Responses: AFO for Tendo Achilles Injury
Troy Fink, CO
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Title:
Responses: AFO for Tendo Achilles Injury
Creator:
Troy Fink, CO
Text:
Yesterday I posted a question and have received numerous replies. thanks to
all who responded. There are some very insightful thoughts.
My plan is to use Double Adjustable Ankle Joints. This will allow me to
utilize all the possible configurations.
Thanks again,
Troy Fink, CO
ORIGINAL POST:
An orthopedic surgeon has written Rx for articulating AFO with plantarflexion
assist. Pt is otherwise active male, 3mos s/p injury with some heeling
evident. Doctor says it is okay for pt. to dorsiflex to neutral but not beyond.
I suggested dorsiflexion stop at about neutral and unrestricted
plantarflexion range of motion. I explained that a plantar assist would not be strong
enough to provide heel-off during stance phase. I also stated that I feared a
plantar assist would only complicate swing phase clearance.
The Doctor insists a plantarflexion assist is appropriate. I don't feel good
about providing an orthosis in this configuration. I don't think this is
appropriate as the patient will likely trip and fall.
Any thoughts? How would you treat a pt. with this diagnosis?
REPLIES:
I have done many of these for a foot and ankle orthopedist we work closely
with.
We make an articulated AFO with very heavy rubber bands (Otto Bock) spanning
the posterior opening to minimize dorsiflexion. It does not eliminate it but
does minimize the initial stretch and shock to TA during toe off. They have
worked extremely well for us.
all who responded. There are some very insightful thoughts.
My plan is to use Double Adjustable Ankle Joints. This will allow me to
utilize all the possible configurations.
Thanks again,
Troy Fink, CO
ORIGINAL POST:
An orthopedic surgeon has written Rx for articulating AFO with plantarflexion
assist. Pt is otherwise active male, 3mos s/p injury with some heeling
evident. Doctor says it is okay for pt. to dorsiflex to neutral but not beyond.
I suggested dorsiflexion stop at about neutral and unrestricted
plantarflexion range of motion. I explained that a plantar assist would not be strong
enough to provide heel-off during stance phase. I also stated that I feared a
plantar assist would only complicate swing phase clearance.
The Doctor insists a plantarflexion assist is appropriate. I don't feel good
about providing an orthosis in this configuration. I don't think this is
appropriate as the patient will likely trip and fall.
Any thoughts? How would you treat a pt. with this diagnosis?
REPLIES:
I have done many of these for a foot and ankle orthopedist we work closely
with.
We make an articulated AFO with very heavy rubber bands (Otto Bock) spanning
the posterior opening to minimize dorsiflexion. It does not eliminate it but
does minimize the initial stretch and shock to TA during toe off. They have
worked extremely well for us.
Citation
Troy Fink, CO, “Responses: AFO for Tendo Achilles Injury,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/225180.