Some Observations in the Field of Orthotics in Israel and the Scandinavian Countries
Maxwell H. Bloomberg, M.D., F.I.C.S. *
During the month of May 1965, I was privileged to give a course in Orthotics at the Tel Hashomer Hospital, Israel, under the auspices of Professor Ernst Spira of the University of Tel Aviv. I had the opportunity to visit the Prosthetic and Orthotic shops at the Tel Hashomer Rehabilitation Center and those of Haddasah Hebrew University in Jerusalem.
Israel, a young energetic country, composed of a large segment of highly educated and well trained people, is particularly interested in the accelerated progress of all phases of living. The study of Prosthetics and Orthotics is no exception. One can't help being impressed with the youthful attitudes of the desire to learn new methods and techniques.
There are about 74 Orthotists and Prosthetists in Israel, many having received their training in the United States. All braces are closely evaluated to determine their usefulness. Many new braces are being tested. The use of aluminum is a problem because of erosion from perspiration and sand. This problem is being solved by the use of coating to prevent disintegration of the metal. Pre-fabricated parts as made in the United States and West Germany are still in small supply. Considerable interest is shown in the desire to progress in this direction.
Their enthusiasm to show progress is beyond description. In one instance, Jimmy Shaltiel, Orthotist for the University of Jerusalem, visited me at the hotel at midnight for a "discussion." This discussion lasted for several hours terminating in his brace shop in the early morning hours. It is remarkable what work in quality and quantity can be produced in a small shop. I wonder what he might accomplish with more modern equipment. Jimmy expressed a desire to exchange ideas with other Orthotists. His address is P.O. Box 1222. Jerusalem, Israel. He is particularly interested in Scoliosis and he is doing excellent work with the use of the Milwaukee Brace.
In the countries I visited there were many combined Orthotic and Prosthetic shops with 100 or more employees—usually part of a large hospital complex. They are run efficiently in their own way. Most of their supplies including pre-fabricated parts and plastics are imported from West Germany. A plastic commercially known as Ortholen has replaced the metal cuff of short and long braces. This plastic, beige in color, is hard, light weight, heat controlled, and can be drilled, sawed, fashioned cold by hammering and may be cupped as desired. It is supplied in sheets in varying thicknesses.
At the Orthopedic Shop Sahlgrenska Sjukhust, Gothenberg, Sweden, Mr. Ake Magnuson demonstrated a new method of coating aluminum by incorporating a powder in the heated metal. The powder "Rilson" is blown on heated aluminum forming a smooth coating which does not chip even with hammering. Many plastics are used in this shop.
Norway is attempting to solve the problem of lack of coordination between the Orthotist and the Physician. Dr. Thomas Wyller, an Orthopedic Surgeon, operates once a week in the local hospital and the remainder of the week is spent in the Orthotic and Prosthetic shop. A clinical session is held weekly. An extensive program is being planned to include research as well as expanding the clinic. Dr. Wyller is particularly interested in the use of the Milwaukee Brace.
In Helsinki, Finland, Professor Kallio at Toolo Hospital, is interested in the immobilization and mobilization of joints and is coordinating this work with the Orthotic shops.
My regrets are that I was not able to stay for a longer period of time.