Pediatrics - April 2008

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Early Prosthetic Fit: Yes or No?

Feature

Children with Unilateral Congenital Below-Elbow Deficiency "How the parents accept a limb deficiency and how well they cope with it has a great deal to do with how well the child does, either with or without a prosthesis. " -Yoshio Setoguchi, MD Caroline is a lively, redheaded fifth-grader. She is a straight-A student who is into dancing, cheerleading, gymnastics, acting, and modeling.

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Better than Spinach: Young Minds and Muscles Benefit Equally with Activity

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Micael McHugh. Photograph courtesy of Adaptive Sports Foundation. Michael McHugh was afraid to fall and hurt himself.

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The Right Resources Make All the Difference

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Limb loss or limb difference can be difficult to cope with for children and parents alike-albeit for different reasons. According to Rebeca Guajardo, CP, of the Amputee and Prosthetic Center at TMC Orthopedic, Houston, Texas, parents are often concerned with how their child will fit in with their peers and whether or not their child will be able to keep up with other kids. "Children will usually have no problem fitting in because they do so well with prostheses," Guajardo says.

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Ankle-Foot Bracing for Young Athletes

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The Practitioner as a Team Player The key for bracing young athletes is to identify the appropriate amount of support without over-bracing the patient and restricting movement. As a clinician, it is a great pleasure to have the opportunity to help those with mobility challenges accomplish what they otherwise couldn't. Helping a young athlete who dreams of being the next Michael Jordan or Mia Hamm step out and play alongside his or her peers is truly a rewarding experience.

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The Battle of Compliance: How to Keep Kids in Their Braces

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At least dental braces are securely attached. Orthotic braces are another story. Given the chance, many children would prefer to toss their orthosis-along with all the time and effort spent diagnosing the situation and fitting the brace-in the hallway closet and forget about it.

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Is Your O&P Practice the Best It Can Be?

Perspective

As the challenges of the 21 st century present themselves to the O&P profession, independent practices often face insurmountable struggles when balancing the rising costs of keeping their doors open and maintaining the same quality of care that they have been providing for years. Education is a clear solution to the challenges facing our profession-good, solid, hands-on education taught by some of the finest and brightest educators in the world. However, education in and of itself is not enough.

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SureStep Shrinks HEKO Brace for Young Patients

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Traditionally, the smallest patients with genu recurvatum-hyperextension of the knee--have been treated with a basic ankle-foot orthosis (AFO). For many years, that was the only treatment option for toddlers as young as a year old, simply because there wasn't a small-enough hyperextension knee orthosis (HEKO) available. Bernie Veldman, CO, owner of Midwest Orthotic & Technology Center, South Bend, Indiana, says fitting younger pediatric patients with an AFO was a necessary evil.

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Brianna Barner: Life's Twists Stun, Inspire Healthcare Family


Tiny Brianna Barner of Atlanta, Georgia, slowly crosses the finish line as her parents' eyes gleam with pride. Their joy is heightened as they remember the battles fought as a family to reach this moment, including moving across the country and disregarding doctors who took one look at Briannas club feet at birth and said she would never walk. Today Brianna is all smiles as she unknowingly proves that prediction wrong.

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Innovative Crutch Designs: More Gain, Much Less Pain


Photographs courtesy of Thomas Fetterman. Although ambulating with crutches would probably not rank on anyone's A-list of favorite activities, it can solve the problem of mobility after injury. Crutches have a long history.

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The Winter of My New-Found Reality


By the time you read this I will have begun my spring thaw. I made it through my first Chicago winter relatively unmarred. Despite the wind tunnels and icy patches, it has been manageable navigating the different pathways on my way to work.

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Father, Son Begin 3,300-mile Freedom Run Across the United States

Sports

A father-and-son team has begun a 3,300-mile trek across the United States to raise funds for the Wounded Warrior Project (WWP), Jacksonville, Florida, the Challenged Athletes Foundation (CAF), San Diego, California, and the Sunshine Foundation, Feasterville, Pennsylvania. Courtney Arciaga (in red) leads the charge, with Warren and Tom Knoll close behind, during the March 1 kick off of the 2008 Freedom Run. Photograph courtesy of the Sunshine Foundation.

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University of Pittsburgh Adds Orthotics and Prosthetics Master’s Program

Industry Review

The University of Pittsburgh School of Health and Rehabilitation Sciences (SHRS), Pennsylvania, announced the addition of a new master's program to its curriculum. The Master of Science in Health and Rehabilitation Science, with a concentration in prosthetics and orthotics (MSPO), will be available to students in the 2008 fall semester. This two-year program within the Department of Rehabilitation Science and Technology is designed to prepare students to be certified prosthetists and orthotists.

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Hanger Education Fair Boasts Record Attendance

Industry Review

The 2008 Hanger Education Fair, held January 28 to February 2 in Reno, Nevada, was marked by record attendance and a major announcement as Ivan R. Sabel, CPO, chief executive officer and chairman of the board, used the occasion to announce that he would be stepping down as CEO. Sabel, who has been Hanger's CEO since 1995, will remain chairman of Hanger's board.

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Five Questions for Jean Williams Gonzalez, CPO


Jean Williams Gonzalez, CPO, decided in her 30s to make a career change. She took the first major step by quitting her job in the banking industry, knowing only that she wanted to "do something of service. " Gonzalez soon started work as an attendant for a close friend with muscular dystrophy who was a wheelchair user and wore a metal TLSHO.

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Got FAQs?

Got FAQs?

Denials are difficult to identify and time consuming to appeal. With competitive bidding, mandatory accreditation, aging technology, and increased billing erros, running an O&P show gets more complicated each year. Q: I have a question regarding the use of patient digital photographs for the sole purpose of fabricating either an orthosis or a transtibial prosthetic socket.

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Connecticut Amputees Rally for Prosthetic Coverage


On February 7, almost 100 amputees flooded the capitol in Hartford, Connecticut, to lobby for the state's parity bill. The activists were pushing for legislation that would require insurance companies to cover prostheses in the same way or on par with other basic medical services. The rallying cry in Hartford was "Parity Works," not only because this policy will work to get people the care they need, but also because it helps keep amputees working and paying taxes.

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'Big Things Come in Small Packages'

Viewpoint

This was my mother's mantra when I was growing up and expressing my frustration at always being smaller than other kids my age. Of course as a child, her words of encouragement didn't mean a lot to me, but as I read through the pages of this month's issue of The O&P EDGE, those words certainly resonate. In this issue, we focus on the smallest O&P patients-but we do so in a big way.

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Velocity Introduces Expulsion Valve


The new Velocity Expulsion Valve works in combination with Velocity's standard mounting plate and is hidden in the distal end of the socket. The use of a dummy during lamination creates a void in the distal end of the socket which accepts the Velocity valve. The valve has a large duckbill for quick air expulsion and easy cleaning.

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Squid Beaks for a Better Prosthetic Fit?


The razor-sharp beaks that giant squids use to attack whales--and maybe even Captain Nemo's submarine--might one day lead to improved artificial limbs for people, according to an article by the Associated Press (AP). That deadly beak may be a surprise to many people, and has long posed a puzzle for scientists. They wonder how a creature without any bones can operate it without hurting itself.

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