5.An idea I haven’t had the chance to try but seems it should work is to
attach a PLS AFO to the KO perhaps making it easily removable.
Harold Anderson, CO
6.Every visit resulting in a KO is a “return of the cone-legs” :-).
Problem increases with weight, though. We have used waist belts for both
prefab and bespoke orthoses in these cases. Usually, attaching the belt
laterally is enough. Even the belt can be problematic in obese cases
(i.e. no waist line…). We have also fitted orthoses with a distal
polypropylene “stick” that goes down in the shoe and becomes a foot (or
just heel) plate. It takes very little material to suspend the orthosis
this way, unless activities are vigorous.Kjell-Ake Nilsson CPO at
Linkoping University Hospital, Sweden
7.Molly, The only thing that has worked for me, on many occasions, is to
attach the KO to an AFO addition. Keep the AFO addition as simple as
possible but mind the tendency for the whole orthosis to rotate.
Patients don’t like the extra hardware but if the KO is a necessary
component to safe and functional ambulation they should accept the
unfortunate but essential add on. Bill DeToro,CO
8.Hi Molly, try chamois (real, not artificial) on the back of the straps
and linning of the shells, so there is better grab when she perspires,
also sometimes we’ve had to switch to a wide elastic strap (4-5″ wide )
in place of the strap system so there is ‘give’ in the straps on leg
flexion/extension, allowing the brace to move a little with her, (some
ofthese people bulk up incredibly during ambulation).The other thing is,
sometimes we’ve found we are better to change to a 3/16″ molded
copolymer shell which wraps the leg past the mid-line (as Townsend can’t
do this, given the rigid material) and then we’ve been able to do more
of a quad cut-out in the femoral section to compensate for the bulk on
flexion, while maintaining control.
Good-luckHeather Prior C.O. (NZ), C.O. (C)
.9.In dealing with these extreme legs there are variations to the theme
of sleeves.One type that’s been successful is a sleeve with silicone and
velcro. The silicone sleeve is worn against the skin and velcro tabs are
sewn outside to
coincide with the bands of the orthosis. Waist belts have been used in a
smaller lighter form, garter belt style. Finally a TES belt ak style.
All of these have had their successes as well as their failures. If this
woman is active she amt tolerate the waist belt or TES belt because it
will allow her to function with the proper support.Good luck and Happy
HolidayCarey GlassCP FAAOP
10.Here’s a few ideas for you:Have you tried building a medial wedge out
of Pelite in the orthosis, I’ve
found this helps suspend in some cases. Also, Ezy wrap/ Professional
Products dropped off a couple of sleeves last week to be worn around the
calf (wrap-around style) that help to suspend KOs on large pt. Lastly,
while I really like Townsend and G 2 products, they can have some
inherent suspension problems, and in cases like this I’ve switched them
into Orthotech Preformers
for the suspension.Good Luck,Josh Ryder, C.O.
