Prosthetic and Orthotic

Introduction

Prosthetic and Orthotic Department is one of the allied health team members who promote the health and rehabilitation of patients. Based on the principles of human anatomy and biomechanics, we provide prostheses, orthoses or assistive devices to patients. In order to achieve the best outcome of rehabilitation, we are focus on patients’ individual needs, such as their occupation, living style and independence of Activity Daily Living (ADL), these are the important elements to the successful implementation of our services.

Scope of Services

Our department dedicates to provide prosthetic and orthotic services to the general public.

1. Prosthesis is also named as artificial limb for replacing the function of missing body part.

• Lower limb prosthesis includes the Syme’s prosthesis for amputation at the ankle joint, transtibial prosthesis for amputation below the knee, transfemoral prosthesis for amputation above knee, hip disarticulation prosthesis and etc.
• Upper limb prosthesis includes cosmetic fingers and hands, below elbow prosthesis, above elbow prosthesis and shoulder disarticulation prosthesis.

2. Orthosis is the brace or device which is fitted to the injured or malfunctioned body parts. It can immobilize the fracture to promotion bone healing; protect and support the underlying soft tissues and musculature; prevent further joint deformation; improve gait and walking stability; improve interface pressure distribution and etc. It is also used to correct bony deformity of children, such as flat feet and scoliosis.

In-patient Service

Our in-patient service covers all patients being admitted into the Acute ward in Main block and Rehabilitation ward in Rehabilitation Block of Tuen Mun Hospital.

The service provided by our in-patient team includes:

1. Prosthetic service to patients of Main and Rehabilitation Block

2. Orthotics service to patients of Main and Rehabilitation Block

3. Orthotic service to patients of Mental Handicapped Unit

4. Prosthetics and Orthotics service to patients of Geriatric Day Hospital

5. Sitting and assistive device design and fabrication

6. Interface pressure analysis and recommendation

7. Clinical gait analysis and recommendation

8. Special clinic or program

1. IPCP in Geriatric Hip Fracture
2. IPCP in Stroke Care Management Plan
3. IPCP in Breast Cancer Management
4. Spasticity management program

9. Staff and carers training in orthosis and prosthesis application

Out-patient Service

Our out-patient service divided into Adult and Paediatric service team, both teams provide similar service to their corresponding target patients, and each team has respective specialized program and service.

The common service provided by our out-patient team includes:

1. Prosthetic service



2. Orthotics service





3. Management of cases referred from Accident and Emergency department
4. Sitting and assistive device design and fabrication
5. Interface pressure analysis and recommendation





6. Clinical gait analysis and recommendation

Plantar pressure mapping and gait analysis provide insight on foot function and gait, helping clinicians conduct more complete assessment and objective treatment evaluation. Prosthetist-Orthotists use in-shoe and floor mat plantar pressure mapping systems, and video-based motion analysis system to assess the root cause of patients’ problems and ensure effectiveness of prosthetic and orthotic intervention prescription, rehabilitation and surgery.

7. Fall and Hip Fracture Prevention Program

Poor balance, gait deviation and lower limb deformities may be the causes of the fall of the elderly. Orthotic interventions, e.g. ankle foot orthosis, insole, raise-sole shoes, knee extensional splint, could tackle the problems of the elderly which may cause fall.

Most cases of hip fracture of elderly are caused in a sideways fall with direct impact on the greater trochanter of the proximal femur. Hip protector is used as an orthosis for protecting the hips, so that at the time of a fall the force and energy of the impact are attenuated and shunted away from the greater trochanter, preventing fracture.







8. Special clinic or program

Adult team:

Foot Assessment Clinic: This clinic is conducted by orthotists specialized in management of foot and ankle problem. The one- stop service model targets to provide timely and effective orthotic treatment to patient with foot and ankle pain condition.

Paediatric team:

Special school outreach service: The team will provide consultation and regular follow-up to students of special school. Group therapy and consultation session will be arranged for the students group. The group treatment session provide an excellent platform which allows communication between patients, therapists, and parents/ carers to establish a comprehensive orthotic management plan to the patients.

9. Staff and carers training in orthosis and prosthesis application

Community Service

Community Care Centre and Community Health Centre

As a member in the multidisciplinary team of Community Care Service, we are committed to provide a community-based, one-stop service model to improve health literacy, provide early intervention, promote secondary prevention for chronic diseases, and reinforce self-help strategies among the population.

Prosthetic and Orthotics Service in community setting including timely intervention to musculoskeletal pain condition (e.g. foot and ankle pain condition), screening and complication management in diabetic patients, and empower patients with chronic disease to stay healthy in their own community

The goals of the Prosthetic and Orthotics Service in Community setting is to

1. Facilitate all patients to get access to the proper orthotic treatment in early phases of the disease.
2. Equip patients with proper self-care technique in daily handling of their foot problem.
3. Triage patients and minimize avoidable medical consultation.
4. Provide one-stop seamless health care to patients within their own community.

Joint special clinic

Seating clinic

Patients suffered from severe neuromuscular diseases are often complicated by improper seating postures. Prolonged seating in an abnormal position may result in further deformities, and often leads to pain and pressure sores. In response to the rising service demand of special seating, the NTWC Seating Clinic was established and commended its service in January 2008.

Services provided at the Seating Clinic

• Clinical assessment, education and advice on the special needs of seating and posture.
• Prescribe, design and fabricate special seats and wheelchairs, customized to the need of individual patient
• Arrange referrals to other specialties for necessary medical attention or follow-up if needed
• Offer advice on the choices, and the application of orthotic treatments and adaptive devices
• Provide short term wheelchair loan service
• Ongoing review and support

Joint Cerebral Palsy clinic

Joint CP clinic adopt a multidisciplinary approach to generate the comprehensive treatment to children with cerebral palsy. Team member includes: paediatric neurologist, paediatric orthopaedic surgeon, prosthetist and orthotist, physiotherapist, occupational therapist, social worker and nurse. All team members meet regularly in the clinic to establish the rehabilitation plan for the children.

Prosthetic and Orthotic Clinic

The P&O Clinic is a joint clinic conducted by Orthopaedic Surgeon together with Prosthetist- Orthotist in monthly basis. The clinic targeted to provide long term follow up to patients with persistent need of prosthetic and orthotic appliances, i.e. patients with amputation and poliomyelitis. The clinic provides orthopaedic and orthotic consultation at the same time, and patients with orthotic or prosthetic need could be referred by orthopaedist to orthotist in the clinic

Special programs

IPCP in Breast Cancer Management

• Out patient and Hospitalization phase
• Community phase

Flow chart for fitting of breast prosthesis

Introduction talk for patients with breast cancer

Fitting of breast prosthesis by female prosthetist

Appointment Procedures

Please bring along with the referrals to our department for appointment booking. It could be done in-person or by relatives.

Service Hours

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