mod 4- orthosis proximal to the knee

metal and leather

which KAFO design involves no casting?

metal and leather

which KAFO design response the best to changes in leg volume

each pair of shoes needs to be modified with caliper box

drawback of metal and leather AFOs attaching directly to the shoe

PP, co-poly, HDPE

materials used to make thermoplastic KAFOs

thermoplastic

which kind of KAFO is the easiest to clean?

thermoplastic

KAFO with the best anatomic control

edema, heat retention, not as comfortable as leather

contraindications for thermoplastic KAFO

MS

what disorder is commonly an automatic contraindication for a thermoplastic KAFO due to heat retention?

controls foot/ankle while leather top increases sitting comfort

benefit of hybrid KAFO with thermoplastic distal section

accommodates edema while thermoplastic thigh provides more control

benefit of hybrid KAFO with conventional distal section

double

kind of upright that is recommended for locking knee joints

excessive genu valgum

knee deformity that may benefit from single uprights (especially if bilateral)

single

kind of upright indicated for smaller, lightweight patients, or patients with genu valgum

lamination, thermoforming

how to make uprights “internal”

must include joint head

condition for trimlines if uprights are internal

creates weak point

drawback of not including the joint head in internal uprights trimlines

frontal, transverse

which planes are free knee joints the most stable in?

hyperextension, frontal plane motion

what motions do free knee joints prevent?

medial tibial flare

what does a contoured joint head actually contour to?

polycentric

which knee joint best mimics anatomic knee motion?

polycentric

which knee joint is used to treat fractures or accommodate a large ROM (like in sports)

polycentric

which knee joint protrudes less during flexion?

no

are the 2 articulation points in a polycentric knee joint independent of each other?

polio, paraplegia

what disorders is the Scott-Craig designed for?

3-5d

what amount of DF does the Scott-Craig lock the foot into?

anterior to ankle, posterior to hip and knee

where does the patient’s WB line fall in relation to their joints when wearing a Scott-Craig?

locked knee, anterior calf band, reinforced stirrup

what elements of a Scott-Craig prevent knee buckling?

standing in locked position

what function does a Scott-Craig provide?

custom-fitted thermoplastic, polycentric knee joint, clamshell, free ankle

most common design for fracture bracing

suspension

function of ankle stirrup in fracture bracing

splintered bone

contraindication for fracture bracing

fracture is in the 1/3 of the bone closer to an articulation

when do adjacent segments need to be locked up for fracture bracing?

IT or soft proximal tissue

what does a WB KAFO bear weight on?

solid ankle, double upright locking knee

ankle and knee joint requirements for WB KAFO

quad brim, ischial containment

ways to WB on IT for a KAFO

padded proximal ring that replaces the thermoplastic cuff in WB KAFOs

what is a ischial ring?

free

most common ankle and knee joint configurations for coronal plane deformities

ligamentous laxity, OA, Rickets, Paget’s, Bount’s

examples of disorders that present with coronal plane deformities

Rickets, Paget’s, Bount’s

deformities in coronal plane that should be checked for flexibility before treatment with an orthosis

when patient has a lot of soft tissue

when may it be helpful to overcorrect a patient’s deformity in the coronal plane?

5-buckle knee pad and lateral knee pad

how to treat genu varum with a conventional KAFO

wraps around medial upright and pulls medially

position of 5-buckle knee pad to correct genu varum

mounted on lateral upright and pushes medially

position of knee pad to correct genu varum

t-strap

what AFO component is a 5-buckle knee pad most similar to?

thigh: high medial, low lateral
calf: high lateral

trimlines for thermoplastic KAFO that is treating genu varum

wraps around lateral upright and pulls laterally

position of 5-buckle knee pad to correct genu valgum

mounts on medial upright, pushes laterally

position of medial knee pad to correct genu valgum

thigh: high lateral, low medial
calf: high medial

trimlines for thermoplastic KAFO that is treating genu valgum

polio, CVA, paralysis, spina bifida, PVD, neuropathy

name 3 causes of sagittal plane weakness

CVA, MS, ALS, MD

name 2 neuromuscular causes of sagittal plane weakness

30d

what is the minimum amount of flexion required for safe ambulation?

pre-flex uprights, elongate footplate

ways to modify KAFO to accommodate for knee contractures

15d

what angle increments can a step-lock lock in?

6d

what angle increments does an adjustable flexion/extension knee joint lock in?

single-axis

are adjustable flexion/extension knee joints single-axis or polycentric?

true

true or false: ultraflex joints use powered concentric torsion to accommodate knee flexion contractures

false

true or false: monodos joints provide bidirectional joint motion

pneumatics, elastomer, powered

ways for joints to assist with knee extension

load response joint

what kind of joint is recommended for stance flexion?

stance flexion/load response

knee joint that locks in full extension and allows up to 15d of motion when unlocked

manually lock knee joint, posterior offset joint, stance control knee joint

3 ways to manage knee buckling at the level of the knee joint

4-buckle knee pad

how to manage knee buckling in a conventional AFO

thigh: high posterior, low anterior

calf: high anterior

how to manage knee buckling by modifying trimlines of the KAFO

gravity

how do drop locks lock?

ball retainers

how to ensure KAFO will not lock without patient physically moving the lock into place

manual

how to unlock drop lock joint

spasticity (hard to unlock when loaded)

contraindication for drop lock joint

automatic

how does trigger lock lock?

proximal release lever

how does trigger lock unlock?

spasticity, knee flexion contracture (difficult to unlock under load)

contraindications for trigger lock

hands-free operation

when may a bail lock be indicated?

may inadvertently unlock

potential downside of using a bail lock

remote control

how does an electronic lock unlock

UE limitations

indication for electronic lock knee joint

torsion-based or powered knee joint

knee joint to use to help patient extend their knee in a KAFO when they have a flexion contracture