Prosthetic and Orthotic


On At the Prosthetic and Orthotic (P&O) Unit or Clinic, we evaluate , measure, fabricate, and fit patients with artificial limbs and braces. Our patients include those with neuromuscular and musculoskeletal disorders and those who have experienced amputation, trauma, and surgical procedures. Prosthetic and orthotic devices are fabricated and fit at our facility with high quality and standard.

Our Team
Our P&O practitioners are prosthetists and orthotists certified by the International Society for Prosthetics and Orthotics. A certified prosthetists and orthotists (CPO) is the P&O practitioner who has been trained and qualified in the technical and clinical aspects of fabricating and fitting custom-made prostheses and/or orthoses.

Head of PO unit
Tawatchai Junsaard, CPO.
Head of the Prosthetic and Orthotic Unit
Bachelor of Prosthetics and Orthotics, La Trobe University, Australia

Massage from Head of PO unit
On behalf of Prosthetic and Orthotic department, my name is TawatchaiJunsa-ard CPO, I would like to express my hearty thanks to you all for interesting and welcome you to visit our department. Our department, we offer a variety of prostheses and orthoses from a team of professional Certified Prosthetist and Orthotist. Our department fully equipped with all machinery needed for a world standard prosthetic and orthotic workshop. Moreover, many staff of our workshop has been working in a field of Prosthetic and Orthotic for over 20years so we could guarantee the entire patient for our product and services. We looking forward to serving all the patient and customer with a device to correct a problem they suffer or give them some advice to live they life.

Treatment process
** On Wednesday: device will be fitted next Wednesday after assessment/casting 1 week **

 

Treatment process

Service


1. Prosthetic Service

Prosthetics is artificial limb or device is designed to replace the missing part of body, which amputated from trauma, disease or present with congenital anomaly. The prosthesis is custom designed for each individual to fulfill both cosmetic and biomechanics needs. In rehabilitation prosthetic can improve ability of amputee to perform activity of daily living.

2. Orthotic services

We provide both of pre-fabricated and custom-made orthoses to suit the patient’s requirements.

What is an orthosis
Orthosis is externally device that is designed to fit with the impaired body segments for achieving the optimal goals in biomechanical functions :

-Improve or control alignment
-Correct or accommodate deformity
-support and protect after injury or operation
-Assist motion and mobility
-Relieve pain
-Increase independence

What kind of orthoses we offer?

Orthotic services

Who need orthoses?
You need an orthosis if you are a person with cerebral palsy (CP), stroke, spinal cord injury, or neuromuscular problems that cause troubles in mobility such as :

Tight Achilles tendons
Drop foot following stroke
Polio – related disabilities
Fracture management
Muscle weakness
Clubfoot Sports related ankle and knee injuries

Choices of orthotic device in our clinic
Supra Malleolar Orthosis (SMO) : this device is recommended for patient who have sub-talar joint instability. As a low profile orthosis, ankle and knee motion cannot compensate.

Rigid AFO
provides the greatest strength and stability around the ankle joint, giving confidence while standing and walking with increased balance.

Ground Reaction Force Orthosis (GRAFO)
by the anterior shell design applies pressure on the front of the knee to straighten it while standing and walking. If your child walks with a “crouch gait”, this orthosis is recommended

Articulated AFO
incorporation of joint allow ankle motions and provide Medio-lateral stability while walking. Good knee control is required due to tibial progression during walking.

Posterior Leaf Spring AFO (PLS) this is prefabricated AFO, allow dorsiflexion and limit plantarflexion during walking and simplify for fitting with the shoes. ** Poor knee control, spasticity and instability of ankle are not recommended.

Carbon – seven AFO
the latest innovation in orthotic design to provide natural gait and return more energy during walking.

Hip Knee Ankle Foot Orthoses
Control of trunk and lower limbs motion, indicates for paraplegia patients.

Knee Ankle Foot Orthoses
Both of Conventional and plastic designs are provide stability during standing and walking. Paraplegia or patients who have a problems with poor knee control, mal – alignment of the knee are recommended.

Serial Knee Ankle Foot Orthoses
the adjustable function around the knee join provide the advantage of decreasing knee contracture problem.

Boston Brace
Prescribed for Scoliosis patient to prevent curve progression and reduce the curve magnitude as much as possible
(in – brace). Body jacketis effective for Post and non-surgical stable fracture of lower thoracic and lumbar spine

3. Orthopedics - Shoes Service

We provide custom-made orthopedic high top shoes which are designed by specialist and made by experienced shoes makers.Our services cover for custom – made orthopedic high top shoes, molded – shoes and shoe modifications. All of the service must be done under doctor prescriptions.

Custom – made orthopedic high top shoes : We provide many choices of custom – made shoes for the patient s who have deformities or problems with their foot.

There are many design option for our custom made orthopedic shoes

Molded shoes :
made from a cast of the problematic or deformed foot of the patients. We precisely design this molded-shoed to accommodate the deformities and achieve biomechanics function of the foot as much as possible.

Shoe modifications :
to provide the functions of the shoes which compensate for movement disorders or foot deformities.
– Why shoe modifications are needed
1. aiding in the transfer of forces; off – loading at – risk or sensitive areas of the foot;
2. rebalancing or realigning the musculoskeletal system
3. accommodating fixed deformities
4. controlling motion.

External shoe modifications :
– Flares : widens the shoe, resisting rotation, making it more difficult for the wearer to roll out on that side.
– Wedges : an external wedge can be applied to the shoe. Medial or lateral heel wedges add an extrinsic posting to the sole of the shoe to promote heel varus or heel valgus respectively
– External Counters : to fully support the foot and ankle, provide a wider base, and reduce flexing.
– Elevations : Shoe lifts to accommodate leg – length discrepancies are probably the most common adjustments seen on regular shoes.
– Rockers : Rocker soles reduce energy consumption while walking. Rockers also can help patients with limited ranges of motion at the ankle or metatarsophalangeal (MTP) joints.
– Metatarsal Bars : designed to relieve plantar pressure by adding a wedge of firm material across the sole of the shoe just proximal to the met heads. This unloads the pressure from the met heads, allowing for rapid transfer from the shafts of the metatarsals to the distal end of the toes, with limited extension of the digits.

Internal Shoe Modifications :
– Heel cushions : Cushions have been shown to relieve mild cases of plantar fasciitis or early heel pain syndrome.
– Heel Elevations : Shoe lifts to accommodate leg-length discrepancies are probably the most common adjustments seen on regular shoes.
– Heel Wedges : to correct a pronated foot displaying heel valgus or supinated foot showing heel varus.
– Metatarsal Bars : The addition of metatarsal pads onto the shoe insole will relieve the symptoms of metatarsalgia by transferring some of the weight bearing pressure from the met heads unto the met shafts.

4. Foot Orthotic Clinic

Foot orthosis is custom made insoles that are placed in your foot wears to provide cushioning to increase shock absorption and distribute pressure from bony prominences or sensitive areas under plantar surface of the foot, and relieve pressure that occurred with a misalignment of the structure of the foot. It can be congenital (born that way) or acquired (the natural support structure relaxes). Foot is aligned in a biomechanical correct position can help your whole musculoskeletal system and influence not only the foot and ankle but also the knees, hips, and lower back are passively affected.

Our Certified Orthotist and Prosthetist (CPO) will provide a full biomechanical analysis to determine the cause of patient’s symptoms and how much degree of correction possible. Our custom made foot orthosis start with hand casting with POP (Plaster of Paris) or Foam compression box to achieve a model of the foot. The on-site fabrication allows the CPO and orthopaedic technicians to design the custom made foot orthosis and provide quality control throughout the process. Furthermore, the CPO will advice appropriate exercise to manage any muscle imbalances in strength and flexibility as well as education on proper foot wears.

What condition do we treat?
1. Pes planus (flat feet)
2. Pes cavus (high arch feet)
3. Plantar fasciitis
4. Metatarsalgia
5. Arthritic foot
6. Diabetic foot
7. Hallux valgus or Hallux rigidus
8. Morton’s neuroma
9. Ankle sprain
10. Achilles tendonitis
11. Hammer/Claw/Mallet toes

And other foot, leg and postural problems have all been known to improve by using the appropriate foot orthosis. After you got your foot orthosis, you will also receive a leaflet “Foot orthotics clinic” which includes information on the use, care of foot orthosis, exercise for muscles, and what to do if you have any concerns.

How to make the appointment? (Mon – Fri 8.30 A.M. – 4.30 P.M.)
1. Get the medical record and see the rehab doctor (physiatrist) at OPD (Outpatient Department).
2. Bring the medical record to general administration section at Prosthetics and Orthotics unit.
3. Receive the appointment for prescription and measurement.

How to get ? the foot orthotics clinic? (Mon 8.30 A.M. – 12.00 A.M.)
Prescription and Measurement day
1. Get the medical record at OPD (Outpatient Department).
2. Bring the medical record with the appointment card to general administration section at Prosthetics and Orthotics unit.
3. See the rehab doctor to get the prescription.
4. See the CPO for assessment, measurement and casting the foot.
5. Receive the appointment card for fitting and delivery date.

*** Don’t forget to bring the proper foot wears on fitting day.

How to get to the foot orthotics clinic? (Wed 8.30 A.M. – 4.30 P.M.)
Fitting day
1. Get the medical record at OPD (Outpatient Department).
2. Bring the medical record with the appointment card to the general administration section at Prosthetics and Orthotics unit.
3. See the CPO for fitting your foot orthosis.
4. Receive the appointment card for initial check out (1 month).

How to repair the foot orthosis? (Mon – Fri 8.30 A.M. – 4.30 P.M.)
1. Get the medical record and see the rehab doctor (physiatrist) at OPD (Outpatient Department).
2. Bring the medical record to the general administration section at Prosthetics and Orthotics unit.
3. See the CPO to check/evaluate and repair your foot orthosis.

5. Silicone Clinic

Our unit understands mental of amputation patient. That suffering and lost their work, become to impulsion to restore their activity by do silicone finger, toe including silicone glove for good appearance and similar to real.

What is the distinguished of silicone finger/silicone glove?
1. Assessment, design and fabrication individually
2. When stained by ink, can clean the stained fade (compare with PVC finger or glove this cannot be cleaned up)
3. Shape similar to remaining stump
4. Colors of silicone finger similar to skin of patient
5. Snugly fit
6. Virtual acrylic nails is made by step for similar to sound side, in the meantime can trim aesthetic if patient needs

Who need silicone finger/silicone glove?
Our unit fabrication silicone finger (thumb, index finger, middle finger, ring finger, and little finger) /hand amputation for congenital disorder patient, trauma patient and lost some part of body, Diabetes Mellitus, stroke patient, Scleroderma etc.

The benefits of silicone finger or silicone glove
Our goal is to restore the shape, and function is similar to normal increase confidence to reintegration and quality of life. Silicone finger may be partly to protect the sensitive area.

Procedure of fabrication of silicone finger or silicone glove
Silicone finger or silicone glove are produced individually, need to be copied finger or hand from the amputation side and sound side. During fabrication we use techniques of Nail Art Acrylic Paint (acrylic nail). Patient can polish nail by themselves. Appointment for evaluation and initial consultations until orthosis delivered for 3 – 4 times.

How Silicone finger hold on patient’s finger?
Silicone finger or silicone glove need stumps of finger to help for suspension in this procedure is quite specialized in fabrication to provide a snug fit with stump, a snug fit will create like vacuums that contribute suspension on finger.

Limitation of silicone finger?
Use full life is limited, cannot resist with heat or sharp, during the night should be remove for rest stump. Cleaning should be done on both silicone and stump.