Name of the Procedure:

Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated (L1970)

Common names: Custom ankle brace, Custom AFO Medical/Technical term: Custom-fabricated Ankle-Foot Orthosis (AFO)

Summary

A custom-fabricated ankle-foot orthosis (AFO) made out of plastic and featuring an ankle joint is designed to provide support and stability to the ankle and foot. It helps to manage various disorders by maintaining proper alignment and facilitating movement.

Purpose

The procedure aims to:

• Address conditions like foot drop, instability, and deformities
• Improve mobility and gait
• Enhance comfort and support
• Prevent further complications and deformities

Indications

Indicated for:

• Patients with neurological disorders such as cerebral palsy or stroke
• Individuals with muscular or joint instability
• Patients experiencing foot drop or other gait abnormalities
• Those requiring immobilization post-surgery or injury

Preparation

• No specific fasting or medication adjustments are typically required.
• Diagnostic assessments may include a physical examination and gait analysis.
• Measurements and molds of the lower extremity will be taken for custom fabrication.

Procedure Description

1. Assessment and measurements: The healthcare provider takes detailed measurements and impressions of the patient's foot and ankle.
2. Customization: A custom mold is created from the measurements.
3. Fabrication: The orthosis is manufactured from durable plastic with an articulated ankle joint to allow controlled movement.
4. Fitting: The patient returns for a fitting session where adjustments are made for comfort and effectiveness.
5. Training: The patient is instructed on how to wear and care for the AFO.

Duration

• Initial assessment and measurements: approximately 30-60 minutes.
• Fabrication and fitting: typically a few weeks, depending on the complexity.

Setting

Performed in an outpatient orthopedic or prosthetic clinic.

Personnel

• Orthotist (specialist in orthotic devices)
• Physical therapist (for gait training post-fitting)
• Support staff for adjustments and follow-up

Risks and Complications

• Skin irritation or pressure sores
• Discomfort or improper fit requiring adjustments
• Allergic reactions to materials (rare)
• Joint stiffness if not used correctly

Benefits

• Improved walking ability and stability
• Reduced risk of falls
• Enhanced quality of life
• Immediate functional improvements once fitted and accustomed

Recovery

• Gradual adaptation to wearing the orthosis, starting with short periods and increasing as tolerated.
• Follow-up appointments for adjustments.
• Possible physical therapy for gait training.

Alternatives

• Off-the-shelf ankle braces or prefabricated AFOs.
• Physical therapy and strengthening exercises.
• Surgical interventions in severe cases.
• Pros and Cons:
  • Custom AFOs offer superior fit and functionality compared to off-the-shelf options.
  • Surgery carries more risks and longer recovery times compared to non-surgical options like AFOs.

Patient Experience

• Some initial discomfort or awkwardness as the patient gets used to the orthosis.
• Regular adjustments may be required to ensure proper fit and function.
• Pain or skin issues should be reported immediately for adjustments.
• Overall, the orthosis should greatly enhance mobility and comfort over time.