Helping children with deformities

Health professionals can correct certain deformities such as knock-knee or bow-leggedness in children through the application of appropriate orthoses.

Although brown is the most common colour for orthoses in Kenya to roughly match people’s skin colour, children’s orthoses are often colourful and include images of flowers, flags, numbers and the alphabet.

“ orthoses are appliances we use to correct certain deformities. You correct or we accommodate. Mostly they are flexible deformities so you either correct or you accommodate as you hold it the way it is or you immobilise,” says Benedict Otieno, an orthopaedic technologist at Gateway Prosthetics and orthoses.

According to him, the best approach when talking to children is to show them why the orthoses are important.

“If a child walks and talks, it is easy. You only have to make them feel there is something you are trying to do to them that would help,” says Mr Otieno.

“So the interaction must create some favourable room so that the child is able to laugh and is able to appreciate what you are giving them,” he adds.

Prosthetics, which are less common among children, are usually used permanently and on a daily basis and act as artificial limbs. However, orthoses are only meant to be used until a deformity is corrected and are not as effective among adults.

For cases such as flat foot, knock-knee, or bow-leggedness, appropriate insole orthoses are applied not just to correct the deformity but also to prevent a deterioration of the condition. In flat foot, for instance, the bone can come in contact with the ground as the child walks, resulting in severe pain that could require surgical treatment.

“The pain can be arthritic. It goes to the knees to the pelvis to the trunk. And you are on a wheelchair,” he says

“Treat things conservatively without loss of meat or blood,” he adds.

Orthoses have a wide range of applications. Those that are more visible are more aesthetically detailed. Children can have weak ankles, knees or spines which require different forms of orthoses.

“There are cases of a child born with weak spine so that they cannot sit. For the back we give corsets. Spinal corset is usually something rigid. So we make something that takes the shape of the trunk. It is very rigid. It does not allow bending,” he says.

According to him, while the materials remain the same, children’s orthoses are lighter because of their size.

Deformities can be identified in a hospital, or through an orthopaedic technologist or even through observation by parents. However, the examination and diagnosis can sometimes be a bit complicated before a child walks or seats for example.

The technologist takes the pattern of the affected body part, for instance the foot, and then makes the required orthoses. For children, orthoses are usually not imported but custom-made on site because they overgrow them fast compared to adults who have a permanent sizes.

“We make it customised because the children are growing. We expect them to grow maybe after two or three months. After three months we have not achieved full healing but the child has grown. We have to make another one,” he says.