72 chapter 7
After checking arm strength and leg straightness, the next thing to check is the
strength in the ankles, knees, and hips. This will help you decide if the child needs
braces, and what kind.
A child with a foot that hangs down
(foot drop), or flops to one side may
be helped by a below-knee brace of
plastic or metal.
PLASTIC
Foot drop:
he cannot
lift his
foot.
Foot
flops
to one
side
METAL
For foot drop, you can make
a brace that lifts the foot
with a spring or rubber band.
(See p. 545.)
spring
piece
of inner
tube
joint
The kind of brace you choose will depend on various factors, including cost, available
skills and materials, and what seems to work best for the particular child. Advantages
and disadvantages of different kinds of braces, and how to make them, are
discussed in Chapter 58.
A child with a weak knee may
need a long-leg brace of plastic
or metal.
weak thigh
and lower
leg muscles
cannot
lift
cannot
lift
plastic
metal
Upper-leg braces may
be made with or without
a knee joint that locks
straight for walking
and bends for sitting.
Different models are
discussed in Chapter 58.
Note: Not all children with no strength to straighten the knee need long-leg braces: A
child with strong butt muscles may be able to walk without a brace.
strong butt
muscles
STRONG butt
muscles
pull the
thigh
back and
keep the
knee from
bending.
A child who
has FAIR butt
strength and a
straight knee
may be helped
enough by
a lower-leg
brace that
pushes the
knee back.
brace pushes
knee back
Slightly downward
angle of a stiff
brace causes it
to push the knee
backward when
weight bearing.
A child with
weak butt
muscles may
walk with one
hand pushing
on the weak
thigh.
Or he may walk
by bending the
knee back
to ‘lock’ it
for weight
bearing.
If a child has a contracture and cannot walk with his knee
straight, correcting the contracture until his knee bends
very slightly backward may allow him to walk better.
CAUTION: A stiff foot with a
moderate tiptoe contracture may
help push the knee back, just
like a stiff brace. Correcting the
contracture may make walking
more difficult or impossible, so
that a brace is needed where none
was needed before. (See Chapter
56.)
Disabled village Children