I’ve gotten several more responses to my question about pediatric knee
braces for a four year old with a TTA
My original question was:
I have a four year old Trans-Tibial amputee who is showing a lot of knee
joint instability, especially in hyperextension. I may just have to fit
him with side joints and thigh lacer but I want to review my other option
of using a knee orthosis. What companies exist that produce a KO of
suitable size or an elbow orthosis that can be adapted?
Responses Follow:
==========================================================
On a few occasions, I have laminated an anterior thigh shell for a bk. I
trim the lamination something like what you would see from a DonJoy Defiance
or Townsend Premier. I have used Bock and Becker joints. I have found it to
be a nice option to a thigh lacer (when needed) since it is clean, light,
and breathable. Certainly, it is very stable.
Also, on two occasions, Flextech (now DeRoyal) has laminated a thigh shell
into a BK prosthesis for me. They call it the ‘BK Brace’. Both times the
results were excellent.
—————————————————————————
What foot ankle combination are you using ? ROM needs to be considered.
—————————————————————————
Why not use a PTS design with supra-patellar trim line. This would provide
M/L and extension control. The downside is cosmesisand if the joint itself
is loose you may aggravate the codition.
—————————————————————————
The other option would be to simply make a thermoplastic thigh cuff (like
the proximal section of a KAFO), attach appropriate knee joints and contour
to the shape of the prosthesis. You can ultimately bend your uprights in
the saggital plane (into flexion) until the hyperextension is eliminated,
or simply utilize dial lock joints, which are easy to adjust after
fabrication.
—————————————————————————
>It sounds like you had several prosthetic responses. I know that Townsend
>Design fabricates pediatric knee braces (they are my favorite knee brace
>company/ an orthotist runs the company). You may be required to take a
>custom mold of the proximal thigh and cast over the prosthesis – but I
>know they are open to all sorts of applications. I successfully fit an
>adult BK with an off the shelf Townsend knee brace and it worked
>beautifully. In my opinion, there certainly comes a time when the lever
>arm offered by a supracondylar brim is not enough, and sitting cosmesis is
>also compromised. Townsends ph # is 800 432 3466. Hope this helps!
==========================================================
Again, my sincere thanks to all who replied.
Ted A. Trower C.P.O.
A-S-C Orthotics & Prosthetics
Jackson, Michigan, USA
www.amputee.com
