Non-verbal patient and Pediatric considerations for Mackie Elbow & Knee brace
Standard protocols for usage of static progressive splinting require the wearer to play an active role in determining a tolerable level of force being applied by the brace. This is dependent on the patient experiencing a sensation of “stretch” and being able to communicate that the tension the device places on the body is tolerable yet adequate. This poses difficulty in determining if these devices are appropriate for use with pre-verbal or non-communicative individuals. Therefore, Ortho Innovations does NOT recommend use of these devices or suggested protocols with non-communicative persons. Physicians, of course, may determine that the level of care and observation of an individual patient is sufficient to assure careful application and use of these devices. Specific wearing protocols must be individualized by the physician for that patient, and all caregivers are required to understand the physician’s instructions prior to release for home care or use in Nursing Care Facilities.
The elbow and knee articulations for children are anatomically undeveloped. Bone structure is “plastic” and subject to deforming forces. Under the age of ten, the elbow is mostly a cartilaginous and ligamentous articulation. Since the use of the Mackie Elbow and Knee braces depend on inducing stress to the soft tissue in order to allow plastic deformation to reduce contractures, there is a concern to avoid unintentionally overstressing the cartilage and bone in the developing pediatric articulation. Therefore we offer the following recommendations for use:
- We do NOT recommend use of these braces for children under the age of 10. The specific prescription and treatment of the patient by a Pediatric Orthopedist or other child specialist familiar with treating joint contractures would be necessary to amend this policy on an individual basis.
- Only custom-made braces are available for use on pediatric patients, or those that are too small to fit in the standard “Small” size.
- Due to the potential for misuse of the device, pediatric patients must be under the close supervision of an adult knowledgeable in the treatment protocol. Training the responsible adult(s) is an essential responsibility of the provider of the device.
- To avoid unintentional changing of the settings or use of the braces in a “non-prescribed” manner, the adjustment knob(s) may be removed. This is also advised for use of the brace during sleep.
If you have any questions about our recommendations, please contact Ortho Innovations.
Ortho Innovations distributes these products through qualified professionals. They are only to be used following the prescription of a Medical Doctor. The prescribing physician’s instructions take precedence over any instructions given here or in printed material.