Our orthotic service is in process of detailing many of our Paediatric Lower Extremity prescription rationales so I’ll thank everyone in advance for entertaining please note this and other queries to come.
Regarding Paediatric Night AFO design rationale:
Barring significant coronal/transverse plane deformation, regardless of the primary diagnosis, we typically utilise standard pre-fabricated Night Splint AFO designs such as Orthomerica’s “Pediatric UFOs” Rationales include lower cost/improved provision efficiency of pre-fab, easily adjustable range, minimum amount of surface area contact (to improve comfort/tolerance by permitting limited medio-lateral movement and minimise heat retention), soft interface for protection when asleep or for sensory neuropathy.
While we occasionally fab Custom Molded night splints these are typically reserved for significant coronal or transverse plane deformation, or range deficits well outside those accommodated by pre-fab splints. We frequently receive referrals specifying “Custom Molded” in particular for the Duchenne patient population and want to ensure we are not missing any major component of common practice as regards this application. We’d welcome review of your Paediatric Nocturnal AFO design rationales, in particular when/why Pre-Fab VS Custom, diagnosis specifics, rationales for including soft padding or not, and rationales for placing “air holes” in AFOs to “reduce heat retention.” Welcome the study reference that measured trans-dermal temperature in lined VS unlined TLSO, 10-15 years ago, seem to recall effects of fenestrations were negligible.
Will submit responses.
Many thanks again!
Frank Frankovitch, CPO
Member AAOP & BAOP
Portsmouth NHS Trust