Haunting plaster impressions of children’s faces hang on a wall of the orthotics and prosthetics lab at Shriners Hospitals for Children Northern California in Sacramento. Each is a mold for a clear plastic mask that reduces scarring on the face of a badly burned child.
Daniel Buchanan stood nearby on a recent day smoothing the rough edges from plaster molds of small legs and feet as another technician, Juana Renteria, wrapped them in heat-softened plastic to make leg braces. At his work station, Rey Eugenio adjusted a ratcheting brace to help correct a nerve condition called brachial plexus that locks a child’s arm at a sharp angle.
The Shriners lab makes about 3,600 devices a year that help kids and teens walk, play sports – and even go to prom on an artificial foot with a high heel. It occupies a sunny wing of the hospital’s tower on Stockton Boulevard. Shriners treats children from Mexico, Canada and the western United States for burns, cleft lips, spinal cord injuries and other conditions, regardless of ability to pay.
The orthotics and prosthetics lab is adopting cutting-edge techniques as the field makes great strides, thanks to advances in computer technology and methods learned from the treatment of veterans coming home from the wars in Iraq and Afghanistan.
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“We’ve always had significant leaps and bounds and changes with war,” said lab manager Dan Munoz. Tiny computers that control prostheses or exoskeletons, and even limbs wired directly to patients’ brains, are among the changes, though they likely will take time to become small and sturdy enough to be used by children, Munoz said.
The lab soon will begin using 3-D cameras to map patients’ faces and bodies to make molds for artificial limbs and braces, he said. The technology will replace the current method of pouring a liquid molding gel over a body part or face, which children often find frightening.
A pilot program at Shriners implants magnets into children’s chests and into close-fitting body braces to slowly pull out sunken breast bones.
“We’re opening up a bunch of new doors,” Munoz said.
The technicians at the lab, who sometimes refer to themselves as “mad scientists,” are constantly being called on to invent solutions to children’s needs, including fabricating hands that can hold baseball bats or ski poles, and feet that are angled to fit comfortably in horse stirrups.
“Oftentimes we come up with stuff on the fly,” Munoz said. “That’s the fun part about the job.”
Working with children keeps the job fresh and meaningful, he said.
The lab’s young patients often pick favorite patterns – such as cartoon dinosaurs, brightly colored peace signs or pink camouflage – to decorate the surface of a leg brace or limb sockets.
“It gives them a choice, a sense of control,” said lab technician Marc Coulombe, as he shaped the mold for a leg socket at a workbench by a tall window. “A lot of times they don’t have choice in any of this since birth.”
Bradley Duquette, a 20-year-old UC Davis junior, counts himself among that group. He was born with spina bifida, a defect in the spinal cord that left him with a lack of feeling in his lower body and a variety of related ailments.
He grew up in the Butte County foothill town of Paradise and has been a patient at Shriners since he was 6. He wore a leg brace for years, and he endured five surgeries at Shriners and others at the UC Davis Medical Center next door.
In May, he chose to have his right leg amputated below the knee. An open foot sore that wouldn’t heal was forcing him to use crutches and severely undermining his quality of life. Duquette, a slight young man with dark hair and intelligent eyes, said he had met other spina bifida patients who had also opted for amputation and were better off.
“I was done dealing with it,” he said. “I thought I would be more mobile.”
Now, Duquette sports a sleek carbon-fiber blade for a foot, and a green leg socket with a geometric pattern and a small picture of a cartoon cat – an inside joke between him and his Shriners prosthetist, Rick Wilcox.
On a recent visit, Wilcox checked the fit on a temporary socket Duquette was trying out in preparation for making a final version. Duquette has had several sockets in the nine months since his surgery; new ones must be fashioned as the leg stump heals and swelling subsides.
“The whole time my leg has been changing,” Duquette said in an exam room last week. “It’s like hitting a moving target.”
During his appointment, Duquette wore a UC Davis rowing team jacket and sweatpants with an insignia of crossed oars. He is a coxswain on the university’s crew team, getting up well before dawn most weekdays to practice at the port of West Sacramento. The coxswain, generally a lightweight person, steers the boat and relays information to the rowers.
Duquette is studying neurobiology and physiology at UC Davis, and intends to go to medical school and become a general practitioner – the area of medicine where he feels there’s the most need.
“I’m going to be a doctor,” he said.
Call The Bee’s Hudson Sangree, (916) 321-1191.