Colleagues,
Keith Smith CO LO FAAOP here. I am submitting this case for a colleague. Please feel to respond directly here to me or to [email protected]. Thanks in advance for all replies and assistance.
I have a ptnt diagnosed with post polio syndrome. She has limited motion at ankle with R2 of gastrocs of left -10 in sagittal plane with severe hindfoot valgus. Right ankle is fixed at -15 and fused in mild varus with rigid plantarflexed first ray. She also has no motion at MTPs bilaterally so wedging shank to vertical angle to neutral requires a large lift. She is currently wearing bilateral solid ankle AFOs with shoe lifts and she is looking for more low profile options. Her existing AFOs have a large medial buttress on left to bring the ground under her medial ankle to accommodate the extreme hindfoot valgus. The trimlines on the AFO are long on the medial footplate on left and lateral footplate on right to control the forefoot. Some of the lift is on the AFOs and the majority of the lift is on the shoes. The shoes are very large to accommodate the necessary buttress and long trimlines of the AFOs. She ambulates with knee hyperextension bilaterally and hip hikes and circumducts legs to clear. Previously, I have made her closed toe Arizona walkers and she seemed to like them at first but now states they are too hot and she feels unstable in them. I am looking for any suggestions for the most low profile AFO that will still control motion and not break down the skin.Â
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Laura Hartung CO
St. Louis, MO
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