ORIGINAL POST
Hi List members,
I have an Alzheimer’s patient who needs to follow hip precautions but when
unsupervised, she has sat up in bed, unstrapped the soft abduction bolster
and dislocated her hip while still in bed. Now the physician wants her to
wear her ambulatory hip orthosis while in bed. Is anyone aware of a soft
orthosis that would prevent hip flexion in while in bed but wouldn’t cause
skin pressure problems? Thanks, Randy McFarland, CPO
RESPONSES
A soft style brace that might fit what you are looking for is philippon from
Bledsoe. I haven’t used it but I have been intrigued by it b/c its low
profile and doesn’t seems so scary to patients as say a normal hip abduction
brace.
we have a soft hip brace on page 8 in 2011 RCAI catalog . product code is
66hs
If she can unstrap the bolster she can doff the orthosis in bed too I’d
think.
The DJO hip orthosis is the closest thing that I have found for this type of
problem. It is a single lateral upright similar to most other HO’s but it
has no pelvic component. There are instead plastic tabs anterior and
posterior to the upright to which a VERY long 6″ wide elastic is fixed.
This elastic is long enough that it wraps around the patient 1 1/2 to 2
times and if you set it up right, it will close in the back. It will not
prevent int. or ext. rotation; it will not provide abduction in the standing
position, but it will prevent combined flexion/addution when recumbent. The
elastic is wide enough that even when fairly tight, there are no circulatory
problems. In my opinion, it provides exactly what most hip dislocation
patients need.
Becker sells the Lerman Hip abduction brace with anterior pelvic band, Model
#145. That is the most comfortable recumband brace.
Well, there’s a “hip guard” that is basically a grandma’s pantie with
large bolster sewn into it. One can not unstrap it. Non-reimbursable,
patient has to pay for it. I do not believe it does much for flexion
prevention, more for lateral impacts.
http://www.hiprotector.com/safehipw.html
I have recently tried the DonJoy hip orthosis on a women in a similar
situation and I’m hearing positive results.
Orthomerica sells a low-profile California hip. Maybe worth looking at.
You may like to have a look at the HipTric orthosis by Ossur. It would
effectively control hip flexion via the ROM hinge, but has a soft
orthosis-patient interface. (We have it here in Australia, and it is
featured on the Ossur UK site, but you may just need to check with Ossur in
the USA to see if it is available in the states?).
http://www.ossur.co.uk/Products/Hips-thigh-and-calf/Hiptric
