Giving Hope

The happy bedlam of chatting mothers and playful children at the Shriners Hospital in Springfield, Mass., last week seemed almost like a family reunion. Yet there was a difference: the children all used artificial limbs. They were at the hospital for a monthly checkup. The very cheerfulness of the gathering, however, illustrated the hope that new advances in orthopedics have brought to both handicapped children and their understandably concerned parents.

Roughly one out of every 4,000 children born in the U.S. is missing part or all of one or more limbs. Except in the rare instance of a mother's taking a harmful drug such as thalidomide during pregnancy, the causes of these congenital deformities are seldom known. But the effects are only too evident: in some cases, arms and legs end in misshapen stumps; in others, vital bones are missing from legs and arms, leaving the limbs partially disabled.

Advantages for Infants. Until a few years ago, children born with such deformities were allowed to reach full growth before any major corrective measures were taken, but now doctors at Shriners and a score of other pioneering hospitals are proceeding differently. Says Dr. Leon M. Kruger, 40, who heads the clinic for crippled children in Springfield: "As soon as a child feels an inclination to stand, we feel he is ready for prosthetics."

Doctors have found that infants are less inclined than adults to develop the "substitution pattern"--the unfortunate tendency in cripples to make do with a stump rather than to rely on an artificial arm or leg. Under the care of skilled therapists, infants spend an average 72 days as in-patients in the Springfield hospital, learning to use simple beginner prostheses--a hook for a hand, a short, thick stilt for a leg. Because they are naturally so eager to walk and to handle objects, infants usually accept the prostheses as parts of their own bodies.

Examples for Adults. The children return to the hospital each month for evaluation by a surgeon, physician, prosthetist, physiotherapist, and sometimes an occupational therapist--a team approach that has won increasing favor since World War II. The evaluation sessions are held with groups of 15 or 20 children so that they see that other similarly handicapped children are also learning to cope. Parents attend the sessions and are encouraged to talk out their problems with one another. As a result, most have found the emotional strength to face up to their children's problems. "We call her hand 'the-hooker,' " explains the young mother of a pert five-year-old girl who was born without a left forearm, "because that is what the kids will call it, and she'll be used to it by then."

Starting out young with artificial limbs helps handicapped children develop a sometimes almost uncanny skill. A two-year-old girl, who was born with only stumps for legs, is already using artificial legs with articulated knees; a four-year-old boy, who was born without arms, can draw as well as a normal child with a crayon clenched in his hook. Other older children can dance, skip rope and even ice skate on artificial legs. As a result, the children, though physically crippled, avoid the greater danger of becoming emotionally crippled. Their spirit is so good, in fact, that doctors in the Springfield clinic invite adult amputees to visit the monthly evaluation sessions to give the older patients new hope.

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