Lower Extremity Oral Questions Flashcards
How do you determine stirrup length?
2 times height of distal tip of medial malleolus plus width of heel plus 1/4” or 6mm
How do you determine band length?
half circumference plus 1 1/2” or 38mm
What are the minimum clearances for ankle joints and knee joints?
Knee: medial side: 1/4” or 6mm - lateral side: 1/8” or 3mm
Ankle: medial side: 1/4” or 6mm - lateral side: 3/16 or 5 mm
In a conventional KAFO, what changes could you use to reduce recurvatum?
Shallow bands, move calf band up – distal thigh down – move these two closer, increase heel height
What problems could you encounter in moving the bands?
Peroneal nerve impingement, limited knee flexion of orthosis
How much plantar flexion would you allow a patient who has suffered a CVA?
neutral
How do you determine if a patient requires locks on his KAO versus free knee?
Hip and/or knee extensor weakness
What do you recommend for a patient who exhibits foot slap at heel strike?
An AFO – conventional or plastic/dorsi-assist and/or plantar stop
What is Legge-Calve-Perthes disease?
Avascular Necrosis of the femoral head usually occurring in boys ages 9-14. Femoral head will return to normal if the leg is abducted and internally rotated to place the femoral head into the acetabulum.
Name 3 orthoses used for Legge-Calve-Perthes?
*Atlanta (Scottish Rite)
*Toronto
*Newington
–Orthoses is set up internally rotated and abducted about 45 degrees
Name 3 orthoses for the treatment of Hip Dysplasia
*Frejka pillow
*Pavlik harness
*ILfeld splint
–Orthoses is set up in a flexed ad abducted position
What is tibial torsion?
Difference between knee and ankle joint axes as viewed in the transverse plane
How is tibial torsion measured?
With the knee at 90 degrees 00 measure apex of each malleolus to a surface behind the leg
What type(s) of functional device can be used for excessive pronation of the foot?
Foot orthotic or UCBL
A UCBL is used for more control of what part of the foot?
hind foot (calcaneus), sub-talar joint
What is the cause of Charcot joints in the feet and ankle?
Any neuropathic disease an have Charcot joints associated with it (diabetes, herpes, syphilis)
Evaluation of a patient with a gunshot wound to the hip reveals weak hip flexors. What peripheral nerve is injured?
Femoral nerve
What is your orthotic recommendation for the above? – (Femoral nerve injury)
Maybe a cane used on the contralateral side
What is the name for a contralateral pelvic drop?
Trendelenberg sign or gluteus medius limp
Describe chondromalacia
Softness of the articular cartilage usually involving patello-femoral joint
What is your orthotic recommendation for chondromalacia?
Palumbo orthosis or other patellar stabilizing orthosis
A patient’s KAFO has free motion knee, but the mechanical joint is 1” distal to the anatomical joint. In flexion the resulting pressures will be?
Proximal, posterior thigh - distal, anterior thigh - brace migrates proximally