Some thoughts on children's PFFD prothetics

Our daughter is now 30 months (just over 2.5 years) old and I feel like we've learned a lot about PFFD children's prostheses. I've written about some of it in the Your first meeting with a prostheticist section. But I thought I'd add a bit more.

First, I 100% agree with Nico13 when he says "|A good prostheticist is worth his weight in gold." It takes skill to make a great PFFD prosthetic device and also there is an art to watching a child walk and then making the small adjustments in shape, padding, angle etc to make the device comfortable. When working with toddlers who typically can't communicate discomfort clearly, a skilled eye is invaluable. Looking to see if there is any redness that persists for more than a few minutes after removing the prosthetic device is how our current prostheticist tells if there is an issue.

In our case the length discrepancy was too large to use a thick sole on the shoe once our daughter got to be about 2 years old.

Some prosthetics things that we've noticed worked well:

• Quick / Easy On and Easy Off.
  • Particularly important for diaper changes or quick pants changes, getting in and out of swings/ shopping carts/ high chairs, etc.
• Ankle mobility: in our case the foot/ankle/tibia/knee were unaffected and so having a prothesis with a mobile ankle was key for developing gait and strength and preventing atrophy of muscles.
• Bottom of prosthesis that fits inside a shoe. We like taking off our shoes in the house and kids like running into all sorts of muck - having something that allows us to remove our daughter's shoes easily means we can remove the shoe and not the entire lift.
• Light weight. For a child, who may only be 20 lbs or so, keeping the lift as light as possible really makes a big difference. I uploaded a file here that talks about some of the lifts we've used. We currently are working with a prostheticist in Des Moines Noel Chladek. He works with carbon fiber and by adding flexible carbon fiber support pieces instead of metal or thicker laminate we get extremely lightweight devices that are strong enough to withstand months of punishment from non-stop leaping/running.
• Breathability - important since the lift is worn all day.