Assistive Feeding Arm Orthosis for Flail Arm Resulting from Arthrogryposis
WAYNE ROSEN CO*, OSCAR ORTIZ, CP, AND HELGA M. ROBINETTE, OTRMiami, Florida
A 4-year-old boy with arthrogryposis had multiple surgical releases and tendon transfers. He ambulates with bilateral KAFOs for very short distances. His upper limbs are flail with the exception of trapezius and deltoids. He depends on family support for all activities of daily living. The child is exceptionally intelligent with strong support from his family.
A device was fabricated consisting of a humeral and a forearm cuff to hold the hand in supination. Both cuffs were joined by below-elbow polycentric joints. Prosthetic cable was attached to the two cuffs. The excursion was limited to 30 degrees of extension to provide mechanical advantage.
A Rancho external power system was adapted to a microswitch and fitted to the patient's left leg. A table-top balanced forearm orthosis was set elbow heavy to aid elbow flexion and a supinator assist was attached. A swivel spoon was strapped to the child's hand. The orthosis enabled the child to flex and extend the elbow, thus bringing spoonfuls of food to his mouth, and aiding him to perform other one handed activities.
*Jackson Memorial Hospital Rehabilitation Center, 1611 NW 12th Avenue, Miami, FL 33136