TA Rupture responses Part 1B

TA Rupture responses Part 1B

Shane Jansen

1/6/2010

Dear Mr. Jansen,

You may consider using one of our products called the Dynamic Walk. It

has a posterior mounted cuff so it allows easy knee flexion and does not

impede forward progress. Also the flexing members have been design for

active use with high strength PEEK rods. Other devices tend to breakdown

in more active use because of the shear in the lower flexing member. The

Dynamic Walk allows for more a more aggressive step length, squatting,

descending stairs, and using a gas pedal. The bilateral uprights also

help with triaxial inversion/eversion.

Let me know if you need more information.

Best regards,

Gerald Stark, CPO/L, FAAOP

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Allard offers a toe off or for heavy use the blue rocker. These are thin

light weight floor reaction AFOs, but might offer the push off needed.

You should call them and ask for a sample of each to try. If it works

great, if not send them back.

Good Luck,

Pat

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Hi Shane,

As an Orthotist I never really worried about missing plantar flexion as

much as dorsi flexion because it really doesn't present safety issues.

But it

does affect stride length and speed of gait. I recently began using the

Toe Off Orthosis from Allard and have been getting remarkable results,

especially for missing plantar flexion. The Blue Rocker is even better

for active patients. The only issue will be climbing ladders and stairs;

they advise that he should do it without the ball of the foot on the

ladder.

The amazing properties of Carbon allow this to be done better than

comparable materials. They have a thirty day return policy if you decide

to try it.

Good Luck,

Rob Biaggi C.P.O.

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Hi Shane

You have a very difficult problem there; I would usually use a Toe Off

or similar product (Otto Bock etc.) for a builder. The only problem is

that

if he is heavy he may destroy the brace. If that was the case I would

have

a custom Toe Off made to accommodate the extra stress, especially on the

ladder. Hope this helps.

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Shane, sounds to me like an excellent candidate for a Carbon Graphite

AFO with full foot plate

Joe Perry CPO

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Shane,

Ah, tendo-achilles, the other TA. :-) (In the states we think first

of tibialis anterior or at least I do!) For lost PF I am currently

treating a man whose therapist asked for plantarflexion assistance for

the same problem, only his weak PF and poor propulsion at terminal

stance is due to lumbar stenosis. PF assistance in this case is really

DF resistance, this energy stored and released back into gait. I brought

an off-the-shelf toe off brace to have something to show and try, but

I am making him plastic ground reaction AFO's because of proximal

weakness and tight hamstrings placing his knees in flexion. Neither of

these are for you: GRF is probably overkill for your otherwise strong

patient, and a toe off carbon fiber type brace may be inappropriate

for someone who will be squatting a lot or going on ladders for the

stress on the strut, which will surely delaminate, but perhaps a PLS or

some such is all he needs, assuming the rest is strong and

medial-lateral stability of the ankle good. If his ankle is not stable,

perhaps a semi-solid trimline. Full toe plate for sure. Good luck!

Kelly Benard, CPO

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I have successfully used a Blue Walker AFO with a custom insert in a

similar case. Worked very well for this 30 year old male construction

worker.