orthoses made for children are motioncontrolling or motionaltering Accommodative devices are less frequently required in this age group The relatively light weight of a child means materials that are more forgiving ID: 776611 Download Presentation
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orthoses. made for children are motion-controlling or . motion-altering. Accommodative . devices are less frequently required in this age group. .. The relatively light weight of a child means materials that are more forgiving .
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Pediatric Orthoses Most
Presentation on theme: " Pediatric Orthoses Most "— Presentation transcript:
made for children are motion-controlling or
devices are less frequently required in this age group
The relatively light weight of a child means materials that are more forgiving
increased flex in a heavier individual such as an adult
resist collapse more readily in a
This allows you to choose from a wide range of material properties, shell thicknesses and filler options while still achieving the desired goal of motion control
for a child will limit excessive or undesired motions while still allowing normal motions that are so important for ideal
Key Posting Considerations
deformities of the
and leg require
The amount of control a post provides is determined by numerous factors
number of degrees the post is angled
the stiffness or resistance to compression of the posting material
anterior-posterior length of the post and the width of the post
A longer, wider post made of a stiffer material will offer the most control to the
There is a reduced need for forefoot posting in children under the age of 6.
Be Aware Of Predisposing Risk Factors In The Pediatric Pronated Foot
A child may exhibit a weak foot structure leading to
, but may also have additional predisposing risk factors that may affect the foot in its overall development and function. These risk factors include, but are not limited to,
laxity, obesity, rotational and angular disorders and ankle
Shells made of more
rigid materials and/or of increased thickness
are the best choices for treating children who have generalized
modifications such as a deep heel seat, increased
pitch to lock the oblique
joint axis and medial and lateral flanges to reduce transverse plane compensations of the
will aid in control of the foot with notable
Thicker shells and more rigid materials are also necessary in managing the
foot in the obese
arch fillers will help reduce the increased compression of the arch area of the shell
overweight patients. Soft tissue supplementation at the foot/
interface may help reduce the hard feel of such devices and increase shock absorption necessary for sports.
How To Handle Rotational And Angular Disorders
and angular disorders that
in-toeing and out-toeing, bowing and knock-knees may contribute to a compensatory
for angular disorders benefit from high posting and out-flared or wide posts to stabilize the post plate in the frontal plane.
Treatment Tips For Ankle Equinus
foot, often characterized by
joint with consequent unlocking of the oblique
joint axis to allow for
and abduction to occur at the
, is a major cause of pediatric
may be developmental or
typically accompanies a rapid bone growth spurt, resulting in relative shortening of the
may be congenital or result from other
exert harmful forces on the foot, either initiating abnormal
already present in the child.
In addition to stretching the tight musculature, orthotic control of the abnormal
heel raises to an orthotic device to
the foot and increasing the amount of available dorsiflexion of the ankle for
are effective at helping to reduce compensation in this foot
addition, the presence of
may limit the degree of control that can be tolerated by
Other Helpful Treatment Insights
Patients with a
coalition have reduced
joint motion and frequent
spasm. Employing a rigid
cast with a deep heel seat and a 0-degree
post is often successful at reducing painful
When you treat children with a
coalition, keep in mind that reduced
joint motion and
spasm are less
disease) is an inflammation (sometimes considered an
) of the secondary growth center of the
. It is frequently accompanied by a tight heel cord and may be aggravated by high loads through the heel.
” (also called “Tone Reducing AFO” and “Total Contact AFO”)
A dynamic, total contact
which works exceptionally well for children with spasticity.
Maintains the correct alignment of the bones in the foot and ankle.
: Cerebral palsy,
: Thin, flexible, molded thermoplastic
covering the entire foot; custom-contoured footplate; designed to distribute weight-bearing forces over large area
: Reduce ankle
, increase ankle stability and provide proper alignment
1 Low Profile D-DAFOProvides dynamic alignment and support for the foot and ankle Allows plantar flexion and dorsiflexion
2 Full Length D-DAFOThe dynamic design and material work on volume and will remain very comfortable even as children begin to outgrow them. This feature allows more time in the orthoses and a decrease in the likelihood that the patient will be unable to wear them before a new, larger D-DAFO is neededBlocks plantar flexion and allows dorsiflexion.
3 Solid Ankle AFOApplication: Varum and valgus deformitiesDescription: Custom-fabricated thermoplastic, metal or composite device designed and trimmed for a patient’s unique needsFunction: Provide proper alignment, block plantar flexion and dorsiflexion
4 Solid Ankle AFO w/ pre-tibial shell (anti-crouch)This Solid Ankle AFO with anterior panel is designed to prevent dorsiflexion and plantar flexion. The 'ground reaction' will also help to push the knee into extension during weight bearing.
5 Articulating AFOAllow flexion at the ankle and has an adjustable/removable plantar flexion stopIt is also possible to add dorsiflexion assist or check straps
6 UCBLCustom made insert for controlling a hyper-mobile pes-planus or cavus. It supports the arches of the foot and maintains the relative position of the hindfoot, midfoot, and forefoot.
patients with the support and ability to stand and take steps with
entire system can
as little as 3.5 lbs. for smaller
is the most frequently used brace for the ambulatory needs of a paralyzed child or
HKAFO incorporating cable system or similar method of mechanically translating hip extension on one side into hip flexion on the
Lower-body neurologic impairment indicated in L1-L3 lesions in children with functioning
and hip adductors.
Provides standing and ambulation ability thereby raising physical and psychological horizons.
HKAFO (hip-knee-ankle Foot
on patients requiring more stability of the hip and lower torso, due to paralysis and weakness, in addition to the lower extremity involvement. The brace will provide pelvic stability in several planes, from rotation, to side-to-side, and front-to-back
Purpose of the Device
Provides adjustable control of the hip, knee and ankle.
Manual locks maybe added to hip and knee joints
Ankle motion maybe fixed or adjustable
ORIF’s, Hip, Femur,
Anterior tibia shell
Range of motion knee joint
Range of motion Hip joint
PRAFO foot plate
Patients who will be bed-to-chair for an extended time should be fit with a PRAFO distally to prevent heel breakdown.
An improvement on the Denis Browne splint for post club foot release splinting
with bilateral footplates; three hinged joints and eight circular rotation joints
torsion, maintenance of post-operative clubfoot or metatarsus
Function: hold feet in corrected external or internal rotated position while allowing independent leg movement and free hip and knee motion.
dysplasia of the hip (DDH)
Description: Pelvic band connected to thigh cuffs by aluminum joint with 20 degree extension stop and 90 degree flexion stop or free
Application: Hip dysplasia in children beyond pre-walking
Function: Provide positive abduction positioning
with patients affected by neurological conditions such as
Description: lightweight, high-strength aluminum and footplate, used to lock and unlock the hip and knee joints
Function: For stability, the footplate, sidebars, and back panel form a continuous rigid loop, cross-braced by a bar at the level of the knee. The shape of the bar virtually eliminates side-to-side movement, thus improving the anterior-posterior and medial-lateral stability of the unit.
14 Scoliosis Jacket
Application: Idiopathic scoliosis
Description: Custom thermoplastic TLSO
Function: Limit curve progression and need for surgical
consisting of metal pelvic band, plastic thigh cuffs, aluminum hip joints with thrust-bearing hip joints or a telescoping spreader bar (older design)
Maintain hips in abduction containing femoral head in the
(Standing, Walking and Sitting Hip
Application: Cerebral palsy; any child whose adduction and/or internal rotation at hip joint interferes with function or induces lateral migration of the femoral head
Description: Plastic padded waist band and two joint assemblies connected by shaped leg bars to adjustable plastic thigh bands
Function: Stabilize hip and oppose excessive adduction and internal rotation; reduce scissor gait while walking and improve balance while
Application: In lieu of plaster cast to provide greater freedom of activity during healing, reduced muscle atrophy and shorter disability time
Description: Total contact, usually thermoplastic, brace with plastic or metal ankle joints and heel insert. Most often custom-molded for pediatric applications
Function: Allow mobilization of the leg during fracture healing; minimize rotation and sheer forces support tibia and fibula
torsion. Used in place of serial casting or corrective shoes
Description: Molded thermoplastic and Velcro knee ankle-foot
Function: Applies direct corrective rotational force on the tibia without any torque on the femur or hip
19 Dennis Brown Bar
The Dennis Brown Bar attaches to corrective shoes to maintain proper hip and foot position. The adjustable rotation allows for desired external/internal rotation.
20 Ponseti OrthosisAbduction device similar to Dennis brown bar with total contact AFO section that delivers excellent correction of clubfoot (deformity with a downward and inward pointed foot) without the risk and complications of foot surgery
21 Pediatric UFO
is a comfortable, prefabricated
for stretching and maintaining
range of motion. This unique lower-limb
positions the foot and ankle in optimal alignment for placing stretch on the
while the patient is sleeping. When used in conjunction with a knee immobilizer, this
can also stretch the two-joint
Palsy or other neuromuscular diseases
Idiopathic toe walking
Tightness at the foot and ankle
B. NIGHT TIME
Designed to increase and maintain ROM and maintain joint alignment during the night.
provide an adjustable stretch that will follow the patient’s ROM as it increases. It also allows for flexion/ extension within the
when the patient is awake and provides a long term, low-load stretch while they are relaxed.
1. RoosterbootThe Rooster boots are available in varying colors which each patient can choose at their casting appointment. Rubber sole on the Rooster boots so that children can get up to use the restroom during the night without slipping and falling or having to remove the orthosisIt is designed to provide an adjustable, dynamic stretch to the heel cords. The custom-overlapping padding provides total contact for pressure reduction and maintaining correct alignment.
This KAFO has a dynamic stretching joint at the knee and incorporates the D-DAFO. This design is made for children with severe spasticity and/or
throughout the foot and ankle. The D-DAFO provides a very intimate, total contact hold for correction and pressure distribution
Holding the ankle at 90 degrees and maintaining correct alignment throughout the foot is crucial for achieving an effective stretch on the
3 Roosterboot with KO attachmentThis “KAFO” is in two parts.The knee orthosis snaps onto the Roosterboot.Both the knee and ankle have dynamic adjustable joints for comfort and stretch. Making this in two parts allows parents the option of using only the Rooster boots at certain times. The KO section also be fabricated at a later date once need is determined.
4 Dynamic KAFOa. This parrticular KAFO has dynamic stretching joints at both the knee and ankle. Each joint can be adjusted for patient cofort and maximum stretch. b. This Dynamic KAFO has a dynamic joint at the knee only. The ankle is held at 90 degrees and in correct alignment.
is used to treat deformational
and other head shape deformities in infants 3—18 months of
can be used to effectively manage a broad spectrum of head shape deformities and clinical indications.
is an adjustable alternative
hard protective devices. It is
a flexible plastic that readily conforms to
shapes, making it easy to fit upon demand.
The protection is ideal for low impact forces that are distributed (like a shock absorber) across the entire surface without cracking or penetrating.
The headgear is equipped with easy-to-adjust straps minimizing the need for chin straps. Optional chin straps are recommended for active and noncompliant patients
posterior strap "locks" the device below the mastoids and accommodates size variations while the lateral straps are used for easy donning and doffing. Lateral straps and side-slits are also optional.
The A-Flex features ventilation holes to reduce trapped heat. It can be easily trimmed with a pair of shop snips without the need for complex equipment and tools.
the standard range,
have been designed to accommodate the unique clinical needs and anatomy of children, to provide the same high standards of protection and support
Specially designed to fit the head shape of young children, They ensure young patients enjoy the same quality of care.
New Options PL1 Elastic Double-side pull lumbar supportFeatures 6" wide elastic belt, two 2" wide adjustable side pulls that overlap in front to increase support and 1/16" nylon 2-sides neoprene pocket for insert.
Shoulder Abduction rotation
• Increased adjustability at the
• Humeral cuff with raised
for additional control
• Lightweight, universal, design can
for the left or right shoulder
• Paralysis or damage to the Brachial Plexus (
Prevention of upper extremity joint
Brachial Plexus exploration and nerve repair
Soft tissue surgery including tendon transfers
F. WRIST & HAND
1 DEROYALEUnique wrist, hand and finger orthosis applys low stretch therapy to contracted fingers, hand and wrist. Features dynamic inflatable air bladders. Fleece type liner helps reduce pressure points and provide comfortable fit.
Pediatric Action Wrist Support 1/8" nylon two sides neoprene. Circumferential adjustable wrist strap. Hook and loop closures. Removable splint for washing.
Comfy Splints Pediatric Hand Wrist Orthosis Provides support and positioning for weak or deformed hands at the wrist, hand and fingers. It serves as an excellent resting splint to prevent trauma to joints and positions to increase ROM. The wings on the side adjust to prevent ulnar or radial deviation and to allow for custom fit and comfort.
Comfyprene Pediatric Separate Finger Hand Orthosis
The Comfyprene Pediatric Separate Finger Hand Orthosis unique splint allows for individualized finger adjustments. Excellent for many deformities, including; dupytrens, swan neck or boutonneire contractures, as well as sprains and fractures. Comes with Finger Separator and available in Left or Right.
Comfy Splints Pediatric Hand Thumb Orthosis
Is uniquely designed to support the thumb without stressing the web space between the index finger and the thumb, known as the thenar eminence. The thumb tab functionally positions the thumb without stretching the thenar eminence like the traditional “C” bar opposition hand splints, making this splint excellent for use on patients with tightly adducted thumbs. The splint is adjustable and re-adjustable without the use of tools, making it easy to use and customize.
The A frame
correct the problems associated with rotational and angular malformations. This type of orthotic is used to apply corrective forces for more proximal malformations.
Calf and thigh bands and pressure pads are attached to an “A”-shaped metal frame. All components are either adjustable or available in several sizes, so that children of varying heights and girths can be accommodated.”
Indicated for femoral torsion, angular deformities, and rotational deformities.
Becker Pediatric Hip Abduction
This prefabricated hip
is designed primarily for the treatment of Legg-Calve-
disease. The preset hip abduction angle is intended to achieve maximum containment during ambulation. The hip joint allows the range of hip flexion and extension to be controlled in 20° increments.
Becker Spherical Hip Abduction
is made with spherical joints in order to provide precise positioning of the hip in all planes. The hip band and calf cuffs are constructed of aluminum, which is padded and covered with
Utilizes the principle of flexion with free abduction to achieve reduction of hip dysplasia and dislocation in infants. Ideal alternative to hip casting. Hook and pile provides easy application, size adjustment and removal. Plastic quick-release buckle for secure closure.
Ilfeld Pediatric Hip Abduction Splint
Splint consists of two aluminum thigh bands fastened to a stainless steel cross bar with swivel joints. The metal thigh bands are covered with fabric or dipped in
. The thigh bands are adjustable and are locked in place with a 3/16" hexagon wrench. The splint is adjustable for growth and progressive relaxation of abductor spasms. For treatment of congenital dislocation of the hip, congenital
of the hip and hip dysplasia and dislocation due to cerebral palsy and other
harness is used in the treatment of hip dysplasia in infants. The
harness is fit to the baby and holds his or her hips in proper position. By flexing up the legs, and allowing the knees to fall outwards, the hips are held in proper position.
harness that is too tight can do more damage to the baby's hips, and a
harness that is too loose will not hold the hips properly.
Pediatric Abduction Bar
, or for conditions requiring abduction control of the hips.
Adjustable bar provides abduction and adduction control during restricted ambulation. Nylon ball and socket joint duplicate the anatomical motion of the hip joint.
Pediatric Hip Abduction Splint
available in standard or adjustable styles.
The standard model holds the infant in 90° hip flexion and 60° abduction.
polypropylene frame with closed-cell foam lining does not retain moisture.
Pediatric Hip Abduction Spreader Bar
Maintains child in abducted position,
For proper hip alignment.
The Pediatric Hip Abduction Spreader Bar attaches by aligning the holes on the medial aspects of the thigh lacers with the holes in the swivel brackets on each end of the Spreader Bar. Adjustable positioning is achieved by loosening the dial located at the center of the adjustment bracket, and sliding the bracket to the desired width.
RCAI HD Pediatric Hip
The Pediatric Hip
Bi-Lateral by RCAI is designed to provide the patient with hip stability and proper hip alignment.
also limits unwanted motion and will reduce the stress put on the pediatric hip. The
is designed to allow for a controlled range of motion.
is ideal for patients that have suffered from hip problems that have required surgery.
• Provide hip stability and alignment following surgery.
• Reduces stress on the pediatric hip and limits motion.
• Washable liner pads.
• Ideal for use with universal leg braces.
• Vertical adjustability for the hip and thigh.
RCAI Pediatric Hip Abduction
Congenital Dysplasia of the Hip (CDH)
One piece design for ease of application
Durable polypropylene construction with closed cell foam lining
Holds infant in 90° hip flexion and 60° abduction
Allows nappy changes without removal of the
Pediatric Hip Abduction
Ideal for congenital hip dysplasia.
Made of easy-to-clean
H. UPPER EX- ELBOW ORTHOSES
DeRoyal pro-glide jr. Elbow OrthosisAddresses joint stiffness of the elbow by using a low load, prolonged stretch modality. Features include single hinge design and lightweight construction. The unit easily converts from an extension splint to a flexion splint with the simple turn of a screw. Fully adjustable. Liner is machine washable. Weight 1 lb 10 oz.
Pediatric comfy elbow hand combo
orthosisAdjustable and readjustable to individual patient without the use of heat or tools. Can be graded up to increase elbow extension.Lightweight and durable.
Pediatric comfy elbow
orthosisProvides excellent support for flaccid or weak extremities Helps immobilize painful extremities. The splint spine can bend to the desired ROM and the cuffs can adjust to the wrists and MP joints for optimal fit.It can also be adjusted to provide for gradual extension of the non-fixed elbow contracture.
goniometer elbow orthosisDesigned to increase elbow extension following CVA, surgery, injury or neurological complications. Also excellent for individuals with strong flexor tone. Has the same benefits as serial casting and allows for progressive extension of the elbow in 10° increments, but does so in a comfortable, adjustable and removable splint form. The goniometer hinge allows one to set a range within which the elbow can flex and extend and it can also lock at a desired degree of extension.
Pediatric comfy spring loaded goniometer elbow
Designed to increase elbow extension following CVA, surgery, injury or neurological complications.
It is also excellent for individuals with strong flexor tone.
has the same benefits as serial casting and allows for progressive extension of the elbow in 10° increments, but does so in a comfortable, adjustable and removable splint form.
hinge allows one to set a range within which the elbow can flex and extend and it can also lock at a desired degree of extension.
comfyprene elbow orthosisProvides excellent support for flaccid or weak extremities and helps immobilize painful extremities. The splint spine can bend to the desired ROM and the cuffs can adjust to the wrists and MP joints for optimal fit. It can also be adjusted to provide for gradual extension of the non-fixed elbow contracture.Pediatric comfyprene goniometer elbow orthosisDesigned to increase elbow extension following CVA, surgery, injury or neurological complications. The orthosis has the same benefits as serial casting and allows for progressive extension of the elbow in 10° increments, but does so in a comfortable, adjustable and removable splint form. The goniometer hinge allows one to set a range within which the elbow can flex and extend, and it can also lock at a desired degree of extension.
pediatric flex elbowElbow sleeveThe Pediatric Elbow Sleeve is made of 1/8" nylon 2-sides neoprene. Provides warmth, compression and protection.
Pediatric universal arm brace
The Universal Arm Brace has bilateral hinges, which provide increased flexion/extension elbow control from 0° to 120°. The lightweight stainless steel hinge construction aids in patient compliance. The precision length adjustment hinge arm assures a personalized fit and the unique forearm design provides protection of the olecranon process. The liner is made of a breathable laminate interface. Pediatric hyperextension elbow supportMade of 1/8" nylon 2-sides neoprene with two loop and lock criss-cross straps.
Aspen Pediatric Cervical Collar Has been carefully designed to provide effective motion restriction without producing the painful pressure points that lead to skin breakdown and noncompliance. Three layers of polyethylene combine to produce a support structure that is extremely rigid yet able to flex at its edges to conform to each patient's anatomy. This layered design spreads the load over a large area, producing a true custom fit, which has been documented not to produce pressure in excess of capillary closing pressure, the underlying cause of skin breakdown.
The Aspen CTO
Combines highly effective immobilization of the cervical and upper thoracic spine with a level of comfort that makes it well tolerated by patients. Research has shown substantially progressive immobilization in going from a stand-alone cervical collar, to a two-post device, and then on to a four-post orthosis.
Aspen Sierra Pediatric Collar
With just one size, the Sierra provides substantial motion restriction for the vast majority of the pediatric patient population. Its flat back panel facilitates a safe application and the DYNA-Capture system contours to the back of the child's head, increasing motion restriction. Access to the tracheal area is unparalleled, allowing for visualization or any procedure on the anterior neck.Corflex Pediatric Ambu Perfit Collar - Features one-piece flat design with flip out chin piece and trachea opening for easy access. Constructed of durable plastic laminated to foam with contact closure.
Pediatric Ultra Cervical CollarFeatures anatomically contoured foam with soft cotton stockinette covering for maximum patient comfort. Manufactured from medium firm density foam with 2" contact closure. DeRoyal Comfo-Eze Cervical CollarHighest quality medium density foam construction. Breathable synthetic stockinette liner. Removable cover can be washed for better patient hygiene.
Infant Cranial Interface
Used to protect the skin, wick moisture, control rashes, and guard against dermatitis. NecLoc Kids CollarImmobilization of pediatric patients under the age of 12 during emergency transport
Miami Jr. Collar
Engineered to fit the unique anatomies of patients age 12 and under.Indications for Use:C-Spine precaution for trauma patientsImmobilization for pre and post c-spine surgerySCIWORA Syndrome Degenerative disordersSpinal Stenosis Spondylolisthesis
Papoose Infant Spinal Immobilizer
Designed for newborns up to 3 months, the Papoose cradles the baby's body, securely and gently immobilizing the head and spine while maintaining airway and spine alignment.Indications for Use:Immobilization of the head and spine in patients 0 – 3 monthsSuturesMR and other diagnostic imagingTreatment situations requiring temporary immobilization
Indications:Positioning of structurally stable spineFollowing complications of standard halo immobilizationPostoperative positioning following sternocleidomasatoid release for congenital muscular torticollisReduction of C1-C2 rotary instability
Pediatric one-piece extrication collar
It has an oversized trachea opening for quick access to carotid pulse monitoring and emergency tracheotomies. Chin support maintains patient in neutral alignment. Mandible support adapts to individual patient's unique jaw line.
OrthosisTorticollis is a condition where the head is rotated and tilted to one side due to the shortening of the muscles of the neck. This orthotic supports the head after surgery and then slowly adjusts it into the proper position.END