Ankle Foot Orthosis, Single Upright with Static or Adjustable Stop (Phelps or Perlstein Type), Custom Fabricated (L1920)

Name of the Procedure:

Common Name: Ankle Foot Orthosis (AFO) Technical Term: Ankle Foot Orthotic Device with Single Upright and Adjustable Stop

Summary

In layman's terms, an Ankle Foot Orthosis (AFO) is a custom-made brace designed to control the movement of the ankle and foot. This specific type features a single support bar (upright) with a mechanism that can either allow limited movement (adjustable stop) or completely restrict it (static stop). It's tailored to fit an individual's unique anatomy to provide optimal support and function.

Purpose

The AFO is used to manage various foot and ankle disorders. It is designed to:

• Provide support and alignment to the foot and ankle.
• Prevent or correct deformities.
• Assist with mobility by improving walking patterns.
• Relieve pain and discomfort.

Indications

The AFO is suitable for individuals with:

• Foot drop (difficulty lifting the front part of the foot).
• Ankle instability.
• Conditions like stroke, cerebral palsy, multiple sclerosis, and other neuromuscular disorders.
• Post-surgical recovery or injury rehabilitation.

Preparation

• The patient may need an initial assessment, which could include physical examination and gait analysis.
• No specific pre-procedure fasting or medication adjustments are typically required.
• Measurements will be taken to ensure the custom fit of the orthosis.

Procedure Description

1. Assessment: A healthcare provider evaluates the patient's condition and takes precise measurements of the foot and ankle.
2. Fabrication: The orthosis is custom-made based on the patient's measurements and specific needs.
3. Fitting: Once fabricated, the patient returns for fitting. Adjustments may be made to ensure comfort and effectiveness.
4. Instructions: The patient is given instructions on how to wear and care for the AFO.

Tools and Equipment: Measurement tools, casting materials, and orthotic fabrication equipment. Anesthesia: Not typically required.

Duration

The fitting process generally takes about 1-2 hours, including adjustments. The overall timeline from assessment to final fitting could span several weeks.

Setting

This procedure is commonly performed in outpatient clinics or specialized orthopedic or prosthetic centers.

Personnel

Involves:

• Orthotists or prosthetists (specialists in braces and orthotic devices).
• Physical therapists for gait training, if necessary.
• Physicians for referrals and overall medical management.

Risks and Complications

• Skin irritation or pressure sores from improper fitting.
• Discomfort or pain during initial adjustment period.
• Rarely, allergic reactions to materials used.

Benefits

• Improved stability and walking patterns.
• Reduction in pain and discomfort.
• Prevention or minimization of deformities.
• Enhanced overall mobility and independence. Benefits can be realized immediately but might require a short adjustment period.

Recovery

• The patient may need a brief period to get used to the AFO.
• Regular follow-up appointments to monitor fit and effectiveness.
• Instructions on wearing schedule, care, and any activity modifications.
• Gradual increase in wear time may be recommended.

Alternatives

• Physical therapy and strengthening exercises.
• Other types of orthotic devices.
• Surgical intervention in some cases.
• Use of walking aids like canes or crutches.

Pros and Cons of Alternatives: Physical therapy is non-invasive but might not be sufficient alone. Surgery can provide definitive correction but involves higher risk and recovery time.

Patient Experience

During the fitting, the patient may feel slight discomfort as adjustments are made, but this is minimal. Once properly fitted, the AFO should feel supportive without causing pain. Initial wear may result in minor discomfort or skin irritation, which subsides as the patient adapts. Pain management measures include proper fitting, gradual wear time increase, and regular adjustments by a specialist.