Orthosis:: an orthopedic appliance or apparatus used to support, align, prevent, or correct deformities or to improve function of movable parts of the body. Also referred to as a brace or splint.
When describing orthoses, the name is an acronym for the joints or the parts of the body that it is treating. For example: Foot orthotics (or FO) are for the feet, an ankle foot orthotic (AFO) is for the ankle and foot, and the KAFO is an orthotic for the knee, ankle and foot.
LOWER EXTREMITY ORTHOSES
FO:: Foot Orthoses/Foot Orthotics
Custom Molded:: A foot orthosis that is molded over a model of the patient’s foot and placed in the shoe to provide support under the ball of the foot. Provides support and correction to the soft tissue and skeletal structure of the foot.
UCBL (Univeristy of California Biomechanics Laboratory):: maximum control foot orthosis that was named after the laboratory where it was developed. It is used to stabilize a flexible foot deformity, which in most cases is a flexible flat foot. This differs from other foot orthoses in that it fully encompasses the heel with a molded heel cup which in turn holds the heel in a neutral, vertical position. While correcting and holding the heel in the neutral position, it also controls the inside of the arch of the foot and the outside border of the forefoot. These three corrective forces keep the foot held in a neutral position.
AFO:: Ankle Foot Orthoses
SMO:: (Supra Malleolar Orthosis): is considered the shortest of the AFO’s. It is prescribed for patients who have soft, flexible, flat feet and are most often worn by children.
DAFO:: maximum control custom orthosis with hindfoot and forefoot control. It is used to treat severe pronation/supination and allows free plantar flexion and dorsiflexion. It is good for toddlers with low to normal muscle tone, moving from floor activities to standing and walking.
CAM WALKER:: Cam walkers are prefabricated devices often used for treatment of ankle sprains and fractures of the foot, tibia or fibula. This brace should help to keep the foot in a stable and immobile position that allows for healing to occur while still allowing the patient to walk. The rocker bottom design allows for relatively smooth gait while maintaining position.
SAFO (Solid Ankle Foot Orthosis):: device often used to treat medial/lateral instability and limited range of motion at the ankle. The device prevents foot drop by blocking plantar flexion as well as helping to control the knee by preventing hyperextension.
HAFO (Hinged Ankle Foot Orthosis):: This is the most versatile AFO that is designed. It can be made to be a solid AFO to start and then move into a limited articulation, then change range of motion as rehabilitation dictates
PLS AFO (Posterior Leaf Spring):: flexible device that allows for more increased motion
KO:: Knee Orthoses
Knee Sleeve:: provides targeted support for pain relief and stabilization of the knee
Osteoarthritis Knee Braces:: Osteoarthritis (OA), also called degenerative joint disease, is the breakdown of cartilage in the knee joint. As one grows older, the wear and tear of daily living and activity slowly wear out the joint. Knee trauma, such as broken bone, cartilage and /or supportive ligaments, can disrupt the integrity of the joint, leading to premature OA. Symptoms can include a low grade ache and/or swelling, and become worse as the joint is used throughout the day. The OA brace treats medial/lateral instability.
POST OP AND ROM BRACES:: generally prescribed post-operative or post trauma. This type of brace is designed to help support the knee as well as limit the range of motion to whatever angles the doctor specifies.
KAFO:: Knee Ankle Foot Orthoses
TOTAL SURFACE BEARING/THERMOPLASTIC:: always preferable due to increased control areas and the reduced pressures on the skin that results. Therefore, the total surface bearing orthosis provides more comfort and better function than the conventional alternative. Total surface bearing/Thermoplastic designs are also considerably lighter and have a better durability vs weight ratio. They are easier to clean and can easily be changed between different shoes.
CONVENTIONAL KAFO:: KAFOs can be a valuable tool, however they are generally a last resort behind the Total Surface Bearing/Thermoplastic or hybrid designs. Conditions that merit their use include fluctuating edema or fluid retention, patient preference, or inability for a patients leg to be casted or scanned.
HYBRID KAFO:: device combines the conventional KAFO with the thermoplastic KAFO by having part of the brace be thermoplastic and part using a metal and leather type design. This is usually indicated when an individual has a tendency for distal edema. In this case, the proximal section of the brace can still provide advantages of a thermoplastic design while the distal section is made conventionally to allow for changing edema volume of the lower leg.
HKAFO:: Hip Knee Ankle Foot Orthoses
The application of a HKAFO is the same as with a KAFO only there is an additional component of a hip joint and a pelvic band. There are several different option of hip joints and pelvic bands/belts. The indication for a HKAFO would include weak or paralyzed hip flexors or extensors. Other indications may be the need to stop rotation or unwanted motion at the hip.
Fracture bracing is obviously indicated for fractures of all different levels. However, a fracture brace may also be prescribed for the other cases such as chronic dislocations, or in post-operative situations. In any case, the brace can be ordered custom fit or custom fabricated. The treatment protocol will depend on the doctors orders for each individual case.
UPPER EXTREMITY ORTHOSES
LSO:: An orthosis that focuses immobilization and support on the Lumbar spine.
TLSO:: A plastic body jacket used for a variety of diagnoses including post-operative protection, scoliosis, and vertebral fractures
HALO ORTHOSES:: used to treat injuries to the cervical spine and is comprised of a vest and superstructure. These are typically used to treat a severe injury or unstable fractures to the neck for post operative stabilization.
CERVICAL THORACIC ORTHOSIS:: designed to provide immobilization of cervical and upper thoracic spine providing a stable cervical or bracing support for high thoracic fractures or dislocation.
RIGID CERVICAL COLLAR:: orthosis that supports from under the jaw down to the chest area to provide maximum support and protection of the cervical and thoracic areas
SOFT CERVICAL COLLAR:: soft support that serves as a kinesthetic reminder for treatment of minor neck strains.
These are just some of the orthoses we provide here at San Francisco Prosthetic Orthotic Service, Inc. If you have any questions regarding these or other types, don’t hesitate to give our office a call.