Clothing For The Limb Deficient Child.

A.K.M. Macnaughtan, M.A.O.T. (Princess Margaret Rose Orthopaedic Hospital, Edinburgh.) 1968. 30 Pages.

Miss Macnaughtan, Head Occupational Therapist, presents a compendium of simple clothing designs and adaptations to further the independence of boys and girls with upper- and lower-extremity amputations. Each garment is sketched with a brief description of the modification and particulars regarding the supplier of the basic article or material utilized in the alteration.

Ease of dressing, comfort under and over prostheses, and absorption of perspiration are the primary considerations. Directions for donning the less conventional garments are noted. Miss Macnaughtan recommends Velcro fastenings for many items.

The child with upper-extremity amelia should be able to manage an undervest of stockinette tubing closed with a tape drawstring at the neck. Underpants adaptation for girls involves the use of lengths of tape sewn to the waistband. The child pulls the tape with her feet or a cleft stick. Other underwear designs for boys and girls are included.

The individual who has marked intercalary deficiencies of the upper extremities may wear a sleeveless vest with large neck and arm holes, or a vest with Velcro front closures. Such a child may be able to don a double garment consisting of underpants and loose waisted skirt (or trousers) with Velcro fastenings attached to corresponding places on each waistband. After slipping the garments over the hips, the child presses the Velcro squares together.

Other under and outer pants adaptations for those with upper-extremity limitations utilize panels secured with strategically located Velcro strips or squares. Underpants may just have a loose dividing front opening which is obscured by the outer garment.

Dresses may have front or shoulder fastenings of Velcro which can be managed with the mouth or prostheses. A front zipper with a large decorative pull ring also aids dressing.

Careful selection of clothing may obviate the need for any modification. Sleeves, skirts, and trousers must be roomy to accommodate the extra bulk of prostheses. Raglan sleeves allow additional space for shoulder sockets. Regular short sleeved pullover and cardigan style sweaters are well suited to those with absence or shortening of the arms.

Minor modification of ordinary dresses, sweaters, shirts, blouses, coats, pajamas, and nightgowns features Velcro squares beneath the usual buttons to facilitate dressing while preserving normal appearance.

The child should apply trouser legs or shirt sleeves to the prostheses first, then don the entire unit.

Two ingenious adaptations consist of Velcro strips along the side and arm seams of snug fitting shirts, and a cape with openings on each side concealed by decorative tape. The girl with short arms can reach through the upper openings while the lower slits may be used for artificial arms.

Footwear also receives attention. The child who depends on pedal dexterity may appreciate socks whose tops have medium elasticity and whose toes are cut out, except for a connection between the first and second digits. Slip-on shoes, elastic laces, and a long handled shoe horn are shown.

-Reviewed by Joan E. Edelstein, R.P.T.