DGMC brace shop designs first tibial fracture orthosis in eight years Published May 1, 2018 By Tech. Sgt. James Hodgman 60th Air Mobility Wing Public Affairs TRAVIS AIR FORCE BASE, Calif. – A 12-year-old boy raced toward the ball. He was determined to kick it into the back of the net to win the game. Another child challenged the would-be goal scorer and their legs slammed into one another in a violent collision. The collision resulted in the boy breaking his tibia, the second largest bone in the body, in his right leg. The boy’s family wanted him to heal as quickly as possible so he could return to playing the sport he loves. After seeking treatment at David Grant USAF Medical Center at Travis Air Force Base, California, in February, he was referred to the orthotics lab, or brace shop, by an orthopedic surgeon to be fitted for a custom brace. “We casted his leg and created a tibial fracture orthosis for him and had him walking in 48 hours,” said Tech. Sgt. Michael Vanderhoef, 60th Surgical Operations Squadron brace shop noncommissioned officer in charge. “Many other places could take between two and four weeks to do the same thing. So 48 hours is outstanding turnaround time for anything that is custom made.” Vanderhoef fabricated the brace, which was the first of its kind created at DGMC in nearly a decade. Without it, Vanderhoef said, the boy likely would’ve been in a hard cast and relying on crutches to get around. “Daily life would’ve been a struggle,” he said. “A hard cast for four to six weeks isn’t ideal because you lose foot and ankle motion. The cast also makes everyday tasks like bathing tedious. Everyone wanted to see the boy heal quickly and the tibial fracture brace applies circumferential compression, which helps stabilize and protect the area around the fracture site. It also increases the inter-cavity pressure in the tissue around the bone and helps provide better stability than a standard hard cast would.” Watching the boy walk out of the clinic shortly after being fitted for the brace was a great feeling, Vanderhoef said. “Having the ability to change someone’s day for the better and help them is awesome,” he said. “I love the job. Some people drastically change after you put a device on them. You can see a change almost immediately in their attitude. Seeing that change and being a part of it is the best part of the job.” The boy wore his brace for a few weeks and is once again playing soccer. Over the past year, the brace shop has seen more than 4,000 patients and fabricated nearly 1,000 custom braces. The clinic has the capability to provide a wide range of braces including ankle and foot orthotics, cranial reshaping helmets for infants and dynamic ligament braces. Vanderhoef, a native of Boise, Idaho, and one of two certified orthotists in the Air Force, said his clinic can design nearly any device a patient needs from head to toe. “Our clinic has the ability to make custom fabricated orthotics to assist patients with whatever they need,” he said. “We are able to design and fabricate devices that will enable patients to have increased motion, we can design braces to immobilize specific joints to enhance stabilization or promote faster healing. We can provide braces to support patients after spinal surgery and we’ve even made shoes for diabetic patients. We can create almost any type of orthotic device in order to meet a patient’s specific needs.” According to the DGMC website, the facility provides services for more than 400,000 people. Vanderhoef said he hopes more people seek the care his team provides in the brace shop. “Our goal is to provide the best care for our patients, and here at DGMC we can likely provide a better patient experience than other places,” he said. “In our brace shop, we cast each patient, fabricate the brace they need and do our best to avoid those patients having to go off-base to receive services. It really is one-stop shopping.” The brace shop sees between 10 and 20 patients a day. To be fitted for a custom brace, patients must first be referred to the clinic by their primary care manager or a specialist, such as a podiatrist or an orthopedist.