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Different Braces for Different Needs

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HealthWiki > Disabled Village Children > Chapter 58: Braces (Calipers) > Different Braces for Different Needs


The main lower-limb brace types are:


Foot brace Below-knee braces
(ankle brace)
usually made of molded plastic
Foot brace.
for weakness or deformities in the lower leg, ankle, and foot Boy's leg in a below-knee brace.
for deformities in the foot (not ankle) such as severe flat foot Foot inside of foot brace, placed in sandal.
Above-knee brace (long-leg brace) Above-knee brace with a hip-band
for weakness in the upper leg and knee — possibly also ankle and foot Boy's leg in an above knee brace. for severe weakness in hips and legs Two legs, one with below the knee brace and one with an above knee brace with a hip-band.

Less commonly used types (described on p. 547 and p. 558) include:

Leg-separating braces Foot-positioning night brace Body brace or corset Body brace with leg braces
for dislocated hips or damaged head of thigh bone for holding the feet, legs, and hips at a set angle when they tend to turn in for curve of the spine
DVC Ch58 Page 539-12.png
for body and back weakness together with hip and leg weakness DVC Ch58 Page 539-13.png
DVC Ch58 Page 539-10.png DVC Ch58 Page 539-11.png

Different materials and ways to make braces

As we discussed in Chapter 56, an ideal brace should:

  • serve its purpose well (help the child walk or function better)
  • be comfortable
  • be lightweight and strong
  • be as attractive as possible
  • be easy to put on and take off
  • do no harm
  • be low cost
  • be easy and quick to make with local tools and limited skills
  • use local or easily available materials
  • be easy to repair and adjust as the child grows or develops
  • be long lasting


Unfortunately, no brace will meet all these requirements. As much as possible, try to put the child’s needs first.

In this chapter we give ideas for making different braces using various materials. When deciding how to make a brace, carefully evaluate both the child’s needs and the available resources (see Chapter 56).

Sometimes it is wise to start with a simple low-cost temporary brace or splint to see how well it works and what the problems are.
Girl walking with parallel bars with tube fastened around one leg with cloth.
Keep old and outgrown braces for testing on new children before final braces are made.

But take care not to discourage the child by making him use braces that do not fit him well.
Man with brace on his leg and many braces hanging on the wall fitting a smal child for a brace.

Examples of very simple, low-cost braces and splints:


A temporary leg splint of cardboard, folded paper, or the thick curved stem of a dried banana leaf, or palm leaf. Aluminum tube finger splint
Stem of banana leaf.
Thin aluminum tube, cut aluminum tube forming finger splint, splint put on finger.
Mango seed finger splint Bamboo ankle splint
Mango, Mango seed, cut mango seed, mangoseed finger splint.
candle held under bamboo strip in order to heat it next to post-heated bent bamboo strip.
Remove the woody coat of a mango seed, and wrap the coat firmly onto the finger. It will dry into a firm splint. To change its shape, first soak it in water. A piece of seasoned bamboo can be heated and bent.

Plastic cup ankle braces for night or temporary use on a small child.

For a small baby:

cup with one side cut out to fit a small child's leg, a piece of would with an end cut into rounded shape to fit into cup, cup wood brace combo strapped to a baby's foot
padding
straps of leather, canvas, or Velcro, if possible
rivets
Rivet or nail wood to cup.
piece of wood
plastic cup
Cut like this

For a child:



one cut cup on its side with two cut cups stacked on top of it, wood piece with on side flat and the other rounded, flat bottle, cup brace strapped to a child's foot.
3 cups cut and riveted together
Make a flat inner sole out of cloth or wood.
Or cut the foot piece from a flat plastic bottle.
Add straps to fasten the brace around leg.


Metal or plastic braces

Modern, high-quality braces are usually made out of metal or molded plastic.

The best metal is a mix or ‘alloy’ of aluminum and steel which is both light and strong. However, this is very costly and often hard to get. Pure aluminum is very light, but breaks easily, especially when you try to bend it. Steel is cheaper and easier to bend and weld, but is much heavier.

The best plastic for braces is probably polypropylene, which is strong, light, and fairly easy to shape when hot.

DVC Ch58 Page 541-1.png
plastic below- knee brace
DVC Ch58 Page 541-2.png
metal below-knee brace with wood clog

Pre-formed metal parts for making these braces are sold at orthopedic supply stores. Unfortunately, they are usually much too expensive for a community program. However, sometimes you can get large orthopedic centers to donate old braces, from which locking knee joints and other pieces can be used to build high-quality metal or plastic braces. Also, many broken or outgrown braces are lying in the corners of thousands of homes. A campaign to get families to donate these can greatly reduce the costs of making high-quality braces.

Low-cost metal or plastic braces can be made in a village shop. They can be made simply, with or without joints. Since children grow quickly, they often need a larger brace every 3 to 6 months. Therefore, keeping cost low and work simple is essential. (See "Precautions in Providing a Child with Aids, Equipment, and Procedures")

Metal and plastic braces each have advantages and disadvantages. We discuss these on "Fitting Plastic or Metal Braces", "Metal Braces", and "Plastic Braces".

In Mexico, we have found that for most children who need below-knee braces, plastic works best. And the children (and parents) like it more.

However, a child with a lot of muscle tightness (due to spasticity or contractures) which pulls his foot a lot to one side, like this, may need a metal brace with an ankle strap.

After the brace is on, the strap is tightened to pull the foot into a better position.
child's curved in foot being put in a metal brace, the foot no longer curves inward when strapped into the brace.
Above-knee braces can be made using a combination of plastic and metal.
DVC Ch58 Page 541-4.jpg


Whenever possible, equip your village shop to make both plastic and metal braces. That way, you can make what seems most appropriate for each child.



This page was updated:19 Jan 2018