Binders for Myelodysplastic Children
JAMES H. LITTLE, PT AND LESLIE C. MEYER, MD*
Thoracolumbar level myelodysplastic children tend to develop hip abduction, flexion and external rotation contractures. Muscle imbalance, diapers, positioning, and gravity contribute to contractures. Binding the lower limbs towards adduction, neutral rotation, and extension of the hips during naps and at night is the usual method of prevention. Elastic bandages wrapped around the legs with a pillow between the knees is the customary way of achieving the desired position. The elastic bandage method is difficult to apply, can slip and restrict circulation, and the pillow between the knees to prevent undue pressure is difficult to keep in place. We developed a binder of polyester-cotton that is easy to apply, does not restrict circulation, stays in place, and has an adjustable pressure-relief pad to protect bony prominences. The binder utilizes Velcro closures and is easily cleaned. A foam pressure-relief pad is waterproofed and housed in a sleeve. Over the past 2 years, we have constructed 55 binders for approximately 35 children between the ages of 4 months and 5 years. Patients are satisfied with the ease of application; the contractures about the hips of the children using the binders have been minimal enough to allow parapodium fitting.
*Shriners Hospital for Crippled Children, 2100 North Pleasantburg Drive, Greenville, SC 29609-3194