Well, I’ve been eddicated! Herewith are the replies that I received to my
query about what these modifications entailed. Thanks to all who replied.
Richard Ziegeler
Richard:
A Carlson modification is a Sustentaculum shelf modification, or S.T.
mod. I don’t know why he calls it the Carlson modification, Marty Carlson
wrote a paper once and addressed the modification but I believe it has been
done a lot longer than the article was written. Hope this helps!
MMartinco
Carlson mod appeared in a JPO (Journal or CPO [predecessors to the JPO])
article about UCBL (University of California at Berkley Laboratory) foot
orthosis authored by Colson Berglund. The Colson was a misspelling of
Marty Carlson, CO’s name.
Bob
Robert N. Brown, Sr. CPO
CEO/R&D FLO-TECH® O&P Systems, Inc.
PO Box 462 2071 Trumansburg Rd.
Trumansburg, NY 14886
800-356-8324
This refers to Marty Carlson’s advocacy of calcaneal grasping. To
stabilize the calcaneous the cast is modified deeply under the sustenaculum
tali. The Oregon orthosis folks promote a very similar modification
technique. It is very effective.
Ted A. Trower C.P.
A-S-C Orthotics & Prosthetics
Jackson, Michigan, USA
My understanding is that Marty Carlson, CO from Minneapolis, Minnesota has
been immortalized by having this modification named after him when he
worked at Gillette Children’s Hospital. The modification as taught at the
Northwestern University Orthotics course in Chicago has a groove cut into
the cast under the sustentaculum tali. This locks in the calcaneus
preventing it from rolling into eversion.
The original way that I was taught the modification was very drastic –
carving a fairly deep groove into the cast. I’ve modified his modification
myself by simply holding the calcaneous in neutral with my thumb pressed in
under the sustentaculum tali and my thenar emminence into the longitudinal
arch. This is a much more natural means of control than carving a groove.
I do deepen the depression caused by my thumb in some cases as needed to
increase control.
I hope that someone else will offer documentation of the technique as I’ve
never seen it myself. I do believe there is an article written about it.
As this seems to be a logical means of controlling the calcaneous, I
suspect that you use a similar technique in AU but call it something else.
Perhaps someone down under is also immortalized?:-).
Harold Anderson
A paraphrase for J. Martin Carlson, CPO
The reference is to the article:
An Effective Orthotic Design for Controlling the Unstable Subtalar Joint,
Orthotics and Prosthetics, Vol. 33, No. 1, PP 39-49, March 1979
My Editorial: An excellent technique largely incorporated into many lower
extremity orthoses in my clinical practice
Good’ay
JP Donovan, CPO
