Dear members
I have a seven year old female with CP who has trouble with Toeing-In.
She is a good walker and has a heel-toe gait. I am currently treating
her with a hinged AFO to prevent foot drop and excess pronation, and
limit a hyperextension moment during gait. On her check out there is a
degree of osseous restriction to external rotation at approx 10 deg
(ext rot). Internal rotation reaches approx 90 deg.
As I am aware there is not a lot to offer in controlling or influencing
with an AFO or any device for that matter if a boney restriction is
present. But there is some room for influencing her gait into more ext
rot’n from a soft tissue approach, even if we achieve a neutral
position.
My question to you all is, Without using any orthoses that extends
proximal to the knee, can we influence the knee into more ext rot’n?. I
have found in a catalogue (Markell) a torque heel that is attached onto
the heel of the shoe, its a lugged wheel where the luggs are wedged and
used for this very problem. Orientation of the wheel determines wether
the leg is influenced internal or external rotation. Has anyone used
these, if so what were the results like?
Ben McMurtrie – Orthotist
Geelong Orthotics
42 Bellerine St
Geelong 3220
Ph-(03) 52 242200
Fax-(03) 52 242829
