AFO question: Replies

RICHARD MILLER

Description

Title:

AFO question: Replies

Creator:

RICHARD MILLER

Date:

8/14/2001

Text:

Here is my question from yesterday with a full spectrum of responses. Thanks to all who entered the discussion. The request refers to the composition of spring wire that had been used to make lightweight dorsi-assist AFOs many moons ago. B. H. you win the prize.
Original post:
1. Patient is in a plastic solid-ankle AFO. Specific Dx is not important.
2. Young therapist notices volume changes of leg causing fit-related
problems.
Seeks recommendations for alternative treatment from C.O. and M.D.
3. C.O. recommends metal and leather dorsi-assist, plantar-stop AFO.
4. M.D. suggests using copper-berylium in orthosis construction.

Question: Copper-berylium? How, why, where, what? (Our secretary said it
can be used in bracelets as a treatment for arthritis)
…………….

The MD is probably referring to a spring-wire type of AFO. When I was
practicing in MN the physiatrists in the University Hospital would refer to
a spring-wire AFO as a CuBe brace (Cu - copper; Be - berylium). Evidently,
this was the composition of the alloy used in the wire. Go figure!
……………..

Check out the Custom Leather / Plastic Arizona AFO at www.ArizonaAFO.com
This might be just what your looking for.
……………..
I am an orthopedic surgeon from Israel, doing a fellowship in rehab.
In Israel these bracelets are very common. people wear them non stop.
I don't know that it ever helped anyone that really had a problem. But I don't know of any studies that were done on the subject.
Before doning it I believe it would be smart to give the person a Copper-berylium ankle bracelet to see if it does anything to this specific patient. If it does leave the bracelet and just do the AFO with any material.
………………
Ever have one of those lightbulb moments? Why hasn't anyone ever mentioned
such a simple concept! Last week I had one and this would be a similar case
to share it. Pt. Has fluctuating edema. Wears an AFO into the office, every
edge is about to break the skin, and she has a referral for a new AFO. I
take the impression with the leg swollen. Days later the patient is
hospitalized and medicated to reduce the swelling. The hospital PT advises
me she needs a new AFO as the swelling is gone, we are placing a washcloth
in the footplate to take up space and make the AFO control her heel.
THAT'S WHEN IT HIT ME!!!! Use sock management like a prosthetist. If in the
morning she needs three socks to have the AFO control her, fine. As the day
progresses and the AFO become tight, remove a sock. You utilize your total
contact principles in an ever changing environment.
I plan to use this method, and wonder if others have tried it. What success'
or failures lie ahead?
…………….

thats what my pitching wedge is made of.... I think the Dr is spending too
much time on the links...
…………….

This is your opportunity to be creative. Sounds like your MD took the
opportunity to use a new word he learned. Beryllium is used in light metal
alloys to resist corrosion. It may be that he is unaware of modern procedures
in orthosis construction that produce non-corrosive finishes. If he is
prescribing the copper construction in a therapeutic context, go to the golf
section in any sporting goods department (Wal Mart) and pick up a couple of
the copper bracelets that they sell for golfers. You can incorporate them
into the construction of the AFO. Of course, they might not do a bit of
good, but your doc should be impressed.
……………….

The issue in my opinion is the volume changes themselves. If volume
fluctuation is the issue, then try shrinkers 24 hours a day until a stable
volume is maintained. If atrophy is the cause of shrinkage, so be it. In
either case, after a stable volume has been achieved, fit with the
appropriate plastic AFO.
…………………

Sir: I have some wonderful lake front property in Fla. at a bargin price. Please call me.
…………………

What? copper berylium is a rare alloy used primarily in the manufacture of
non sparking tools for fire fighters and areas where there may be highly
volatile substances. I don't know of any one making orthoses out of the
stuff, it is pretty tough but it usually has to be cast. What possible service
it could afford your patient I could not guess, unless maybe he works in an
oil refinery or a chemical plant.

                          

Citation

RICHARD MILLER, “AFO question: Replies,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 28, 2024, https://library.drfop.org/items/show/217049.