UCBL - Management of Ankle Mortise

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Last updated 2:35 PM on 9/14/26
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6 Terms

1
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ucbl requirements

flexible deformity - flexible hind foot and mid foot that allows for correction with orthosis

little or no spasticity

less than 10 degrees hind foot angulation


2
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ucbl contraindications

severe spasticity

vertical talus - talar angle > 45°

severe mid foot break

3
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design principles for ucbl

  1. create inner contour capable of giving foot maximum passive support

  2. stabilization of the orthosis in the shoe - cannot be rolled into valgus orientation

  3. stabilization of the shoe on the walking surface


4
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trimlines for ucbl

inferior to malleoli

contain shafts - 1st and 5th met —> also add dorsal wrap as high and comfortable as practical

metatarsal heads

2-3mm proximal (or full toe plate)

hind foot posting —> varus/valgus control

5
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modifications of ucbl

intrinsic - support the ST - remove plaster posterior aspect of ML arch; 4-7° medial wedge - remove more plaster from medial plantar surface at angle; reduce ML of calcaneus on lateral side (very minimal 0.3cm)

extrinsic - medioplantar aspect of heel “Gillette” modification - extension to increase moment arm; can extend this in wedge to match intrinsic modification in severe cases

6
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3 point force system

  • corrective force: ST modification

  • stabilizing forces

    • medial directed force on the lateral calcaneus

    • shaft of 5th metatarsal