In-Toeing summary

In-Toeing summary

Ben McMurtrie

11/21/2019

Thankyou for all the replies, overwhelming - 41 in Total. So many responses
and an amazing collective wisdom and experience, much appreciated.

What a great resource.



The majority of replies recommended the Becker twister cables:

Becker suggested is the H-400X


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Other suggestions were:

* Fillauer Twister cables (couldn't find)

* alimed straps
* Rotator de-rotation straps -
<URL Redacted>
* Toe Plates - pad under the lesser toes - 2-5 or cutting the toeplate
of the AFO so that it has a rigid lateral area and under the big toe it is
cut to behind the metheads
* Cascade DAFO and SureStep fabricate de-rotation straps, aka. twister
cables. They can custom fabricate so you should be able to have them made
for an adult https://urldefense.proofpoint.com/v2/url?u=https-3A__cascadedafo.com_products_twister-2Dstraps&d=DwICAg&c=sJ6xIWYx-zLMB3EPkvcnVg&r=KmuawjwNpT9A2bnhzaNVjw8wO7L_TDosEXIk33h_tlw&m=_9_8rTP3cF6JwjaZSDnuaR4yttlnJvBsupEKau7JjPY&s=eWBIs4P8M1RGzJai3g3smtACkcBPhlNgcaEGM3DBnrQ&e=
* elastic straps with a waist belt - several designs suggested - most
with a 2 waist belt and 1.5 elastic torsion leg traps
* a 2 pelvic belt of cotton webbing (see waist belt in prosthetics)
attached laterally to 1 1/2 elastic that spirals lateral to medial around
leg. Attachment is to distal shoe laces or clips to medial side of AFO.
Length of elastic is adjustable proximally, as it stretches.
* KAFO - with lateral upright only
* HKAFO - Lateral upright
* DJO surf strap https://urldefense.proofpoint.com/v2/url?u=https-3A__www.betterbraces.com.au_donjoy-2Dserf-2Dstrap&d=DwICAg&c=sJ6xIWYx-zLMB3EPkvcnVg&r=KmuawjwNpT9A2bnhzaNVjw8wO7L_TDosEXIk33h_tlw&m=_9_8rTP3cF6JwjaZSDnuaR4yttlnJvBsupEKau7JjPY&s=CheJtgT0TFNAhAEREAnQ1_1ldAr-R-8FmS0FXXXgX-w&e=





I am probably going to try my own home made strap system - waist and elastic
leg straps first. Failing that will consider the Becker twister cable.



Thanks again for all the replies.



Regards Ben



ORIGINAL POST:



Hi List



I'm helping to manage a 67y old male with cerebellar ataxia. I have
provided AFO's in the past to help control the varus ankles (custom tamarack
and Valga-noodle). He now has developed an in-toeing Right lower leg/foot.
The rotation is around 45-50deg and is causing him to trip when the rotated
leg advances in swing - clips the left medial shoe.

The rotation is coming from laxity at the knee joint not the hip as you
would normally expect. We have ruled out tight or overactive hip adductors.


His neuro physio and I are trying to come up with a solution. His PT wants
me to try elasticated straps that wrap around and attach to the thigh
somehow Im not sure this will be effective, will probably rotate on thigh
and loose the ext rotation force. My other thought was a type of twister
cable attached to a hip band, that we used a long time ago for kids, but
don't now.

I can't find anything of this design from the suppliers.

I'm hoping I can find something that can anchor onto the top of his AFO



Any suggestions will be appreciated, thanks



Regards Ben







Ben McMurtrie
Geelong Orthotics P/L
70 Bellerine St
Geelong 3220
Vic Australia



Ph 613 5224 2200
Fax 613 5223 3229
Mob 0412 822 427



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