KAFO question
James Falcone
Description
Collection
Title:
KAFO question
Creator:
James Falcone
Date:
3/10/2014
Text:
Hi Group. I just wanted some feedback about a case I picked up. Pt is an elderly female, right hemi who presently uses a solid AFO and now has a custom KAFO. She has well over 30 degrees of recurvatum and has -5 degrees plantar flexion contracture. She presently goes to PT (just restarted) but her issues are this:
She can walk with the KAFO better than the AFO but there is so much gapping in the posterior thigh shell in stance I can fit my fist in there. There is heavy pressure on the anterior thigh straps. She had posterior offset drop lock knee joints and I wound up removing them because I don't feel the locks drop appropriately on them and it wasn't doing her much good on eval. I added a posterior check strap to send her to PT in order to have better knee control and some adjustability. That has proved beneficial to a point but, she cannot tolerate much correction of her recurvatum. In talking to PT and doing some adjustments myself, she is unbalanced and feels unstable at the knee with more neutral correction.
I would like to try a different style of KAFO, as she keeps popping screws on the thigh shell and posterior check strap, even after adjusting the shell position to reduce the gapping. We have even tried a heel lift which did help slightly but, still present. I know we cant take away all of her recurvatum, as she relies on this for balance. I was debating trying a Townsend style KAFO. Even though she is a right hemi, she actually is able to don the device independently, as I usually don't consider a KAFO for hemi patients due to the lack of ability and home help to don. Anyone else have a case like this? Some advice if I wind up recasting her? I know she was casted in knee extension, not allowing any recurvatum which is probably some of the issue there, as well as the foot angle. Thank you all in advance for your feedback.
James Falcone, Co/Lo
Orthotist
Armac,Inc.
973-998-8950 ext.207
The Advance Medical Center of Cedar Knolls Building, South Entrance
197 Ridgedale Ave., Suite 130
Cedar Knolls, NJ 07927
Armac Confidentiality Notice
This message is intended exclusively for the individual or entity to which it is addressed. This communication may contain information that is proprietary, privileged, confidential, or otherwise legally exempt from disclosure. If you are not the named addressee, you are not authorized to read, print, retain, copy, or disseminate this message or any part of it. If you have received this message in error, please notify the sender immediately either by phone (888-422-3044 or fax (973-328-3753) or reply to this e-mail and delete all copies of this message.
She can walk with the KAFO better than the AFO but there is so much gapping in the posterior thigh shell in stance I can fit my fist in there. There is heavy pressure on the anterior thigh straps. She had posterior offset drop lock knee joints and I wound up removing them because I don't feel the locks drop appropriately on them and it wasn't doing her much good on eval. I added a posterior check strap to send her to PT in order to have better knee control and some adjustability. That has proved beneficial to a point but, she cannot tolerate much correction of her recurvatum. In talking to PT and doing some adjustments myself, she is unbalanced and feels unstable at the knee with more neutral correction.
I would like to try a different style of KAFO, as she keeps popping screws on the thigh shell and posterior check strap, even after adjusting the shell position to reduce the gapping. We have even tried a heel lift which did help slightly but, still present. I know we cant take away all of her recurvatum, as she relies on this for balance. I was debating trying a Townsend style KAFO. Even though she is a right hemi, she actually is able to don the device independently, as I usually don't consider a KAFO for hemi patients due to the lack of ability and home help to don. Anyone else have a case like this? Some advice if I wind up recasting her? I know she was casted in knee extension, not allowing any recurvatum which is probably some of the issue there, as well as the foot angle. Thank you all in advance for your feedback.
James Falcone, Co/Lo
Orthotist
Armac,Inc.
973-998-8950 ext.207
The Advance Medical Center of Cedar Knolls Building, South Entrance
197 Ridgedale Ave., Suite 130
Cedar Knolls, NJ 07927
Armac Confidentiality Notice
This message is intended exclusively for the individual or entity to which it is addressed. This communication may contain information that is proprietary, privileged, confidential, or otherwise legally exempt from disclosure. If you are not the named addressee, you are not authorized to read, print, retain, copy, or disseminate this message or any part of it. If you have received this message in error, please notify the sender immediately either by phone (888-422-3044 or fax (973-328-3753) or reply to this e-mail and delete all copies of this message.
Citation
James Falcone, “KAFO question,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/236152.
