Orthotics CPM Newest Updated Exam with verified || || || || || || ||
detailed solutions ||
AFO casting - ✔✔1. Don gloves and gather materials
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2. Take measurements either on form or calf circumference, ankle
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circumference, fib head height, foot length || || || || ||
3. apply 2 layers of stockinette
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4. mark landmarks: fib head/neck, tibial crest, malleoli, calcaneal tuberosity if
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prominent, base of 5th met head, navicular, cuboid, met heads 1 and 5, to
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sulcus, any other prominent/painful areas
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5. apply cut tube anteriorly and insert into cut slits of stockinette
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6. wrap with fiberglass, ensure fib head is captured
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7. Use foot board to align foot as neutrally as possible
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8. As fiberglass sets draw vertical cut line and horizontal match lines
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9. Use cast saw to cut the cast off. Warn patient of vibration and loud noise. Use
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2 hands and thumb as a guide
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10. cut top layer of stockinette and remove cast
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11. clean patients leg and remove 2nd layer stockinette. don shocks and shoes
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12. Clean area and answer questions about patient considerations
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KAFO: Knee joint too distal - ✔✔1. pressure at anterior distal and posterior
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proximal thigh ||
2. thigh band shifts proximal
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3. cant rotate as much as anatomical knee
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,2
KAFO: knee joint too proximal - ✔✔1. pressure at posterior distal and anterior
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proximal of thigh || ||
2. thigh band shifts distal
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3. bends too much
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KAFO: knee joint too posterior - ✔✔1. pressure at anterior proximal and
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posterior distal thigh || ||
2. orthosis shifts proximally
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KAFO: knee joint too anterior - ✔✔1. pressure at anterior distal and proximal
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posterior thigh ||
2. orthosis shifts distally
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KAFO: proper knee joint location - ✔✔1. bisection of adductor tubercle and
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medial tibial plateau
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2. 60:40 anterior: posterior
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KAFO Trimlines: - ✔✔1. medial proximal 30 mm distal to perinneum
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2. proximal lateral distal to greater trochanter
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3. proximal posterior thigh set at 15 deg slant connecting lateral to medial
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4. popliteal region allows 105 deg knee flexion
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KAFO knee joint clearances - ✔✔6mm medial 3 mm lateral
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,2
KAFO ankle clearances - ✔✔6 mm medial and 5 mm lateral
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KAFO analysis - ✔✔1. Correct side and foot plate
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2. proper strapping materials
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3. plastic thickness
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4. rivets-- speedy rivets not durable for attaching metal uprights
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5. plastazote /p-cell packs down quickly
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6. check measurements
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7. Check proper ankle and knee joints
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8. If KAFO doesn't meet patient's needs do not deliver
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KAFO : varus moment control - ✔✔AFO section: 3 pt pressure 1) prox medial
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(medial chafe at tibial strap) 2) proximal lateral malleoli (lateral flange) 3) 1st
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met head (encompass)
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KAFO hyperextension control after delivery - ✔✔1) add padding to calf section
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2) increase dorsiassist power (stiffer joints, adjust double action)
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3) increase plantarflexion resistance (pf stop, adjust double action)
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4) add heel wedge to AFO
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KAFO joints that prevent hyperextension (without limiting ADLs) - ✔✔1.
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posterior offset ||
, 2
KAFO correct genuvarum/genuvalgum after delivery - ✔✔1. add pull strap
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proximal and distal to the knee joint so line of pull corrects deformity
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2. add padding proximal and distal to KC (if valgus add padding medially, and if
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varus add padding laterally) to increase corrective force
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KAFO: pain at at posterior distal thigh indicates what? - ✔✔knee joint is too
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proximal
KAFO: pain at anterior distal thigh and posterior proximal thigh indicates
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what? - ✔✔knee joint is too distal
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KAFO: what may be the issue if knee joints will not fully lock? - ✔✔1. drop
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locks may be upside down
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2. mechanical KC not aligned with anatomical KC
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3. The joints are not squared properly
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4. excursion length are uneven
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Scenario: pt with metal and leather KAFO with drop locks and double action
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ankle joints feels unsteady and trips easily going down ramps. what
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adjustments? - ✔✔1. allow more plantarflexion at the ankle || || || || || || || ||
2. provide dorsiassist with a spring in the posterior channel (will resist pf and
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smooth the foot flat transition) || || || ||
3. add cushioned heel to shoe
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AFO 3 point force system for dorsiflexion weakness (resist PF in swing): - ✔✔1.
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anteriorly directed force at posterior calf || || || || || ||