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.