HIP ORTHOSES

 

S.W.A.S.H Brace
Patients with Cerebral Palsy often present with one or more of the following problems:

  • Difficulty in standing
  • Difficulty in walking

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  • Unstable sitting
  • Poor hip development

Impact of High Adductor Tone

  • Drives the feet into pronation
  • Internally rotates the lower limbs
  • Flexion influence on both the knees and the hips
  • Influences the trunk into a slouched posture

History of Brace

  • Since 1992 this orthosis has been used for thousands of CP children in many countries
  • S.W.A.S.H. “seems” a simple device, which works by a combination of 21 joints and angles
  • S.W.A.S.H. means a great help in the treatment of CP children

Classic

  • When maximum trunk control is required (patient that lacks muscle strength to sit upright)
  • When smaller diameter uprights are desired for less restriction of movement
  • When the greater pelvic and torso coverage triggers more desirable neuro-sensory response

Low Profile II

  • When the primary goal is to control scissor gait
  • When wearer has limited space between iliac crest and the rib cage
  • When maximum upright strength is required
  • When patient/caregiver acceptance of “bracing” is an issue

Indications

  • 9 months to 5 years old
  • Risk of hip dysfunction
  • Spastic diplegia - Easiest to fit
  • Spastic quadriplegia - Best with 115 uprights
  • Night splint - 6 to 24 hours use OK
  • Post-operative - When fixed abduction not necessary

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Pavlik Harness
The Pavlik harness is a fabric brace designed to gently position a baby’s hips so they are aligned in the joint, and to keep the hip joint secure. It is typically used to treat babies from birth to six months of age who suffer from developmental hip dysplasia. This condition is characterised by either one or both of a baby’s hips being underdeveloped.

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By positioning a baby’s hips in a Pavlik harness, it will keep the hip joint aligned and stable, this will assist with normal growth and development of the hip joint. It is recommended that the baby wear the brace full-time for 6-12 weeks. Some doctors allow the Pavlik harness to be removed for bathing and, as long as the legs are kept in a similar position as in the brace. Diaper changes can be done without removing the brace. Babies are checked every week to ensure that the hips are still in the correct position.

Brace Characteristics:

  • Made from a soft material to prevent chaffing
  • Easily adjustable
  • Easy for parents to apply and remove

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X-Act™ ROM Hip Brace
Indications:
Minimally invasive hip procedures, labral repair with or without gluteus medius repair, post-operative proximal hamstring repair, range of motion control following primary or hip revision surgery.

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Characteristics

  • Lightweight design with compression belt provides support to the lower back
  • Adjustable fittings enable easy customisation to provide an exact fit
  • Virtual joint protects the hip capsule by providing stability and can safely limit range of motion following surgical procedures
  • Lateral abduction paddle assists the three point design, decreasing risk of dislocation
  • Fits left or right hip

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Hip Orthoses are used to either correct the hip joint or to support the hip while walking. Hip orthoses are commonly used in adults when a patient struggles with recurring dislocations of the hip joint. They are also used to support the joint after surgery, to thus prevent any problems as it heals.

Hip Orthoses would also be prescribed in the event of developmental problems in children, which is commonly referred to as congenital dysplasia of the hips. With this condition the hip is prone to dislocation because the ball of the femur is not properly contained in the socket section of the hip. Placing the child in a brace for a few months would give the joint enough time to develop properly and should prevent future dislocations.

Hip orthoses, like most orthoses, can be placed in to two categories: Supportive and Corrective. In adults it would be supportive because they are skeletally mature, which means the there is no more bony growth taking place. Children on the other had are still growing, thus it is possible to correct some conditions with a temporary brace.

Hip orthoses can also form part of a larger orthosis that include support of the knee as well as the ankle and foot. These are known as Hip-Knee-Ankle-Foot Orthoses (HKAFOs) and they are usually prescribed when a patient struggles with muscle weakness and is not able to fully control one or both their legs. The function of a HKAFO is to stabilise the joints of the leg and to assist the patient to walk with more ease.