Responses: Prefab AFO for child

Responses: Prefab AFO for child

Randall McFarland, CPO

Below is the original question followed by the responses, which are separated
by a blank line. THANK YOU to all who took the time to answer!
Have a good long weekend, everyone!!

Original post:
I have a Medicaid 4 year old with bilateral tight heel cords. The doc wants a
night splint for a gentle stretch. Where can I procure a prefab. AFO? (The
Wheaton modules have built in correction for metatarsus adductus, which isn't
needed in this case)

Randy McFarland, CPO


Responses:
PLEASE don't use a prefab on a 4 year old child with tight heel cords. I do a
great deal of pediatric work. Make a custom brace. I don't care if you use
polypro or laminate, but do it custom. The child will be more comfortable,
and
the doc will be happy when the Mom doesn't come back complaining when the
prefab
causes problems. I'm sure if the heel cords are significantly tight, there
has to
be some degree of pronation/valgus, unless the child is a hemi and the foot
is in
equinovarus.
Consider if this night time stretch will be static or gradually adjustable.
You
may want to consider an adjustable posterior stop so you can gradually
increase
the stretch. Sometimes I use an outside strap rigged up from the under side
of
the metheads, diagonally up to the mid tibia. Then I'll tighten that strap or
instruct the mom to do so when the child goes to sleep depending o the
tolerance
and just how tight those heel cords are. Is the kid C.P., or is he/she an
habitual toe walker? Boney little kid or chunky? This all makes a
difference.

RJ Orthopedics manufactures a pediatric pre-fab AFO line called SOCKS.
Not sure of the phone #; however, I can get it tomorrow if needed.

Dear Randy, You can try SOCS they have 44 sizes for children that you can
adapt to make night splints. Their number is 1-800-560-3255. I have used
them recently and had good results. Joann Marx, CPO

Try Dobi-Symplex in Orlando/Winter Park, FL

SOCS ( Sized orthotics for children) from RJ Industries @ 800 560 3255. Many
sizes for kids but too pricey if you have to use prefab L code.

Sounds like the UFO by Orthoamerica is what you are looking for.

Wheaton brace has line called SOCS that should work for your pt. They
have no angular corrections and I have used them successfully several
times. Esp. with the wiggly little ones that are difficult to cast.

I only have to ask the question why the heels cord tightness? Of course the
Doc wants a night splint so he can do surgery in a years time. We keep from
doing new stuff because it is not proven, but why do things that do not
work. Am I wrong in saying that I have never heard of a study that states
that night splints work or don't work?

Randy, you may find something through Empi, they are located in MPLS MN. I do
not have their toll free number but you can call directory assistance.

I have used the RJ Industries SOCs (sized Orthoses for Children) with good
success. I stock them. I am in the
process of writing an article on our experiences. $89.00 each

Orthomerica makes a product called a UFO that they will make custom to
measurement including ones for kids. Some orthotists have used it as a
night splint because it has a coolfoam liner, a 45 degree ankle strap, and a
strap on each side that is adjustable for increasing the amount of
dorsiflexion. It is set at 90--it may even be in some dorsiflexion but you
should be able to accommodate some plantarflexion by wedging it on the
inside.

It was originally designed to stretch out tight plantar fascia. I think it
will serve your purposes. The number there is 800-446-6770. If you have
any questions talk to Dale who is the lead person in custom to measure.

Have you considered the UFO from Orthamerica?

Anatomical Concepts, Inc. has both pediatric and infant AFO's that might fit
your need for this patient.

RANDALL, PEL SUPPLY HAS THE 550PRAFO WHICH IS THE CHILDS VERSION
OF THE 650PRAFO.


We have an extensive line of prefabricated orthoses including several models
of the pediatric AFO.

If you'd like to view our products, please visit <URL Redacted>

The pediatric AFOs are under Ankle Foot Orthoses/Drop Foot Splints

Why prefab? Most prefabs for pediatrics are poorly sized and require more
time to fit than if you made it custom. If molding the patient who has
already undergone the serial casting procedure is the problem, coordinate
molding with a cast change. A poyethelene AFO would suffice as a comfortable
nightsplint. If you really have to use a prefab try SOCS.

Have you tried SOCS ( Sized Orthotics for Children).I don't have an
address for them here but they fit quite well. Also Orthomerica carries
Prefab pediatric AFO's.