PO-12 · Pediatric Prosthetics and Orthotics

Pediatric Prosthetics and Orthotics. Part of the Prosthetics & Orthotics series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: 80 to 90 percent of patients require a percutaneous Achilles tenotomy. — Correct: Percutaneous Achilles tenotomy is needed in roughly 70 to 90 percent of Ponseti-treated clubfeet, commonly quoted as about 80 percent, with the highest rates in the most severe feet. The episode narrates the top of the range as the whole range. (2) In the audio: At six to nine months, which is the developmental window when a child begins pulling to stand, they get a non-articulated device. — Correct: Pulling to stand is a nine to twelve month milestone, and that is when the first lower-extremity prosthesis, a non-articulated device for standing support, is fitted. Six to nine months is not the pull-to-stand window. (3) In the audio: However, you must note a specific literature caveat. Some sources name the fibula as the most commonly affected bone overall. Be prepared to recognize both the humerus and the fibula as high risk structures depending on how the question is phrased. — Correct: Retract the caveat, not the ordering. The humerus is the single most commonly affected bone. The fibula is second, and within transtibial amputations it overgrows more often than the tibia, but that is a within-level comparison and does not displace the humerus. A stem asking which bone is most commonly affected has one answer. (4) In the audio: The trial was actually stopped early by the Data and Safety Monitoring Board because the efficacy of bracing was so clear that it was deemed unethical to continue randomizing patients to the observation arm. — Correct: BrAIST was stopped early for demonstrated benefit. Its monitoring board halted it because bracing had shown efficacy, which is not the same as declaring continued observation unethical, and the chapter retracted the unethical framing. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/PO-12-a.