Notes From The Prosthetics Research Program
An item of particular interest concerning a new brace appeared in the October 13, 1967, Interim Report of the Orthotic Research Project, Ontario Crippled Children's Centre (Colin A. McLaurin, Project Director). Pending publication of a fuller report at a later date, a brief description of the brace is presented here.
One of the accepted methods of treating Legg-Perthes disease in three-to six-year-old children involves the application of plaster casts to both legs up to midthigh. The casts are then cross-braced to hold the hips in 90 degrees of abduction. The plaster is heavy and expensive ($40 to $50 for bandages), and must be removed every two months to exercise the knees and ankle joints. Also, sitting with the knees straight and the hips in 90 degrees of abduction is awkward.
A brace to provide the necessary hip abduction was designed and fabricated by this project. It consists of a diamond-shaped aluminium frame to which are attached San Splint* thigh cuffs. The lower apex of the frame has a fitting for two ball joints, each attached to a radial arm extending to a 45-degree block to which a shoe is attached. This pair of ball joints (automotive type) allows flexion and extension of knee and ankle joints, yet controls axial motion and always maintains a 90-degree angle at the hips for all sitting and standing positions. Plans for constructing the brace have been discussed with the personnel of a local brace shop, who are now producing the appliance. The advantages of this brace over the plaster casts are lighter weight, greater mobility, unrestricted knee and ankle motion, and ease of removal for sleeping and bathing. The design is extremely rugged and more durable than plaster for an active boy.
The fact that periodic cast removal and therapy are not required to maintain knee function results in considerable saving in time and money. It has been estimated that the saving possible with some 60 patients now in the Metropolitan Toronto area would total about a quarter of a million dollars.
*"San Splint" is the trade name for a thermoplastic material that is formable at 140 F. It was developed by Polymer Corporation of Sarnia, Ontario, and is supplied by Smith and Nephew.