Thursday, March 28, 2024

UE Challenge Response

PP240Z

Dear colleagues,

My apologies for a late return of these responses most generously posted to

me. I suffered one of the worst type of computer problems imaginable.

Here are the last responses before the “event”.

Pat–

I have successfuly fit three Cornelia de Lange kids over the past few years.

Most have been a bit older when the attempt was made–the youngest being about

5 years.

The first was a bialteral BE (In WY) with forearms tapering to single digits.

Hermetically sealed switches were used to actuate “cookie crusher” enabled

VASI 2-6 hands. Measured IQ of 7. Originally fit at about age 12 and as far

as I know, the first CdL to attempt electric prosthetic fitting. Training

began by using a microswitch operated fan–(she liked the fan to blow on her

face) until she understood cause and effect. Once the arms were fit, her

favorite food (french fries!) was inserted to demonstrate the hand’s

usfulness.

She is now about 22 years and wears the arms all day. In fact, she gets quite

upset when they are missing. If we have to keep them for repairs, she ends up

wearing slippers on her arms or she’s not happy. We presented this case at

ACPOC a few years ago w/ video.

#2 was a bilateral AE (In NY)–short right/ very long left (a skinny “stick”

basically). Measured IQ–I don’t remember; however, greater than patient #1.

We fit with a cookie crusher enables single electrode and a VASI 0-3 hand

mounted on a modified Otto Bock ball & socket wrist which was itself mounted

at almost 90° to the axis of the humerus on the anteromedial corner of the

distal humerus, i.e., No Forearm. A so-called “Mommy” swtich was installed so

the OT & Mom couild open the hand esternally to insert objects. Training was

basically “accidental” discovery of the hand.

#3 is a bialteral BE with “chicken wing” appearing arms. He is being fit with

our collaboration in TX. The fit presently is unilateral, BE, with a

microswitch/cookie crusher actuated w/ Mommy switch and VASI 0-3 hand–similar

to the first case.

Dexterity of the digit is questionable. The switch is being incorporated into

an electric toy for training. Final result is pending.

I’d be happy to consult in the case if you have the need.

I can be contacted at this eMail address or at [email protected]

otherwise, call 801-328-9728.

J. Thomas Andrew, CP

Ability Prosthetic Systems, Inc.

Dear Pat Peick,

Just some comments for thought.

We recently evaluated an (otherwise healthy) 22 month old BE child for the

consideration of a myo arm.

This young girl has been using a passive prosthesis for more than a year

..

—The mother has made it painfully clear that her daughter would not

tolerate the necessary harness for a body powered prosthesis.

—Keep in mind the child would also have to learn that an extended reach

for some object would open the terminal device of the body powered arm.

—The mother of this young patient said the most difficult problem for her

daughter has been proprioception; and recognizing that her prosthetic arm

(and thus prosthetic hand) are much longer then her residuum. She reports

that the child often, and accidentally, pushes objects away with the

prosthesis on her “approach”.

Perhaps obvious observations but just thought I’d share these comments.

Once again, this was a young patient of normal cognitive abilities.

Good luck,

Dan

Once again I apologize for the lateness of these postings, I hope you all find

them informative.

Pat

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