Newport JR Hip Orthoses: Early Intervention Aids Joint Alignment
By Dulcey Lima, CO, OTR/L, Deanna Fish, MS, CPO
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Dulcey Lima, CO, OTR/L |
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The Newport JR Hip Orthosis was designed to
restore and maintain joint alignment to produce improved mechanics
and effective alignment of the hip structures. Early intervention
is most effective when the child is actively growing to better
direct the soft tissue development and bony alignment.
Adult alignment will be compromised if the skeletal system fails
to achieve mechanically effective alignment during periods of
active growth. Spastic muscles around the joint continue to impact
joint integrity and also interfere with the attainment of
functional activities. The residual abnormal bony alignment and
deformity continue to have a profound impact on function. Ideally,
providing more normal joint positioning will encourage more
effective modeling and provide the child with an opportunity for
improved structural stability.
Early Hip Development
The development of normal hip skeletal alignment, shape, and
function is directly affected by a baby's development in the first
months and years of life. At birth, the hip is held in flexion and
lateral rotation. The acetabulum is shallow and lax, allowing
maximum range of motion to facilitate the baby's descent into and
out of the birth canal.
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Deanna Fish, MS, CPO |
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As the baby begins to creep, crawl, and stand, the
angle between the neck and shaft of the femur decreases from 140 to
125 degrees by six years of age, creating greater acetabular
coverage and structural stability for walking, running, and other
gross motor skills. As hip flexion tightness and medial rotation
become more balanced with the emergence of hip extensors and
lateral rotators, the femur "untwists" and becomes more aligned
with the femoral condyles.
The hips of children with orthopedic problems often lack proper
alignment and stability because spastic muscles exert abnormal
forces on the bones. The lack of normal developmental activities
reduces the opportunity for normal weight-bearing forces to
stimulate bone and joint congruity. Use of a hip orthosis
facilitates more stable positioning and provides an opportunity for
more normalized structures to develop.
Clinical Indications of the Newport JR
 Functional standing and sitting are important
developmental skills that are often delayed in physically
challenged children. For functional purposes, potential uses of the
Newport JR include:
1. Orthosis to widen the base of support in sitting to promote
increased stability and hands-free sitting.
2. Orthosis to provide more neutral alignment for children who
have painful hips and multiple orthopedic problems.
3. Night positioning orthosis to stretch tight hip adductor,
abductor, flexor, and/or extensor muscle groups.
4. Orthosis to promote a more abducted and stable independent
standing position.
5. Orthosis to stabilize the hips within a standing frame for
supported standing.
6. Orthosis to position the hips, knees, and feet for improved
independent walking.
Many surgeons use a bilateral hip spica cast to stabilize the
hips for six-eight weeks after soft tissue or bony procedures.
These casts provide stabilization, but are also heavy, awkward, and
non-removable. Spica casts often create hygiene issues and do not
allow observation of the incision site. The Newport JR can be used
in place of the hip spica and set at the exact range needed for
postoperative stabilization.
Advantages to using the Newport JR in place of a hip spica cast
include:
1. Ability to set flexion, extension, abduction, adduction, and
change settings over time.
2. Ability to make the orthosis non-removable by riveting the
straps shut or applying a layer of fiberglass over the straps for
easy removal in the physician's office.
3. Ability to remove the orthosis to perform hygiene tasks and
replace the soiled liners with the extra set of liners
provided.
4. Curved proximal offset of the PJ Virtual Joint allows
clearance over the incision site and allows hips to be fully
abducted in the orthosis without impingement.
5. Thigh cuffs encompass the thigh and distribute contact over a
broad area.
The Newport JR is available in five sizes.
For more information, contact Orthomerica Products Inc.,
800.446.6770.
Dulcey Lima and Deanna Fish are clinical education managers
for Orthomerica Products Inc. They lecture regularly at national
and international meetings, assist with new product and marketing
efforts, and provide seminars and consultation to the orthotic and
prosthetic community. 
Table Of Contents - April 2004
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