Thursday, October 10, 2024

FW: More Replies: Silicone AFO

Jacob Townsend

One more helpful clinical response.
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Thank you for publishing these responses. I have done about 10 SAFOs and they are excellent for the right patient. The only diagnosis it is treating is dropfoot with no other comorbid conditions. Since you cannot do any correction on the plantar surface, the foot will continue to collapse, if it were going to collapse prior to this intervention. If the individual needs correction for their mid foot collapse, then they will need the same thing with or without the SAFO.
I am one who is very pessimistic about the Arizona AFO for PTTD and you would never prescribe an SAFO for this diagnosis. The only solution for PTTD is a laminated UCB-St, which for those who need an explanation, has pressure under the sustentaculum tali preventing most pronation with the counter pressures lateral and plantar to the shaft of the 5th metatarsal and peroneal notch. The issue with this, is that very few insurance companies will pay for the laminated UCB-St and it takes quite a bit of talent to make these orthoses and maintain them functionally with each patient. The solution for this would be a UCB-St AFO, which would be covered.

The UCB-St would be the same as the photo without the joints and proximal section with the heel being taller, the same as a standard UCB. It would be possible to do an Arizona brace, if the foot section was the same as the photo above, but, in my opinion, anything less will not work to stop the collapse.

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