Lower Extremity Prosthetics

Components

Shoe

Footplate

Ankle Control

Knee Control

Superstructure

Conventional Non-Locking

Must be attached to shoe

Less cosmetic

Heavier

Easy to adjust

Durable

Strong

Indications

Reduction of knee hyperextension

Control of mild/moderate varus/valgus angulations

Posterior offset joints

Locking

Strong

Durable

Easy to adjust

Heavier

Less cosmetic

Must be attached to shoe

Indications

Control of knee buckling

Single axis joints

Features

Bail locking

Drop lock knee joints

Control knee hyperextension

Stance Control KAFO

Interchangability

Better cosmoses

Lightweight

Can be hot

Harder to adjust

Indications

Control of knee buckling

Features

Prevents knee flexion during stance phase

Allows flexion during swing phase

Assists knee flexion

Indications

When AFO cannot provide gait or standing stability

Inability to control early stance phase knee flexion

Late stance phase excessive genu recurvatum

Abnormal knee varus or valgus

Excessive hypertonicity that overpowers external moments

Populations

Neurologic

CVA

TBI

SCI

Post-polio

Conventional HKAFO

Action

Restore functional mobility

Extension for upright standing

Indications

SCI

Myelomeningocele

Progressive NM disorders

Reciprocal Gait Orthosis

Action

rigid stability for stance

hip joint motion for swing phase

Indications

traumatic SCI

Dynamic

Hinged thermoplastic AFO

Actions

PF/DF stop

Reduce energy expenditure of walking

Indications

MSK

Knee hyperextension

Weak ankle mms

Ankle protection

Neuro

Post-stroke

Children w/ CP

Posterior Leaf Spring AFO

Action

Assist limb clearance

Preposition foot for IC

Allow ankle rocker function

Indications

Dorsiflexion weakness

impaired motor control

LMN flaccid paralysis of DFs

Contraindications

moderate to severe hypertonicity

Metal (single or double) Upright

Action

BICAAL (locking mechanism)

Assist foot clearance

Indication

Edema/swelling

Ankle protection

Transition from IC to LR

Solid

Solid AFO

Action

Holds ankle in fixed position

Assist swing foot clearance

Preposition foot for initial contact

Limitations

Stairs

Uneven Surfaces

Sit to stand

Floor Reaction Orthosis (FRO)

Action

Hold ankle in slight plantarflexion

Restriction of tibia rolling forward over foot

Indications

Children with CP

Myelomeningocele

Post polio syndrome

Contraindications

Recurvatum during stance

Cruciate ligament insufficiency

Supramalleolar Orthotic (SMO)

Action

Stabilize Subtalar & Tarsal Joint

Preposition foot for IC

Indications

Flexible Pes planus

Mild/Moderate Spasticity

Hypotonicity

Contraindications

Hypertonicity

Significant equinovarus

Conventional KO

Action

Preventative/corrective tx

Control hypermobility

Protection from loading/stress

Indication

Insufficiency of lesser devices

Malalignment

Genu recurvatum

Genu valgum

Genu varum

FNMES

Action

Dorsiflexion

Indications

Intact common peroneal nerve

Stroke

TBI

MS

PD

Contraindications

pacemakers

metal implants

healing fracture

defibrillators

history of phlebitis