Name of the Procedure:

Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated
Common names: AFO with dorsiflexion assist, Dorsiflexion Assist AFO

Summary

An Ankle Foot Orthosis (AFO) is a custom-made brace designed to support the ankle and foot. This specific type uses spring wire and a calf band to assist with dorsiflexion, helping lift the front part of the foot. It’s crafted to fit an individual patient's anatomy and needs.

Purpose

This orthosis is used to:

• Address foot drop and other conditions causing difficulty in lifting the front part of the foot.
• Improve walking patterns and gait stability.
• Prevent foot dragging, reducing the risk of falls and injuries.

Indications

• Conditions: Foot drop, stroke, multiple sclerosis, cerebral palsy, peripheral neuropathy.
• Symptoms: Difficulty lifting the front part of the foot, frequent tripping or stumbling.
• Criteria: Patients who have mobility issues due to weakened dorsiflexion and could benefit from mechanical assistance.

Preparation

• Patients may be asked to undergo a physical examination to assess muscle strength and mobility.
• In some cases, a gait analysis or imaging studies might be required.
• No specific fasting or medication adjustments are typically needed.

Procedure Description

1. Assessment: A healthcare provider evaluates the patient's condition and takes measurements of the lower leg, ankle, and foot.
2. Fabrication: An orthotist custom-makes the AFO using spring wire and a calf band, ensuring a precise fit for optimal support.
3. Fitting: The patient tries on the AFO, and adjustments are made for comfort and effectiveness.
4. Training: The patient is trained on how to properly wear and care for the AFO, and instructed on exercises or movement techniques to maximize its benefit.

Duration

• Initial assessment and measurements: 30-60 minutes.
• Fabrication time: Usually takes a few days to a couple of weeks, depending on complexity.
• Fitting session: 30-60 minutes.

Setting

• Typically performed in an outpatient clinic specializing in orthotics and prosthetics.

Personnel

• Orthotist
• Healthcare provider (e.g., a physical therapist or orthopedic specialist)

Risks and Complications

• Common Risks: Initial discomfort, skin irritation, or pressure sores.
• Rare Complications: Improper fit leading to injury, allergic reactions to materials.

Benefits

• Improved mobility and gait.
• Reduced risk of falls and related injuries.
• Enhanced quality of life by allowing greater independence and activity.

Recovery

• Minimal recovery time needed; patients can usually start wearing the AFO immediately after fitting.
• Follow-up appointments to monitor fit and function.
• Ongoing care: Checking skin for irritation and ensuring the AFO maintains its integrity.

Alternatives

• Other orthoses: Different types/simpler off-the-shelf AFOs.
• Physical Therapy: Strengthening and mobility exercises.
• Surgery: In some cases, surgical intervention may be considered.

Pros and Cons:

• Custom AFO offers more precise support compared to off-the-shelf options but is more expensive and takes longer to fabricate.
• Physical therapy addresses underlying muscular issues but may not offer immediate mobility improvement.
• Surgery can provide permanent solutions, but involves higher risk and longer recovery.

Patient Experience

• During Fitting: May feel some initial discomfort as adjustments are made.
• After Procedure: Typically feel more stable and have increased ease when walking. It might take a few days to get accustomed to wearing the AFO regularly.
• Pain Management: Usually minimal, managed with proper fitting and occasional use of skin protection like padding or special socks.