Orthopaedic Technician Research Articles

Knowledge-based System for Guided Modeling of Sockets for Lower Limb Prostheses

AbstractThis paper presents a 3D CAD system to design sockets of lower limb prostheses, both transfemoral and transtibial. The proposed system, named Virtual Socket Laboratory, can be seen as a virtual laboratory where the user has at her/his disposal virtual tools that permit to emulate the procedures applied by orthopaedic technicians during the traditional socket manufacturing. The module is centred on the digital model of the patient and is based on the specific domain knowledge to guide the user during socket modelling suggesting the most appropriate design rules and procedures. First, main steps of the new design-modelling process and system functionalities are presented. Then, for each step, procedures carried during the traditional process, how they are executed with the new module and tools specifically developed are described.

Pediatric Fracture Clinics: Current Status and Future Directions

The increasing demand for fracture care in pediatric patients, along with the shortage of fellowship-trained pediatric orthopedic surgeons and the growing number of uninsured or under-insured children, places considerable demands on institutions that provide such care. High-volume, multidisciplinary, outpatient fracture clinics can be efficient and cost effective, and can ease the burden on crowded emergency departments. Using a team approach with an orthopedic surgeon and a number of mid-level care providers stream-lines care and makes the most efficient use of the varied skills of these individuals. The fracture-care team may include nurse practitioners, physician assistants, nurse coordinators, orthopedic technicians, physical therapists, radiology technicians and even social services, such as case managers, child-life specialists and translators. Having all of these resources readily accessible provides a ‘one-stop shop’ for pediatric fracture care. This can decrease the number of visits to the emergency department for cast concerns, in turn decreasing the cost of fracture treatment.

Exoskeletale prothetische Versorgungsmöglichkeiten nach angeborenen oder erworbenen Defekten an den oberen Extremitäten

The exoskeletal prosthetic care of the upper extremities poses a variety of challenges to the experienced orthopaedic technician. In addition to the clinical factors which are initially decisive, such as general condition, amputation level, condition of the stump and resilience, the patient must be given equal attention when it comes to the design of the prosthetic device. The requirement to regain physical appearance which, in most cases, approaches the same importance as retrieving the best possible motor skills, underscores the necessary variety in design options for the prosthetic device. The following article intends to demonstrate diverse options in orthopaedic care for the upper extremities. On the basis of various care examples, the requirements and individual approaches in exoskeletal prosthetic care of the upper extremities will be illustrated.

Correction effects of the ScoliOlogiC "Chêneau light" brace in patients with scoliosis.

BackgroundDifferent bracing concepts are used today for the treatment of scoliosis. The plaster cast method worldwide seems to be the most practiced technique at the moment. CAD (Computer Aided Design) systems are on the market which allow brace adjustments without plaster. The latest development however, is the use of the ScoliOlogiC™ off the shelf system enabling the orthopaedic technician to construct a light brace for scoliosis correction from a variety of pattern specific shells to be connected to an anterior and a posterior upright. This „Chêneau light" brace, developed according to the Chêneau principle, promises a reduced impediment of quality of life in the brace. However, material reduction should not result in reduced effectiveness. Therefore the primary correction effect in the „Chêneau light" brace has been evaluated and compared with that of other braces used today.MethodsThe correction effects of the first 81 patients (main diagnosis Adolescent Idiopathic Scoliosis (AIS) [n = 64] or Early Onset Scoliosis (EOS) [n = 15]), treated according to the principle of the „Chêneau light" brace were evaluated after an average treatment time of 6 weeks by a full-body X-ray made in the standing position whilst wearing the brace and compared with the last X-ray before bracing. The average curvature angle of the whole group was 35,6°, the average age was 12,9 years (SD 1,9), average Risser sign was 1,3 (SD 1,5), average Tanner rating 2,75 (SD 0,7).ResultsThe Cobb angle in the whole group was reduced by an average of 16,4°, which corresponds to a correction effect of 51%. The differences were highly significant in the T-test (T = 17,4; p < 0,001). The best correction effects reported in literature so far are about 40% in two different studies. The correction effect was highest in lumbar and thoracolumbar curve pattern (62 %; n = 18). In thoracic scoliosis the correction effect was 36 % (n = 41) and in double major curve pattern 50 % (n = 22). The correction effect correlated slightly negative with age (r = -0,24; p = 0,014), negatively with the Risser stage (-0,29; p = 0,0096) and correlated negatively with the Cobb angle measured before treatment (r = -0,43; p < 0,0001).ConclusionThe use of the „Chêneau light" brace leads to correction effects above average when compared to the correction effects of other braces described in literature. The reduction of material seems to affect the desired correction in a positive way.

André-R. Bähler (10 March 1925 – 13 September 2006)

Prosthetics and Orthotics International 31(1):p 101-102, March 2007. | DOI: 10.1080/03093640601058147

ORAL HEALTH CARE AND PROFESSIONAL ABSTINENCE

In the May 2004 issue of the Journal, Lamster1 and Formicola et al.2 lament the sorry status of oral health and oral health care for major segments of our population, specifically, poor children, the elderly, the institutionalized, and the uninsured. They state the usual pious platitudes—the “shoulds” and the “oughts”—without recognizing the contributing deficiencies in dental education and training that are perpetuated by organized dentistry’s unflagging resistance to fundamental change. So long as filling a tooth and making a denture are considered doctoral-level activities, dentistry will not escape its persistent regressive character and will not be able to adequately serve the public need. More than 80 years ago, New Zealand began to use school dental nurses, highly trained dental technicians assigned to public elementary schools to provide basic preventive and restorative (filling) treatment. These dental nurses are supported by nurse supervisors and by public health and private dentists as needed. Also in New Zealand, and in other countries, dental prosthetists provide dentures much as orthopedic technicians construct artificial limbs. Periodic efforts by US state and federal public health agencies to implement programs employing dental nurses, now called dental therapists, have been squashed by the American Dental Association, despite the documented success of such programs in New Zealand, Australia, Canada, and many developing countries.3 The Alaska Native Tribal Health Corsortium is currently initiating a dental therapist program for the Alaskan Eskimo population despite the opposition of the American Dental Association. The use of such sophisticated technicians in the United States would allow dentists to be trained as complete specialists in stomatology. Instead, dentistry is becoming more and more specialized, to the point of absurdity. Filling the root canal of a tooth (endodontics) and filling children’s teeth (pediatric dentistry) do not require specialized knowledge and techniques, thus qualifying as true specialties, but are merely “limited practices.” The result of the existing overspecialization is to restrict the supply of competent general practitioners, to restrict access, and to increase the cost of these services to the point where only the insured and the wealthy can readily afford them. It is a puzzle and a disgrace that the American Journal of Public Health could devote so much space to oral health care issues in this country without referring to the more obvious deficiencies and their resolution, or to the flagrant fraud and abuse in functionally unnecessary treatment and overcharging that is rampant in dentistry.4

Emanuel Christen and Elio Erriquez released

Emanuel Christen and Elio Erriquez, the two ICRC orthopaedic technicians abducted while on their way to work in Sidon, Lebanon, on 6 October 1989, were released on 8 and 13 August 1990 respectively after 307 and 312 days of captivity.Both delegates followed the same path to freedom. They were handed over to Syrian forces in Lebanon and then transferred to Damascus where, in the presence of the head of the ICRC's delegation in the Syrian capital, they were entrusted to the care of the Swiss embassy. From Damascus a special aircraft chartered by the ICRC brought them back to Switzerland, where they were welcomed by their families, by Mr. René Felber, head of the Swiss Federal Department of Foreign Affairs, and by ICRC President Mr. Cornelio Sommaruga.

Proceedings of the Scandinavian Society of the Foot: Trondheim, Norway, June 11,1986

The Scandinavian Society of the Foot (Nordisk Forening for Podologi) was founded in Stockholm on October 4, 1985. Each Scandinavian country is represented on the board, whose members are Uffe Jorgensen (Denmark), Jarl-Erik Michelsson (Finland), Halldor Jonsson Jr. (Iceland), Kjell Nokleby (Norway), and Gert Walheim (Sweden).The society will promote research and education in podology and different specialists interested in foot problems, such as orthopedic surgeons, shoe and orthosis technicians, foot therapists, and physiotherapists, are invited to participate in the meetings of the society.Abstracts from the first meeting of the society at Trondheim, Norway are presented below.

Transport traction.

Mr. Smith is the Orthopedic Technician at the Children's Rehabilitation Center, University of Virginia Medical Center, in Charlottesville, Virginia.

For the War Disabled: An ICRC achievement in Sana'a

At a ceremony held in Sana'a towards the end of March 1972, the ICRC formally handed over to the authorities in the Yemen Arab Republic the workshop which it had opened in 1970 for the manufacture of artificial limbs for the war disabled in that country.Under the responsibility of the Ministry of Health, the Yemeni employees will henceforth use the skill they acquired in the workshop and in which five of them, thanks to grants, received further training at the Teheran specialized centre of the Iranian Red Lion and Sun Society. The orthopaedic technician delegated by the ICRC will stay in Sana'a for another six months, under an agreement with the Yemeni Government and the World Health Organization, which is providing assistance. This decision was reached with a view to easing the transitional phase.