient has presented me with a bigger challenge than I expected when I
saw him on the schedule. His ROM is a slightly limited, but he can be
ranged to neutral.
I am not sure how well this will work, but I think I may be trying a
combination of ideas including the use of the doll (glad I have
daughters)and premolding the 3-D Lite from Allard. I have ordered a sheet
of the material and I am hoping to complete the delivery by the end of the
week. I will repost when complete to report my progress. Thanks again.
There were a lot of great ideas that I may still need to resort too.

Paul Werner, LPO
Treasure Coast P&O
Vero Beach, FL


-Would a Benik WHO be reasonable or too hard to don? Custom Beniks by
measurement usually work fairly well for me.


-What about using scotch cast and adding padding and straps and wrapping
the edges with moleskin or self adhesive padding? Nothing will be easy
for such a small limb - but you will need to replace them frequently -
maybe the baby will have grown enough for low-temp on the next set.

Just a thought - Please post responses.


-From an OT friend of mine:

I know he said he tried casting but did he try focused rigidity casting? I
have used this for arthrogryposis kids. It is delta cast that I used
casting scissors to cut on the dorsum side to make it static splint (like
a wrist cock up splint) and rivet Velcro strapping so it can be easily
donned and doffed. No need for a casting saw since it is so thin but
sometimes works better than traditional thermoplastic materials especially
for severe contractures. Also you can make a series of them as the
contractures improve and gain PROM. I usually start with pre-wrap, then
casting stockinette then apply the delta cast. Only one layer.

I would suggest trying Roylan Ezeform or even the Ezeform Light the 1/8
inch. It's low temperature and very forgiving for getting reheated and
remolded repeatedly for a good fit.

Another consideration that I have done for kids with very deformed hands
is soft putty elastomer and then making a shell out of aquaplast 1/8 inch.
The elastomir starts off like a putty and then as it hardens it becomes a
pencil eraser consistency and then I have used liquid cement to attach the
aquaplast to the elastomir mold and was able to add Velcro straps to the
aquaplast to secure the splint on the child. I hope this makes sense. Feel
free to pass my contact info onto Paul.


-I am not an orthotist. I am the Marketing Manager for Allard USA and we
do have a
product called X-LITE and another called 3D-LITE.

And I certainly don’t mean to promote our product however I just felt
compelled to
tell you about it after reading your ListServ post.

Our raw material comes in sheets. The X-LITE is a 100% cotton material
that has been
impregnated with a thermoplastic. And the 3D-LITE is a spacer fabric
impregnated
with the same polycaprolactone thermoplastic. The 3D-LITE comes in 3MM,
5MM and 7MM
thickness. The larger the anatomy you are trying to cover would use the
thicker
material and also, depending upon the contracture you may need to go with the
thicker material.

Both materials have excellent conformity are 100% reversible when
re-heated. They
are also environmentally friendly and contain no irritants like fiberglass.

If you would like to check it out visit www.allardusa.com and click on
Products at
the top then click on X-LITE.

I would be happy to answer any questions.


-Hi I don’t know of a low temp thermoplastic but it occurred to me that
perhaps you can take measurements of the baby, obtain an inexpensive baby
doll from somewhere like a family friend or goodwill. A dollar store.
Something that looks realistic, dolls come in all kinds of sizes, and
close to the size of the baby. Cast the baby dolls hands and arms or if
you can remove the arms and hook them to vacuum mold the hands and arms
directly. I wouldn’t recommend removing the arms if the doll belongs to a
family friend of course. I hate using low temp thermo like
orthoplast...they come out looking terrible and I think to mold them to a
baby would be as difficult as casting. I’d mold to the baby doll. You
could probably use a polyethylene 1/8 thickness or even a low temp plastic
if anyone else has any ideas. This may work great as long as the baby
doesn’t have any major deformities of the hand and wrist. Just a
suggestion.


-There's Orthoplast


-I've had good results on older kids using a Custom Benick WHO with
plastic inserts. The plastic can be softened on Low temp in a micro wave
and molded directly to the Pt. IF you try it, be cautious of hot spots in
the plastic and rotate-reheat rather than over-cooking. If a full palmar
extension is required this may not be the best method.


-Allard 3d lite, 3mm

-Try 3mm 3d lite material from Allard

-You can try with 2 mm Aquaplast/orfit-non sticky option.
Try search for ORFIT.You can find hips of options and colours as well


-Look into shapelock. It's usually sold as beads but there are a few
vendors who
sell it in sheets. I have purchases the beads and rolled them out into
sheets on
several occasions. This works just fine but its one more step.


-This a long shot for a patient of this age but maybe try an alginate
impression using small oblong container
for the material and press limb into material to obtain either a palmer or
dorsal imprint Good luck.


-I would find a qualified pediatric OT that specializes in this, if
possible. If you are not experienced with the material it is not easy.
Good luck


-Orthoplast s really your only choice


-Cast him using RTV silicone and then make his splints using 3mm thick Dura
Flex material.
I have used this quite successfully on this patient population.


-Benik,, I have used their products on small infants.


-You could make an aluminum who custom from measurements and then cover
in 1/8 plastazote. That way you can contour it as you achieve the
position you desire. Atlas of Orthotics will give you a picture....Rancho
style

-Not sure if you got any answers or not...sorry it's so late. But, I just
finished using AquaPlast Prodrape-T Ultraperf from Patterson Medical for
some fully encompassing adult wrist splints. I used 1/16 (very thin) but
it was still plenty of support. I think 1/16 of this stuff would be
perfect for your little one that you are fitting.


-After recently hand casting several very young kids, it dawned on me to
maybe try impression foam next time. The tiny casts take significant
rectification,and the foam should get you pretty darn close! Just a
thought.

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Citation

Paul Werner, LPO, “Responses: Searching for Low Temp. Thermoplastic,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/235039.