CLIENT: Age 8, bilateral absent radius (bone in the forearm), range of motion limitations in fingers

OCCUPATION: managing pant fasteners for toileting

FACTORS AFFECTING FUNCTION: Limited ability to reach the fasteners of pants, limited ability to pinch button and pant material, decreased strength in hands

 OTHER CONSIDERATIONS: Should be small, pocket sized for discreet carrying to the bathroom


There are a lot of commercially available button hooks and zipper pulls available. No seriously, you could get lost Googling these things. There are antiques and ones that bend and ones that look like a pocket knife and ones that cuff to your hand and the options continue. Even with the variety available, I always seem to make them myself because they don't meet the needs of the individuals I'm working with.

The biggest issue I have with button hooks are that most are made for small buttons on shirts, not pants. I work with kids who could care less about wearing a button down shirt. What they would like to be able to do is wear jeans to school. Families end up buying their kids elastic waste pants only. It's a good strategy. Avoiding needing help in the bathroom is arguably more important then being able to dress like your peers. But why can't you have both?


The most common buttonhook has a cylindrical handle, but my client is unable to form a gross grasp due to range of motion limitations in their fingers. They are able to grasp between their 2nd and 3rd fingers. A cylinder shaped handle is going to be very difficult for my client to generate any force. 

This button-zipper hook fits right on the palm, no grasp or pinch necessary, but my client can't reach down that far. 

There are zipper loops, but who wants to keep that attached to their pants zipper?

This deluxe pocket dresser is intriguing. It solves the problem of being compact and in theory would give my client added reach, but it seems like too much