Orthotics and Prosthetics

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Fig. 31. During donning of the orthosis, the patient inserts the anterior PTB shell; final fitting and "checkout" complete the process. 1. A length of stockinette is applied to the patient's leg. 2. The shank section is donned by spreading apart the patellar-tendon groove and sliding the foot through (Fig. 31). 3. The section is applied by sliding in from the anterior section until the section keys into the shank section. 4. Velcro is placed around the patellar-tendon area and the mid-point of the anterior section. 5. The patient's shoe is placed on the orthosis and the patient is asked to stand. 6. Normal checkout for the PTB is performed making sure weight-bearing is on the patellar tendon and medial flare of tibia. If the orthosis is fitted correctly, the patient should experience a contact of the sole on the footplate of the orthosis but no weight-bearing. Fig. 30. Following completion of the second lamination, the orthosis is marked for cutting away from the cast. FITTING SUMMARY Our experience with plastic patellar-tendonbearing orthoses in ten individuals with varying musculoskeletal defects of their lower limbs has been presented. We concluded that several disabilities of the lower limb can be successfully managed with this device, affording superior cosmesis, reduced orthotic weight, more comfort, and improved physiological and anatomical alignment. Disadvantages included increased cost, frequent replacement in children, and potential skin problems in those individuals with impaired vascular and sensory areas. Our preliminary 18-month experience led us to the conclusion that the plastic patellar-tendon orthosis is a valuable tool in the care of disabled adults and children; we are continuing our clinical trials and will publish a subsequent paper outlining our experiences with neuromuscular disabilities.
LITERATURE CITED 1. Corcoran, P. J., Evaluation of a plastic short leg brace. A thesis for Degree of Master of Science, University of Washington, May 1968. 2. Demopoulos, J. T., and A. Cassvan, Experience with plastic orthoses in children: preliminary observations. Bull Hosp. Joint Dis. 32:148-167, October 1971. 11. Lehneis, H.R., New concepts in lower extremity orthotics. Med. Clin. N. Amer. 53:3:585-592, May 3. Demopoulos, J.T., A. Cassvan, and J. M. Snowden, 1969. Experience with plastic lower extremity othoses. Bull. Hosp. Joint Dis. 33:22-46, April 1972. 12. Mcllmurray, William, and Werner Greenbaum, 4. Demopulos, J. T., and J. E. Eschen, Modification A below-knee weight bearing brace. Orth. Pros. Appl. of plastic orthoses for children. Bull. Hosp. Joint Dis. J. 12:2:81-82, June 1958. 34:156-160, October 1973. 5. Jebsen, R.H., B.C. Simons, and P. J. Corcoran, Experimental plastic short leg braces. Arch Phys. Med. Rehabil. 49:2:108-109, February 1968. 6. Kay, H. W., Clinical applications of the Veterans Administration Prosthetics Center patellar-tendonbearing brace. Artif. Limbs 15:1:46-67, Spring 1971. 7. Kay, H. W., and H. Vorchheimer, A Survey of Eight Wearers of the Veterans Administration Prosthetics Center Patellar Tendon-Bearing Brace. School of Engineering and Science, New York University, July 1965. 8. Lehmann, J. F., B. J. DeLateur, C.G. Warren, and B.C. Simons, Trends in lower extremity bracing. Arch. Phys. Med. Rehabil. 51:6:338-353, June 1970. 9. Lehmann, J.F., and C.G. Warren, Ischial and patellar-tendon weight-bearing braces: function, design, adjustment, and training. Bull Pros. Res. 10-19:6-19, Spring 1973. 10. Lehneis, H.R., Brace alignment consideration, Orthop. Pros. Appl. J., 18:2:110-114, June 1964. 13. Mcllmurray, William, and Werner Greenbaum, The application of SACH foot principles to orthotics. Orth. Pros. Appl. J. 13:4:37-40, December 1959. 14. Sarno, J.E., and H. R. Lehneis, Prescription considerations for plastic below-knee orthoses. Arch. Phys. Med. Rehabil. 52:11:503-510, November 1971. 15. Simons, B. C, R. H. Jebsen, and L. E. Wildman, Plastic short leg brace fabrication. Orth. and Pros. 21:3:215-218, September 1967. 16. Veterans Administration Prosthetics Center, A Manual for Fabrication and Fitting of the Below-Knee Weight-Bearing Brace, April 1967.
Page 1 and 2: DECEMBER 1974 Orthotics and Prosthe
Page 3 and 4: Orthotics and Prosthetics EDITOR A.
Page 5 and 6: THE AMERICAN ORTHOTIC AND PROSTHETI
Page 7 and 8: PROSTHETIC SOPPLY CO. 947 JUNIPER S
Page 9 and 10: POST-SURGICAL SUPPLIES ABOVE-KNEE S
Page 12 and 13: Choose it - Because body conditions
Page 14 and 15: CAMP TAYLOR-TYPE ORTHOSES are full
Page 17 and 18: SOME OBSERVATIONS ON UPPER-LIMB PRO
Page 19 and 20: EXPERIENCE WITH PLASTIC PATELLAR-TE
Page 21 and 22: the plastic orthosis is applied snu
Page 23 and 24: earing orthosis was more acceptable
Page 25 and 26: Case No. 4. H.S., a 61-year-old ind
Page 27 and 28: other pertinent bony prominences. T
Page 29 and 30: Fig. 20. Finished plantar surface o
Page 31 and 32: Fig. 23. The positive mold has Fig.
Page 33: 3. A PVA bag is placed over the cas
Page 38 and 39: sphere which is held in the mandrel
Page 40 and 41: stress concentrations at the end of
Page 42 and 43: Fig. 8. Prosthesis ready for fittin
Page 45 and 46: DEVELOPMENT OF A THERMOPLASTIC BELO
Page 47 and 48: Fig. 6. Cutaway view of pylon lamin
Page 49: to point out that his own contribut
Page 52 and 53: well as the foot; and a "KAFO" (kne
Page 54 and 55: fresh approach to the problem was m
Page 56 and 57: TABLE II. AMPUTATION LEVELS—LOWER
Page 58 and 59: • That from six to ten prosthetic
Page 60 and 61: ACKNOWLEDGMENTS The Task Force was
Page 63 and 64: A PROPOSED PROSTHETICS TERMINOLOGY
Page 65 and 66: The nature of the distribution will
Page 67 and 68: PROSTHETICS FORM/Upper Limb APPENDI
Page 69 and 70: X-RAYS: A "FITTING TOOL" FOR THE PR
Page 71: Fig. 4. Closed Syme's prosthesis; a
Page 74 and 75: turned. The following information w
Page 76: APPENDIX A COMMITTEE ON PROSTHETICS
Page 80 and 81: 66 NEW PUBLICATIONS THE CARE OF THE
Page 82 and 83: 68 NEW PUBLICATIONS PUBLICATIONS AV
Page 84 and 85:
70 INFORMATION FOR AUTHORS ORTHOTIC
Page 86 and 87:
72 METRIC SYSTEM Conversion Factors
Page 88 and 89:
74 NEW ABC CERTIFIED PRACTITIONERS
Page 90 and 91:
dm CompleteLineOf Components &Supli
Page 92 and 93:
Riaidlv spinal doctors Spinal appli
Page 94 and 95:
Sutton's SJ/4 Jack Sander.. . YOU'L
Page 96 and 97:
Cut it. Mold it. Bend it. Shape it.
Page 98 and 99:
WASHINGTON PROSTHETIC SUPPLIES WHY
Page 100 and 101:
CLASSIFIED ADVERTISEMENTS Advertisi
Page 102:
AMERICAN BOARD FOR CERTIFICATION IN
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