Development and evaluation of extension gloves for children with recessive dystrophic epidermolysis bullosa: A case report.

Background
Recessive dystrophic epidermolysis bullosa causes severe skin fragility and progressive hand deformities, significantly impairing hand function. Strategies for these pseudosyndactyly include hand dressings, orthoses, and surgery.Purpose
This report outlines the development of extension gloves designed for children and adolescents with recessive dystrophic epidermolysis bullosa.Study Design
Case report.Methods
Soft-material gloves were designed to prevent progression of pseudosyndactyly and thumb adduction while promoting finger extension. Prototypes were iteratively modified based on clinical assessments and patient feedback.Results
Two pediatric patients with severe recessive dystrophic epidermolysis bullosa tested the gloves for 12 and 13 months. Both had previously rejected conventional orthoses due to discomfort. Up to three custom glove versions were developed per patient, featuring dynamic finger straps, fused finger compartments, and Velcro closures. Despite personalization, long-term use was limited to 30 min/day due to donning difficulties, wound issues, and discomfort. One patient discontinued due to health decline and contracture progression; the other stopped all orthotic use due to persistent discomfort.Conclusions
This case report highlights challenges in developing extension gloves for children with recessive dystrophic epidermolysis bullosa, including limited long-term use due to material and usability issues. However, the iterative, patient-centered design process offered valuable insights that informed the development of 3D-printed orthoses for future exploration.