Transradial Crawling Stubbies

Nicole T. Soltys


Background:

4-year-old child with amputations secondary to meningococcemia during the first year of life. [Image 1 ]

Amputations include:
Bilateral transradial amputations, Right transtibial amputation, Left transfemoral amputation

Also resulting from illness:
Cortical blindness, Physical and communicative delay, Extensive scarring on residual limbs, Lack of soft tissue padding on residual limbs

Problem:

Child shows a desire for independent mobility, but his lowerlimb amputations, cortical blindness, and core weakness limit his gross mobility. [Image 2 , Image 3 ]

Objective:

Upper-limb devices to be used for crawling, with the following goals:

  • Raise head and shoulders off of the floor to allow child to see environment, and to encourage back and shoulder strengthening
  • Provide padding to bony residual limbs
  • Independent donning and doffing

Solution:

Bocklite liners with distal buildups provide comfort to his limbs in crawling, raise the shoulders off of the floor, and are easy to don and doff to use the upper-limbs for sensory exploration.

  • Plaster cast taken of each arm with elbow in near-extension
  • 12mm Plastazote distal end pads custom molded over distal cast
  • 4mm Bocklite custom cones pulled over distal end pads
  • Liners capped with 4mm Bocklite in the traditional manner
  • Several layers of 4mm Bocklite added distally to create desired height
  • During fitting/delivery, Bocklite pads were added above the humeral epicondyles to improve anatomical suspension

Contact:

Nicole T. Soltys, CP
Rehabilitation Institute of Chicago
Prosthetics & Orthotics Clinical Center
312-238-2810
nsoltys1@ric.org
[Image 4 ]

Nicole T. Soltys, CP; Rehab Institute of Chicago