Össur AFO DYNAMIC Instrucciones De Uso página 6

CUSTOMIZING THE AFO
The following procedures are not part of the standard fitting of the
orthosis and will only be carried out according to specific needs of the
patient.
1. Standardized padding material is available. This can be applied
according to the patient's wishes. It is advised to provide padding on
the anterior shell alongside the tibia and on the medial strut covering
the malleoli.
2. The use of the lower lateral support member strongly depends on the
degree of voluntary control and the selection of the shoe. In case of
sufficient control it is advised to remove the lateral support member
according to the line shown in picture 7.
3. If the distal section of the anterior shell causes excessive pressure on
the leg, the footplate should be trimmed at the toe. The lack of length
at the heel is compensated by correct placement of the insert.
4. The Carbon fiber orthosis is fabricated to accommodate
approximately 1,7 cm (6/9 inch) heel-height. If the shoe has
a significantly higher or lower heel, add or reduce the heel height by
adding on material under the footplate.
5. It is recommended to use a well-fitting off-theshelf or a custom-made
insole in combination with the Dynamic AFO. This is especially the
case with excessive pronators where the insole can prevent the medial
malleolus and the navicular bone from getting in contact with the
medial strut of the AFO.
6. To relieve contact between the medial strut and the apex of the medial
malleolus, grind the edge of the strut according to the shape shown
(Figure 8).
– you may grind up to 1 cm into the strut
– stay at least 7 cm from the footplate
GENERAL REMARKS AND ADDITIONAL ADVICE:
1. To shorten the footplate, cut or grind off the appropriate length. Be
certain to buff the edges to eliminate sharp edges. To lengthen the
footplate, use foot insert of choice, and fixate it to the foot plate.
2. To adjust the biomechanics of the foot, the use of the correct insert is
advised.
3. Contraindications: Do not use the AFO in case of excessive ankle
instability or in case excessive deformities to the foot where pressure
relief cannot be solved by additional padding. It is contraindicated to
use the AFO in case of fluctuation oedema and in case of severe
spasticity.
4. The AFO cannot be reshaped by heating. Heating will cause
delaminating and negatively alter the dynamics of the orthosis.
5. The right footwear is critically important for proper function of the
AFO. The following criteria should be met when selecting the righ
footwear to use with this AFO:
– Firm heel counter - for proper control of the rear foot
– Firm shank - to take stress off the AFO
– Laced or hook and loop fastening - for easier donning and doffing,
and to allow adjustable compressive support over the mid-foot
– The shoes have to be wide enough to allow proper fitting of the
AFO inside the shoe
– Removable insole - to allow space for the AFO footplate with
modifications
– Approximately 6/9" (1,7 cm) heel height - as a starting point to
control the knee extension
D r a f t
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