Module 5: Conventional KAFO design

In what positions must a KAFO be checked?

Sitting and standing

What should be checked prior to fitting?

Do knee joints move freely, do locks lock/unlock simultaneously, are M/L joints congruent

What should be checked while sitting?

Can it be donned without assistance, does it fit in their shoe, is the ankle joint properly aligned, does the knee bend to 105d, is there enough popliteal clearance, is it a snug fit but not excessive pressure

Where is pressure felt when sitting if the knee joint is placed too proximal?

Thigh: Postero-distal and antero-proximal
Calf: anterior aspect

Where is pressure felt when sitting if the knee joint is placed too distal?

Thigh: postero-proxmimal and antero-distal
Calf: posterior aspect

Where is pressure felt when sitting if the knee joint is placed too anterior?

Thigh: postero-proxmimal and antero-distal

Calf: anterior aspect

Where is pressure felt when sitting if the knee joint is placed too posterior?

Thigh: Postero-distal and antero-proximal

Calf: Posterior aspect

How should sitting flexion be checked?

Passively flex with hand protecting popliteal, actively flex with protection, then actively without protection

Where should be checked for redness/irritation?

Bony prominences, areas where corrective forces are applied (Locked knee (Posterior proximal thigh), hyperextension control, varus control, valgus control)

How should the ankle joint be aligned in the frontal plane?

Perpendicular to mid-sagittal line

How should the ankle joint be aligned in the sagittal plane?

Midpoint of distal tip of medial malleolus

How should the ankle joint be aligned in the transverse plane?

In line with the midpoints of the malleoli

How should the knee joint be aligned in the frontal plane?

Perpendicular to mid-sagittal line

How should the knee joint be aligned in the sagittal plane?

Between adductor tubercle and medial tibial plateau

How should the knee joint be aligned in the transverse plane?

Perpendicular to plane of motion of shank

How should the hip joint be aligned in the frontal plane?

Perpendicular to mid-sagittal line

How should the hip joint be aligned in the sagittal plane?

1” superior and 1/2” anterior to apex of GT

How should the hip joint be aligned in the transverse plane?

Parallel to knee joint