Gibbus Cut-Out Seats for Myelodysplastics

JAMES H. LITTLE, PT AND L. C. MEYER, MD


Gibbus deformities in myelodysplasia produce significant seating problems. Pressure over the gibbus causes skin breakdown and keeps the child out of the seated position. A large gibbus in the thoracic or lumbar area prevents the child from sitting back far enough in the wheelchair to operate the chair effectively and keeps the center of gravity inappropriately positioned in the chair.

We have developed a seating system which allows for total pressure relief for the fragile skin over the gibbus and positions the child properly in the wheelchair. Over the past 3 years, 30 children have been fitted with special chairs with excellent results in pressure relief and functional positioning. The chair design consists of a plywood or plastic seat base with 5 to 7.5 cm (2 to 3 in) of dense foam for pressure relief and support. The seat back is made of 7.5 to 15 cm (3 to 6 in) of dense foam on an ABS plastic or plywood base which is carved so that the seat back only contacts healthy skin. The seat back is recessed so that the child is aligned functionally in the wheelchair. The seat back and cushion are vacuum formed with the appropriate covering material. Footrests are adapted if necessary.

Shriners Hospital for Crippled Children, 2100 North Pleasantburg Drive, Greenville, SC 29609-3194