CAST EVALUATION

Question 1

what are the steps?

Answer 1

bisect posterior surface of the heel

tilt cast until heel is vertical and allow cast to rest on flat surface

plantar surface of the cast at the area of MTJ should be convex

sulcus of the toes

plantar surface of lateral arch of negative cast

compare right and left negative casts

not any difference

determine supinated vs pronated cast

examine position of 4th and 5th toes on sagittal plane

Question 2

what is the purpose of the cast evaluation?

Answer 2

from negative cast, you can ID the forefoot to rearfoot relationship or locking position of MTJ but can’t ID neutral STJ because lower 1/3 of leg is not in the cast

Question 3

position of the heel reflects?

Answer 3

forefoot to rearfoot relationship

Question 4

affect of supination? vs pronation?

Answer 4

supination makes lateral 1/2 of convexity even sharper and more lateral flattening out medial convexity

pronation flattens out the lateral convexity

Question 5

can we use this technique if the patient has forefoot Caruso compensated equinas?

Answer 5

nope

Question 6

how should the toe be?

Answer 6

thumb print should be parallel to plantar plane of lesser metatarsal heads and only contacts 4th and 5th toes

Question 7

how should the lateral arch be?

Answer 7

smooth plantar concavity, an acute or sharp angulation of the lateral arch represents a supinated cast (not acceptable)

Question 8

right and left negative casts should be?

Answer 8

relatively symmetrical

Question 9

forefoot cast is more inverted than seen on clinical exam, what does this indicate?

Answer 9

supinated cast

Question 10

how should the position of the 4th and 5th toes on sagittal plane?

what happens if they are dorsiflexed?

Answer 10

straight or parallel to ground

this plantar flexes the metatarsal head