Making orthotic and prosthetic devices for children is totally different than making the same items for an adult. The abilities of the orthotist or prosthetist are challenged in completely different ways. The clinicians at De La Torre Orthotics and Prosthetics are educated and experienced in dealing with these challenges. Each device is designed to support the active child. Our specialties and products allow for care of children with cerebral palsy, spina bifida, scoliosis, multiple sclerosis – and many other diagnoses.
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Purpose of the Device
- Post Operative knee brace
- Full Range of Motion knee hinge
Indications
- For immediate application to knee for locked or limited motion control during rehabilitation after operative procedures or injury to knee ligaments, patellar ligament, articular cartilage, meniscus, or stable or internally fixed fractures of tibial plateau, condyles, proximal tibia or distal femur.
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Purpose of the Device
- Benik style wrist and hand splints are custom neoprene splints that offer support to the wrist & hand, with additions that can support carious joints in the thumbs and fingers.
Indications
- Hand & wrist deformities where mild support is appropriate
- hand & wrist deformities requiring proprioceptive feedback is helpful
Common Additions
- Glove-style Hand Splint W/ Thumb Support
- Glove-style Hand Splint W/ Thumb and Wrist Support
- Glove-style Hand Splint W/ Thumb and Finger Support
- Wrist Wrap W/ Thermoplastic Thumb Support
- Wrist Support W/ Dorsal and Volar Aluminum Stays
- Wrist and Thumb Support W/ Dorsal and Volar Aluminum Stays
Special Considerations
- Benik’s popular line of pediatric wrist and hand splints come in a variety of stock styles and sizes.
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Purpose of the Device
- To immobilize the elbow to prevent a child from being able to get their hands to their head & chest
Indications
- Prevents pulling NG tubes, IV tubes Tracheotomy
- Highly recommended following cleft palate surgery
- Prevents putting objects into mouth, scratching bandages, injuries or skin
- During x-rays (X-Rayable)
- Prevents self inflicted injury (Retts)
Common Additions
- Most commonly used bilaterally
- Can use shoulder strap to connect bilateral pair
Special Considerations
- Shoulder strap included
- Available in colorful designs
- Male
- Female
- Unisex
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Purpose of the Device
- Stabilize and limit range of motion of the elbow joint
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Purpose of the Device
- In additon to AFO’s or shoes, non-surgical correction of Clubfoot.
Indications
- When more independent movement is preferred
- Less heel friction
Special Considerations
- Adjustable from 8 to 14 inches for growth
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Purpose of the Device
- Non-Surgical correction of Clubfoot
Indications
- Infant feet pointing down and inward
- Can be mild or severe
- Can be bi-lateral
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Purpose of the Device
- Maintains abducted position of foot, achieved by surgery or manipulation
Indications
- Congenital talipes equinovarus clubfoot
- Metatarsus adductus
Common Additions
- Lateral T-strap
- Dennis Browne bar
Special Considerations
- Open-toed shoe is recommended for infants for easy donning and doffing to prevent clawed toes
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Purpose of the Device
- Increases support to medial aspect of foot
Indications
- Hyperpronation
Common Additions
- Medial longitudinal arch support pad can be added for additional pronation control
Special Considerations
- A chubby pediatric foot may not fit this style because of the closed-toe design; may have to go to open-toe model
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Purpose of the Device
- Provides biomechanical control to establish better foot and leg function
Indications
- Plantar fasciitis
- Abnormal supination
- Metatarsalgia
- Heel spurs
- Neuroma
- Degenerative joint disease
- Abnormal pronation
- Shin splints
- Achilles Tendonitis
Common Additions
- Heel spur pads
- Heel lifts up to 1/4 inch
- Metatarsal pads
- Morton’s extensions
Special Considerations
- Rigid to semi-rigid plastic shell is combined with stable heel posting for good bio-mechanical control
- A full-length soft cover helps protect against pressure and impact shock
- Varying thicknesses and types of plastics are available to suit individual patient needs
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Purpose of the Device
- Helps correct mild in-toeing
Indications
- Toe-in
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Purpose of the Device
- Provides support and corrective forces to the foot and ankle
Indications
- Severe pronation
- CVA
- Cerebral palsy
- Muscular Dystrophy
Special Considerations
- These come in various colors
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Purpose of the Device
- Early intervention tool to help stabalize and align the foot and ankle of children with hypotonia
Indications
- Designed for Children with normal to lower muscle tone who:
- Display moderate to severe pronation, when standing and/or walking
- Display a general instability when pulling to stand and during cruising
- Have developmental delays and are late in learning to advance beyond cruising around furniture
- Are under 85 pounds
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Purpose of the Device
- AFO’s can be provided with hinges, and a plantarflexion stop, they are also available in a spring leaf design
Indications
- Foot Drop
- Cerebral Palsy
- Muscular dystrophy
- Spina Bifida
- and many other conditions….
Special Considerations
- These come in various styles and colors
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Purpose of the Device
- KiddieGAIT offers innovative options that manage functional environments and create the supplemental gait function instead of immobilizing and inhibiting that function.
Indications
- Footdrop
- Gait deviations secondary to proprioceptive deficit
- Idiophathic toe walker with no midfoot collapse
- Low tone crouch gait
- Spina Bifida
- Spastic Diplegia
- Muscular Dystrophy
Common Additions
- Bi Lateral
Special Considerations
- Lacking full R.O.M.Too rigid foot structure
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Purpose of the Device
- To apply rotational corrective forces on the legs of children to correct foot and leg position during gait.
Indications
- Intoeing [internally rotated foot & leg]
- Outtoeing [externally rotated foot & leg]
Special Considerations
- Often used bilaterally, but can be used unilaterally
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Purpose of the Device
- Custom Carbon AFO’s can be made in various strut flexibility and boot heights
Indications
- Foot Drop
- Cerebral Palsy
- Muscular dystrophy
- Spina Bifida
- and many other conditions….
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Purpose of the Device
- Provides positional support for maximum femoral head positioning in the acetabulum for proper growth
Indications
- Hip dysplasia
Special Considerations
- This harness is typically used on newborns up to 3 months old
- Older children are fit with a flexion abduction orthosis
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Purpose of the Device
- Positions pediatric patients in a variable abducted position with the hips at 90 degrees flexion
Indications
- Congenital hip dysplasia
- Congenital hip displacement
Special Considerations
- Prefabricated sizes fit patients up to 30 pounds
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Purpose of the Device
- An adjustable arc type hip joint provides stability and corrective action to pediatric patients with an unstable gait
- Allows for hands free sitting stability
Indications
- Crossover Gait
- Narrow Gait
- Instability in standing and sitting
Special Considerations
- Five prefabricated sizes and variable leg cuffs allow for fitting of most pediatric patients
- Liners can be hand washed
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Purpose of the Device
- The PTO is one of the most effective braces for reducing patellofemoral pain resulting from maltracking or patellar instability.
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Purpose of the Device
- Post Operative knee brace
- Full Range of Motion knee hinge
Indications
- For immediate application to knee for locked or limited motion control during rehabilitation after operative procedures or injury to knee ligaments, patellar ligament, articular cartilage, meniscus, or stable or internally fixed fractures of tibial plateau, condyles, proximal tibia or distal femur.
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Purpose of the Device
- Limit Hyperextention in the knee in pediatric patients
- Limits knee movement without limiting knee function
Indications
- focuses localized control of ;
- genu-recurvatum
- genu-varum
- genu-valgum
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Purpose of the Device
- To immobilize the knee
Indications
- Prevents knee flexion
Common Additions
- Most commonly used bilaterally
Special Considerations
- Available in colorful designs
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Purpose of the Device
- Limits cervical motion in all three planes
- Mechanically restricts forward flexion and extension and, to a lesser degree, lateral flexion and extension
Indications
- Minor cervical instability
- Degenerative disc disease
- Post-operative stability is required
Common Additions
- Thoracic extension can be applied
- Can be attached to custom-molded TLSO to increase control of upper thoracic and cervical spine
Special Considerations
- Comes in various sizes and can be easily modified to fit the vast majority of patients
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Purpose of the Device
- Limits cervical motion in all three planes
- Mechanically restricts forward flexion and extension and, to a lesser degree, lateral flexion and extension
Indications
- Minor cervical instability
- Degenerative disc disease
- Post-operative stability is required
Common Additions
- Thoracic extension can be applied
- Can be attached to custom-molded TLSO to increase control of upper thoracic and cervical spine
Special Considerations
- Comes in various sizes and can be easily modified to fit the vast majority of patients
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- Effective Motion Restriction of Cervical Spine by vertebral level
- Can be “stepped down” from a 4 post CTO, to a 2 post CTO and then finally a stand alone collar
- Brace is MRI Compatible
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Papoose Infant Immobilizer
- Securely and gently immobilizes the head and spine in the proper anatomical airway and spinal alignment
- Occipital shape protects against positional plagiocephaly
- Allows for continue intimacy between caregiver and child
- True cervical spine immobilizer for infants up to 3 months
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Purpose of the Device
- Encloses entire posterior skull, encompassing mandible, occiput and chin, extended downward to inferior angles of the scapula
Indications
- Positions the head and relieves the cervical spine from a portion of the weight of the head
- Limits thoracic motion to varying degrees
- For patients such as pediatrics who require maximum control and a halo is not an option
Common Additions
- Minerva type may be extended to include pelvic girdle for greater control of cervical and thoracic motion
Special Considerations
- Minerva type encloses entire posterior skull and includes a band around forehead and extends downward to inferior costal margin
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Purpose of the Device
- Correction of pectus carinatum deformities
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Purpose of the Device
- Stabilizes the thoracolumbar spinal region in all three planes
Indications
- Instability of spinal levels T5 through L5
- Low back pain
- Scoliosis support
- Spinal fracture
- Degenerative disc disease
- Post-operative
Common Additions
- Not very adaptable to additions
Special Considerations
- Allows for cutouts for patient access
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Purpose of the Device
- Supports the thoracolumbar spinal region in all three planes
- Used for patients who cannot tolerate a rigid TLSO or to accommodate patients anatomy
Indications
- Instability of spinal levels T5 through L5
- Osteoarthritis
- Low back pain
- Minimal scoliosis support required
- Scoliosis Accommodation
- Spinal fracture
- Post-operative
Common Additions
- Not very adaptable to additions
Special Considerations
- Allows for cutouts in soft foam area for patient access
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Purpose of the Device
- The orthosis provides upper trunk support and proprioceptive input for trunk musculature & posture training
Indications
- Weak trunk musculature
- Inappropriate trunk positioning due to various neuro muscular deficiencies
Common Additions
- Dynamic Trunk Orthosis Vest and Zipper
- Straps for shoulders & perineum
Special Considerations
- Available in multiple color choices
- The vest will provide warmth and added buoyancy during hydrotherapy and other water activities, but is NOT to be used as a life preserver.
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Purpose of the Device
- Protection of the head
Common Additions
- Custom strapping systems
- Visors
- Eyeglass relief area
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The Wood Cheneau Rigo (WCR) brace is a thermoplastic brace designed to treat scoliosis conservatively while taking into consideration that scoliosis is a three-dimensional deformity.
What you get with the WCR Brace.
The WCR brace involves a team of scoliosis professionals from around the world working on the patient’s classification of curve. The patient curve type is individually classified from the Classification of Rigo using the x-rays and clinical photos of each patient. Based on this classification, an individual brace design from the Classification of Rigo brace designs is selected for each patient. Dr. Manuel Rigo is personally consulted on WCR brace cases for verification of the patient’s curve type and scoliosis brace design when necessary. This is a multi-disciplinary approach using feedback from the patients prescribing MD and Schroth or Barcelona Scoliosis Physical Therapy School (BSPTS) physical therapist in combination with the orthotist’s skills. Subsequently, the measurements, x-rays, and clinical photos are used to design and fabricate a custom-made Wood Cheneau Rigo brace.All stages of treatment (clinical photos in and out of brace, X-rays and team notes) are posted on a secure orthotic and prosthetic database (OPIE). We discuss the fittings, follow-up photos, and in-brace x-rays between the MD, Schroth Therapist (PT) and orthotist, which optimizes the treatment and results.
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Purpose of the Device
- Provides corrective forces to the thoraco-lumbar spine
- Incorporates abdominal intercavity pressure to reduce lumbar lordosis
- Most commonly used for patients prior to skeletal maturity
Indications
- Scoliosis for T8 – L5 apex
- Excessive lumbar lordosis and associated conditions
- Learn more about Scoliosis here
Common Additions
- Thoracic, lumbar and trochanteric corrective pads
- Thoracic gussets
Special Considerations
- Obesity hinders proper fit and effectiveness of the orthosis
- Read the latest study on Scoliosis Bracing here.
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Purpose of the Device
- This brace is worn during sleep. It is molded to conform to the patient’s body while bending towards the convexity of the curve.
Indications
- There are several distinct advantages to the Providence Brace program, nearly all of which are related to the nightwear component:
- Allows full, unrestricted musculoskeletal development.
- Allows opportunity for athletic participation, if desired.
- Causes fewer and less severe complications.
- Delayed complications are negligible, since brace is worn less time than not.
- Results can be assessed without the customary long-term follow-up.
- Decision-making regarding success or failure of the program can be made earlier.
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Purpose of the Device
- This brace is worn during sleep. It is molded to conform to the patient’s body while bending towards the convexity of the curve.
Indications
- There are several distinct advantages to the Charleston Bending Brace program, nearly all of which are related to the nightwear component:
- Allows full, unrestricted musculoskeletal development.
- Allows opportunity for athletic participation, if desired.
- Causes fewer and less severe complications.
- Delayed complications are negligible, since brace is worn less time than not.
- Results can be assessed without the customary long-term follow-up.
- Decision-making regarding success or failure of the program can be made earlier.
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Most widely prescribed headband design
Materials
- Plastic shell with foam liner
- Side and top opening
Style
- Side and top openings
Indications:
- Plagiocephaly
- Brachycephaly
- Scaphocephaly
- Post- Operative Craniosynostosis
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Most used for scaphocephaly head
Materials
- Plastic shell with foam liner
Style
- Overlap design
Indications
- Plagiocephaly
- Brachycephaly
- Scaphocephaly
- Post-operative Craniosynostosis