Musculoskeletal VI- Orthotics, Prosthetics and Amputation

Question 1

Orthotic

Answer 1

• external device that provides support or stabilization, improves function, corrects deformities, and distributes pressure from one area to another
• made from a variety of materials including plastic, metal, leather, fabric, elastic, or hybrid materials
• can be custom made or over the counter

Question 2

Orthotic functions

Answer 2

• include preventing deformity, maintaining proper alignment, inhibiting tone, assisting weak limbs, protecting against injusy, and facilitating motion

Question 3

Orthotic factors to consider…

Answer 3

• static vs dynamic
• temporary vs permanent
• level of support required
• energy efficiency
• cosmesis
• cost

Question 4

Foot Orthosis

Answer 4

• semirigid or rigid insert
• worn inside a shoe that corrects foot alignment and improves function
• may also relieve pain

Question 5

Ankle Foot Orthosis (AFO)

Answer 5

• metal ankle foot orthosis of two metal uprights connected proximally to a calf band and distally to a mechanical ankle joint and shoe
• ankle joint may have ability to be locked and not allow any motion, or set to have limited ant/post capability depending on the patient’s need

Question 6

AFO plastic

Answer 6

• plastic AFO is fabricated by a cast mold of pts LE
• plastic is more cosmetic, lighter, and does not fulcuate if patient has edema
• proper fit of plastic AFO requires patient be casted in subtalar neutral
• footplate can be incorporated into AFo to assist with tone reduction
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Question 7

AFO Spring leaf

Answer 7

• primary purpose is to assist with Df and prevent foot drop
• requires adequate med/lat controlmby the patient

Question 8

Floor reaction AFO

Answer 8

• assists with knee extension during stance through positioning of a calf band and/or positioning at the ankle

Question 9

Knee ankle foot orthosis (KAFO)

Answer 9

• provides support and stability to the knee and ankle
• can be fabricated using two metal uprights extending from foot/shoe to the thigh with calf and thigh bands

Question 10

Craig scott knee ankle foot orthosis

Answer 10

• designed specifically for persons with paraplegia
• allows person to stand with a posterior lean of the trunk

Question 11

Hip knee ankle foot orthosis (HKAFO)

Answer 11

• indicated for patients with hip, foot, knee, and ankle weakness
• consists of bilateral knee ankle foot orthoses with an extension to the hip joints and a pelvic band
• can control rotation at the hip and abd/add
• heavy and restricts patients to a swing to or swing through gait pattern

Question 12

Reciprocating Gait Orthosis (RGO)

Answer 12

• derivative of the HKAFO and incorporates a cable system to assist with advancement of the LE during gait
• when patient shifts weight into a selected LE, cable system advances the opposite LE
• primarily for patient with paraplegia

Question 13

Parapodium

Answer 13

• standing frame designed to allow a patient to sit when necessary
• prefabricated frame and ambulation is achieved by shifting weight and rocking the base across the floor
• primarily used by pediatric population

Question 14

Spine Orthotic- Corset

Answer 14

• constructed of fabric and may have metal uprights within the material to provide abdominal compression and support
• utilized to provide pressur and relieve pain associated with mid to low back pathologies

Question 15

Spine orthotic- Halo vest orthosis

Answer 15

• invasive cervical thoracic orthosis that provides full restriction of all cervical motion
• metal ring with four posts is placed on patient and secured by inserting four pins through ring into the skull
• commonly used for vervical spinal cord injuries to prevent further damage or dislocation during the recovery period

Question 16

Spine orthotic- Milwaukee orthosis

Answer 16

• designed to promotoe realignment of spine due to scoliotic curvature
• custom made and extends from pelvis to upper chest

Question 17

Spine orthotic- Taylor Brace

Answer 17

• thoracolumbosacral orthosis that limits trunk flexion and extension through three point control system

Question 18

Spine orthotic- Thoracolumbosacral orthosis (TLSO)

Answer 18

• utilized to prevent all trunk motions and is commonly utilized as a means of post surgical stabilization
• the rigid shell is fabricated from plastics in a bivalve style using straps/velcro to secure orthosis