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Post by deejay on Apr 1, 2020 23:14:35 GMT
My interest in braces and wanting to wear them started when I was in primary school and I saw a boy wearing a fully weight-releiving brace with ischial ring. After making a variety of simple braces over the years, I eventually made one from a single long length of steel bar (down, across under the heel and up again) attached to an ischial ring which I padded well. I was about 2 inches longer than my leg, so it took my full weight. It did satisfy my curiosity at the time and I did wear it out at night a couple of times for a very short distance. However, as it was still only a lash-up, it did become uncomfortable fairly quickly.
Now that I have a 'proper' KAFO I am fairly happy but I would like to get a detachable top extension made with a ring so I can wear it that way when I choose.
The good thing is that I have some of the practical skills necessary to make mods for comfort once I have the basics.
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Post by rowland on Apr 2, 2020 16:51:43 GMT
deejay,
Your post describing your early DIY KAFO with ischial ring has reminded me that my teenage attempts usually had an ischial ring or a rear semi-circle on which I sat. The KAFO I wear now has recently had an ischial ring attached. The medical purpose was to deal with instability at the hips, but psychologically it suits me well because I had primed myself to wear it years ago when I couldn't have known I would need it! Weird!
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Post by milkid on Jun 30, 2020 8:16:12 GMT
Hi Roland Just been reading your posts about ischial rings. As a kid I wore bilateral patten ended callipers and concerning ischial rings the rule of thumb is if you are wearing only one calliper with an ischial ring then it can be a complete steel ring padded and covered with soft leather or it can be an half ischial ring padded and covered with soft leather and closed with a leather strap and buckle. When callipers with ischial rings are to be worn on both legs (bilateral) then complete or half ischial rings are not used because it makes walking so difficult because the rings do not pass each other easily unless you walk with your legs wide apart. In the case of ischial bearing callipers to be worn on both legs they are replaced with an ischial bearing upper leg corsets. In my case they were of hardened leather moulded to a cast of my upper legs and groin area where the body weight is taken as these pass each other much easier when walking and you dont have to walk with legs apart in order to allow the corsets to pass each other. Mine were long being moulded into my groins and extended to enclose all my upper legs to just above my knees and fastened at the front with lacing through steel lace eyelets.
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rmar
New Member
Posts: 23
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Post by rmar on Jul 1, 2020 13:59:24 GMT
I have to add my 2 cents to this discussion - My current pair of HKAFOs have ischial rings on both legs - these act as weigh bearing because I actually sit on them to support my body weight. They do not rub together and, because of the pelvic belt, my legs are not spread wide apart. These are the half ring with strap and buckle. I have worn braces with the ischial bucket top and they do not support as well and are not as comfortable to wear.
With regard to the perthes braces- I'm in the US and in all my 70+ years I have never seen anyone in 2 weight bearing braces like you wore. There were several kinds of braces used when both legs were effected - all of them spread the legs very wide and positioned the feet so they were off the ground and the brace supported the wearer. I guess that's the difference between the treatment ideas. And in the US the weight bearing brace had what was sometimes called a platten base. Again different ideas !
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Post by milkid on Jul 1, 2020 16:11:08 GMT
The ischial bucket top did very well support the weight of an 8 year old kid and was told they were being used due to bilateral callipers as they would pass each other when walking. I am from the UK and treatments in the 1960s may well have differed from that of the USA. Bilateral perthes callipers were quite rare due to the fact that bilateral perthes was not all that common in most only one hip was affected. I have seen two cases of bilateral perthes callipers in my treatment years at the hospital I was attending. Funny enough they were both boys.
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Post by milkid on Jul 1, 2020 17:10:09 GMT
Hi Mar. Here is a photograph of a boy in bilateral patten end braces. These were another version of the patten ended calipers used and they had bucket tops arcording to the reading. Attachments:
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Post by rowland on Jul 22, 2020 17:14:24 GMT
Update: An ischial ring was added to one of my kafos some months ago with a view to the orthotist designing a new brace when I had got used to it and could report back on benefits and problems. The coronavirus has delayed the meeting. The extra time has allowed me to come to some firm conclusions: The exact length of the inner upright is crucial. The ring at the top of the inner upright must fit snugly into the crotch. If the upright is short there will be vertical movement likely to unlock the medial (inner) knee-lock. I have two pairs of boots which fulfil this requirement; the others allow vertical movement. As I have slightly valgus knees, I want the knee-lock to be free of contact with my knee. In fact when I walk I can feel that some muscles are loose or flabby. This accentuates my dropfoot so that the inner edge of the sole of my boot catches the ground. Enough fot the moment, but any comments and experience would be welcome.
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Post by rowland on Jul 23, 2020 16:52:13 GMT
Continued from yesteday:
I have recently found that a strap above the front of the knee holds the ischial ring in place under my buttock so that I put weight on the ring via the bone of the ischium as well as at the crotch. Previously I was getting used to re-positioning the ring by bending forward or with my hand. I don't like using the extra strap but I am feeling it less than I thought I would.
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