The Ontario Crippled Children's Centre: An Introduction

.R. Mutrie, M.D., C.M., F.R.C.S.(Ed.) & (C). , F.A.C.S.

To provide treatment and specialized services for physically handicapped children in the Province of Ontario, the Ontario Society for Crippled Children, after several years of planning, built and opened the doors of this active children's rehabilitation centre in May 1962.

The Centre provides hospital facilities of 105 beds for an active inpatient rehabilitation programme, as well as outpatient services for more than 200 children daily from metropolitan Toronto. There is also a 14-room school associated with the Centre, which is staffed with specialized teachers.

Among the many services provided is the Children's Prosthetic Clinic, directed by Dr. John E. Hall, B.A., F.R.C.S. (C), F.A.C.S., Chairman of the Prosthetic Clinicians group.*

* Composed of Dr. Donald A. Gibson, F.R.C.S.(Eng)(C); Dr. Hugh G.Thomson, F.R.C.S.(C); and Dr. James F. Murray, F.R.C.S.(C).

This programme has been one of our most rapidly growing services, with cases continually being referred to us from further and further afield in Ontario and from other provinces in Canada. The active amputee case load for the Centre is now 289 children. The work of the clinicians, therapists, prosthetists, and others involved in the treatment programme has been further stimulated by a very close working association with Colin A. McLaurin, B.A.Sc, P.Eng., Project Director of the Prosthetic Research and Training Unit (PRTU), which is housed in this Centre and is supported financially by the Department of National Health and Welfare of the Federal Government of Canada.

As a result of the excellent teamwork of the personnel in the programme and the reputation that they are building for the prosthetic services of this Centre, the growing number of child amputee referrals has caused us to progressively expand our services. The number of clinics has had to be increased, as well as the staff to man them.

The developments emanating from the Prosthetic Research and Training Unit have served to focus attention on the research aspects of the programme at this Centre. Some of these developments, which will be discussed elsewhere in this issue of the Inter-Clinic Information Bulletin, are the swivel walker electrically powered components for children such as an electric hook, a wrist rotator, and an elbow; and recently a coordinated upper-extremity prosthesis which is also electrically powered. Moreover, Mr. McLaurin has been closely associated with Professor Robert N. Scott, of the University of New Brunswick, and the latter's work on myoelectrical controls. Professor Scott has used the electrically powered components supplied by the PRTU as test devices in the development of his system.

Until recently, the prostheses prescribed by the clinic have been manufactured by commercial firms in and around Toronto. To supplement the work of these firms, particularly when the incorporation of new materials, experimental components, or new fabrication ideas are involved, we have now gone into the "prosthetic business" ourselves. At the present time our Centre Prosthetic Service, which was inaugurated on May 15, 1966, provides or makes any special item or new-type component, and on the more conventional items is responsible for directing and supervising the quality and workmanship of the items provided by the commercial firms. This new arrangement seems to be working reasonably well. At times delivery is still a little slower than we would like. However, by and large, the arrangement whereby the Centre prosthe-tist is responsible for the check-out of all prostheses, whether made in the Centre shop or the commercial shop, prior to the patient being checked out by the therapist and the medical clinicians of the clinic, has, I think, resulted in a marked improvement in service and in quality, as well as in the workmanship of the prosthesis.

I appreciate this opportunity to briefly introduce you to the Ontario Crippled Children's Centre and particularly to our programme in prosthetics for children. Having Mr. McLaurin and his Prosthetic Research and Training Unit located in this Centre and closely associated with the total clinical programme makes this prosthetic service an exciting and stimulating experience for all of us. With so many persons involved in this work on a world-side basis, the future of prosthetics for juvenile amputees is much brighter than ever before and hopefully will result in spectacular advances in this era of the "space age".

The following abstract is reprinted from the September 1966 issue of Birth Defects with permission of the National Foundation-March of Dimes.

Why Search For Congenital Defects? Canad. Med. Ass. J. 95(6): 270-272, Aug. 6, 1966.

Collins, J.F. (Med. Arts Building, St. John's, Newfoundland.)

Specific survey techniques to determine the incidence of congenital defects and related epidemiological and etiological factors are recommended to ascertain the national prevalence rate of such anomalies in Canada rather than the creation of a Central Registry which may indicate trends but does not provide sufficiently accurate or depth of information (26 references.)

.R. Mutrie, M.D., C.M., F.R.C.S.(Ed.) & (C). , F.A.C.S. is the Medical Director Ontario Crippled Children's Centre Toronto, Ontario