Orthotic Types Flashcards
types of orthoses
orthotic orthosis prothesis foot orthosis custom foot orthosis perscription custom foot orthosis
shell
is the firm material that is pressed to the positive to hold the shape of the orthosis
plaster modifications depends upon
they type of orthosis
what are plaster modifications
are additions or subtractions of plaster to the original positive for specific purposes
heel cup also referred to as
heel seat
depth of the heel seat helps to determine
how much control an orthosis will provide
flanges generally extend to
just proximal to the MT heads
what types of flanges may be used
meidal or lateral flanges
can be used separately or together
lateral clip extend to just
proximal to the styloid process of the 5th MT
forefoot extensions extend
distally beyond the shell
what type of length can topcovers be
full length
sulcus length
length of the shell
spectrum of devices
insole temporary pre-fabricated (pre-fabs)/over the counter/off the shelf/pre-made customized custom
other types of custom foot orthoses
UCB(L)
Pronated
Schaffer plate
Neutral Shell
how do you cast for UCBL Orthoses
may be casted neutral, rectus or PWB (partial weight bearing)
how do you cast for pronated orthoses
casted STJ pronated
what is a Schaffer plate
an arch support
how do you cast for a Schaffer plate
depends on how high you want the arch
what is a neutral shell
is a functional orthoses w/o posting
how do you cast for neutral shell
casted neutral
do accommodative orthoses change function
NO!
how do you cast for accommodative orthoses
partial weightbearing
what type of material are accommodative orthoses
usually multi-laminar to reduce shear force
material depends on the purpose, size of the patient and the shoe in which they will be worn
are accommodative orthoses always soft
NO!
are accommodative orthoses only for diabetic patients?
NO
what are the different pediatric devices
Heel Stabilizers (A-D or E) Whitman Roberts Whitman-Roberts Reverse Roberts
how do you cast pediatric devices
almost always casted rectus
Type A heel stabilizer
forefoot platform under 1-3 MT
Type B heel stabilizer
Deep heel seat and MT FF extension with lateral clip and medial flange
Type C heel stabilizer
Deep heel seat with medial and lateral flanges to the 1st and 5th MT head
true Whitman devices purposely caused pain at
the navicular tuberosity
Roberts device uses what type of clip
lateral clip to keep the calcaneus from everting
what is Reverse Roberts
like a type D heel stabilizer and functions by forcing an abductory twist as well as potentially increasing STJ pronation
what is the purpose of Functional Orthoses
- Prevent compensation
- *Allow the STJ to function around NP
- Promote the normal timing of the gait cycle
- Change function
what are the different types of posts
intrinsic posts
extrinsic posts
flat posts
intrinsic posts are a result of
positive modifications
what are intrinsic posts
posts are made within the shell itself so the foot forms to the post
what are extrinsic posts
adding wedges to the outside of the shell
extrinsic posts are appropriate for what type of foot?
rigid type of foot
flat posts provide stability in
the rearfoot by preventing the device from rocking
flat posts do not provide for — plane correction
frontal
what are arch fills
- are modifications to the positive
- is the material under the shell to help support the shell
what is the purpose of an arch fill
provides for the arch height and contour of the device, but is not a control point
what is Kirby Skive
- a form of rearfoot posting
- a small amount of the positive is rasped off, usually in the area of the medial tubercle of the calcaneal tuberosity, to increase the supinatory moment at the STJ
what is an inverted pour (Blake Modification)
- anti-pronation modification
- take calcaneal bisection and stick a nail in there to tilt the forefoot in significant amounts (25,35 or 45’ moments)
when would you want to do a 1st ray cutout
-to allow plantarflexion of the 1st ray to allow dorsiflexion of 1st MTP and supination of the STJ
when would you not perform a 1st ray cut off?
for a patient with hallux rigidus bc you are encouraging motion they can’t do
what are the relative contraindications to functional orthoses
- obesity
- genu valgum
- equinus
- severe flexible flatfoot
- painful and/pr significantly reduced range of motion
(see slide 42)
what are the cast techniques for functional orthosis
-neutral always off weight bearing STJ in neutral MTJ maximally pronated ankle joint dorsiflexed to resistance
