Infant Harness For Upper Extreminty Amella

Hermina L. Levy, O.T.R.

For the very young amputee, adequate stabilization of shoulder-disarticulation prostheses is difficult. This problem is encountered not only with bilateral amelias, but also with "phocomelia" deformities characterized by hypoplastic humeral segments and shoulders.

The patient described in this report has complete bilateral amelia, and was initially fitted at the age of eight months. The prostheses helped him to achieve good sitting balance. However, at the beginning balance was maintained by leaning on the terminal devices (Fig. 1 and Fig. 2 ). The initial "harnessing" which consisted of horizontal anterior and posterior straps allowed the sockets to shift under the weight-bearing load causing irritation of the neck.

The harness arrangement illustrated was found to be practical and comfortable for children who were still in diapers. The wide, dacron "crotch" strap is protected by plastic tubing, and is buckled in the front for convenience in diaper-changing. The "Y" straps, and the horizontal posterior strap, are of elastic webbing. When the child reaches forward by flexing his trunk, the posterior "Y" stretches while the elasticity of the horizontal strap permits some freedom of scapular motion. Stretching of the anterior "Y" permits the child to lie down.

This child is now nineteen months old and this harness arrangement is still satisfactory. It does not interfere with standing or walking. (The child backs a-gainst a Weill and pushes himself to a standing position with his legs.)

Hermina L. Levy, O.T.R. is Director of Occupational Therapy Elks Aidmore Hospital Atlanta, Georgia and Consultant, Georgia Juvenile Amputee Clinic