Thanks to all who responded, there were many excellent suggestions. The
third Tamarack posteriorly seemed to be a fantastic idea.
Here are a few of the responses
There is the Otto Bock “Snap stop” system, however we have successfully
been using a 3rd Tamarack joint as the posterior “stop”. The AFO can be
finished as you would an articulated AFO and the opposing surfaces can
be buffed smooth, then the joint can be inserted and left whole until
articulation is required. All it needs is a Stanley knife cut though
the posterior Tamarack joint and the two halves become a nice silent
bumper! Before moulding the tamarack joint dummy should be placed a
little higher on the posterior aspect of the cast so it sits just
outside the top of the shoe. I hope this helps.
why not use a “two stage” afo…a solid super thin polyethyl liner
inside an articulated afo…that way when they are ready to move and
groove…jsut pop out the liner..or cut it down to the smafo style..I’m
sure Claude at Orthomerica can do this…
You should consider the Allard Kid-Dee-Lite metal ankle joint. It’s
lower profile than the other pediatric joints on the market and can be
adjusted with an allen wrench provided with each set of joints.
Try the Becker Camber Axis Hinge Kit, #750-M. It can has several slotted
pieces that can lock the ankle and stop all motion. Then change the
slotted piece out for LM Ankle or what ever. Not much more difficult to
fabricate than for the Tamarak.
Would using a Double Adjustable Ankle Joint be acceptable? You could
lock it
out initially, and then very easily allow motion when requested. I’ve
used
Otto Bock pediatric DAAJs with great success-they are small and
relatively
thin. I’ve also used Kid-Dee-Lite joints, but found they are quite
light-duty. You won’t be in the grey area of billing L1970, when it
could be
argued that you are technically delivering an L1960–you’ll save time,
and
you can also bill out L2220 x2.
Check out the TC Stop
You have the option of either a articulating AFO or a fixed AFO With
the ability to switch from one to the other by simple removing of
bumpers
Try the Becker 755-MCL(motion control limiter). They have an option for
putting a plate in the posterior of the afo that can later be removed.
Also, when articulated, the posterior bumper may be ground down to
change the plantarflexion range. While not very effective for active
adults, this would be ideal for temporary pediatric situations.
You can make it a hinged afo that is cut and add stock aluminum band
where the posterior stop is on the outside and use a chicago screw above
the cut line and below the line and just take off when ready to use as
hinged. We call them here at Children’s Mercy Hospital In Kansas City.
“Transformers”
Christopher J. Phillips, C.P.O.
New England Brace Co.
1 Hampton Rd. Suite 204
Exeter, NH 03833
(603) 772-2388
(603) 775-7120 (fax)
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