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Frequently
Asked Questions
If
you have a question that is not answered here, please contact
us and we will be glad to assist you.
Can
a broken AFO be repaired?
Did
you know we can repair most parts of a broken AFO? While our
breakage rate is less than 5%, the following problems are the
most common ones practitioners face.
> Can
calf bands be fixed?
Yes.
We can repair or replace it by laminating over it or gluing on
a replacement one.
> Can
footplate be fixed?
Yes,
if the fracture is a horizontal crack (perpendicular to the
strut). The strut must be in good shape. We grind off the existing
footplate and laminate a new one in it’s place.
> Can
struts be fixed?
Not
usually. We cannot fix broken or de-laminated strut portions
of a brace. In this case the brace will have to be remade.
If the patient’s weight or activity level has changed,
this is critical information in making a good decision with
regard to design and lay-up when the brace is remade. Giving
us accurate information is the key to a lightweight, functional
and durable brace for your patient.
How
do I deal with fitting
issues?
While our custom made AFOs are fabricated to fit with little or
no modifications, you may occasionally encounter some fitting issues.
This list, while not exhaustive, provides suggested resolutions
to some of the more common issues practitioners face.
> What can I do to relieve pressure on the tibial crest (for
Energy Return AFO)?
Try
padding either side of the tibial crest, if that does not relieve
the problem, you can: 1) Trim the anterior
portion of the calf
band away from the crest so that it does not irritate
the area; 2) Trim it all the way back to the strut with out
affecting the
ability of the brace to pick up the foot. The draw back
is the strut may have more motion in it as the patient
moves
through the
gait cycle because you are relying on the strap to keep
the strut centrally located on the leg.
> Can
I modify the foam footbed?
The
foam foot bed can be modified to suit the patient’s needs.
If you know ahead of time the modifications that
you desire we will try accommodate your patient’s needs.
Sometimes it may be necessary to wedge the heel section or
the entire foot
bed.
Simply unglue the footbed add/remove the necessary
foam and re-glue
to the carbon foot bed. For patients with severe
varus (for example), we can run the foam footbed above the
the lateral
malleolus and
add a supra mallelor strap which pulls the ankle
to the medial strut to actively control the varus tendency.
This
gives good
mechanical control in a low profile design.
> How
can I reduce the affect of a Solid Ankle AFO?
One
of the complaints we have had is that our solid ankle designs
are too solid. Carbon
fiber is not
like poly
pro and there is
no give or flexibility in this material. Things
you can do to reduce
the affect of a solid ankle brace: 1) Add a rocker
bottom to the bottom of the shoe. This helps
the patient roll
through the
gait
cycle with greater ease; 2) Trim the foot plate
back to reduce the anterior lever arm. This can be done
in increments
to
gauge the affect this may have on the patient’s
walking. The footplate can generally be trimmed
back to the base of the 1st
metatarsal
head without affecting the structural integrity
of the brace. All of our solid ankle braces have
core material in them and
caution
should be used not to trim the brace into the
core material (this would affect the warranty
of the
brace). When in doubt, give
us a call and we can walk you through the process.
> The
foam liner is compressing–what can I do?
In
general, the stiffer the material a brace is constructed with
the more stress there will
be
on the interface
material. Therefore,
it is important to inspect the foam linings
in our braces, especially for patients that
are
heavy users.
You can
purchase additional
liners from us or larger sheets of foam if
you prefer to keep some on hand. An additional
layer
of foam
in high
stress areas is a
good idea.
How
do I deal with ankle contractures? Ankle
contractures present a challenge in obtaining good fit and function
of the orthosis. There are two ways of treating the
problem:
1.
Fabricate the brace to match the contracted ankle position.
If this solution is chosen, then it is incumbent that
the orthotist
adjust the heel height of the shoe to get the leg perpendicular
to the floor. The benefit of this approach is the foot and
ankle will fit normally into the shoe. The drawback is external
buildup
on the shoe may not satisfy the patient.
2.
Fabricate the brace to be perpendicular with the floor once
it is in the shoe (accommodating
for the heel height of the
shoe to be used), then build up the foam footbed to accommodate
the
ankle contracture. The benefit of this approach is the
lift is hidden and the shoe does not need to be modified. Another
benefit
is the footbed will allow for increased ankle range of
motion.
The drawback is only a small contracture can be accommodated
this way–usually no more than 3/8” to 1/2” of
buildup can be used before the heel rises out of the shoe.
We
need to know how you are planning to treat a contracture
before we make your composite AFO. It will save you, your
patient and
us a lot of time. Do
you have a prefered casting
procedure?
Yes.
The importance of taking a good cast cannot be overemphasized.
It is the key to proper fit and function of a composite brace.
From our standpoint, a good cast captures the patient’s
foot and ankle position in a semi-weight bearing position or
a full weight bearing position if there is excessive ankle or
foot deviation. We also encourage the use of a casting board
to simulate heel height if at all possible. Please
use these Casting Instructions as
a guide when taking a casting.
What
is your turnaround time? In-house
turnaround time is typically 2-3 days.
I
am a new customer. What do I need to do?
> How
do set up an account?
Currently,
we do not use account numbers. We reference your
account by company/facility name and location (if your
company has more
than one office). If this is the first time your company
has ordered from us, payment for your first order, or until
you
are approved for credit, is by C.O.D. or Credit Card.
Once you complete
a Credit Application and we approve you for credit, future
orders will be billed by invoice.
> Do
you have an order form I need to use?
Yes.
Please complete an AFO
Order Form (pdf download) for each order.
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