Name of the Procedure:

Ankle Foot Orthosis (AFO), Plastic, Rigid Anterior Tibial Section (Floor Reaction), Custom Fabricated (L1945)

Summary

This procedure involves creating a custom-made ankle-foot orthosis (AFO) designed to support the ankle and foot. Specifically, the orthosis is made from rigid plastic with an anterior tibial section that provides a floor reaction force to aid in improving mobility and stability.

Purpose

The primary purpose of this orthosis is to address conditions that affect the ankle and foot, such as weakness or deformities. This custom-fabricated device helps in maintaining proper posture, improving walking (gait), and preventing falls or further injury.

Indications

• Weakness or paralysis of the lower limbs
• Foot drop or dorsiflexion weakness
• Conditions like cerebral palsy, cerebrovascular accident (stroke), multiple sclerosis, or traumatic brain injury
• Post-surgical stabilization and recovery
• Correcting and preventing ankle and foot deformities

Preparation

Before getting fitted for the orthosis:

• A thorough physical examination by a healthcare provider.
• Imaging tests (e.g., X-rays, MRIs) may be required to understand the underlying bone and muscle structure.
• There are generally no special fasting or medication adjustments needed.

Procedure Description

1. Assessment and Casting: A healthcare provider will assess the ankle and foot, and then take a cast or 3D scan to create a custom mold.
2. Fabrication: The orthosis is custom-fabricated using durable plastic materials to ensure a precise fit.
3. Fitting: Once ready, the orthosis is fitted to the patient. Adjustments are made to ensure comfort and effectiveness.
4. Education: The patient is educated on how to wear, adjust, and care for the orthosis.

No anesthesia or sedation is required since the process is non-invasive.

Duration

The entire process from assessment to fitting can take several weeks, but each individual fitting or assessment session typically takes 30-60 minutes.

Setting

Mostly performed in outpatient clinics, orthopedic or prosthetic centers.

Personnel

• Orthotist or prosthetist for measurement, casting, fabrication, and fitting
• Healthcare providers (physiatrists, orthopedists) for initial and follow-up assessments

Risks and Complications

• Skin irritation or pressure sores
• Discomfort or improper fit requiring adjustments
• Possible allergy to materials used

Benefits

• Improved stability and walking ability
• Prevention of further deformities or injuries
• Enhanced quality of life and greater independence in mobility Benefits are usually noticed immediately upon proper fitting and use.

Recovery

• Patients are generally advised to wear the orthosis as directed and to regularly check for any signs of skin irritation.
• Follow-up appointments are essential for adjustments and ensuring the effectiveness of the orthosis.
• Physical therapy may be recommended to maximize mobility benefits.

Alternatives

• Off-the-shelf orthotic devices (less custom fit)
• Physical therapy alone
• Other supportive devices or braces
• Surgical interventions in severe cases Each alternative has its own pros and cons regarding cost, effectiveness, and patient compliance.

Patient Experience

• Initial discomfort is possible but usually resolves with proper adjustment and habituation.
• Regular monitoring for any skin issues is crucial.
• Pain management is typically not an issue, but any discomfort should be reported to the healthcare provider for adjustments.