Custom made modular bracing for each patient's specific needs.
Modular versus custom – modular meaning “constructed with standardized units or dimensions for flexibility and variety in use” - custom meaning “to build, fit, or alter according to individual specifications”. Typically, these terms are used separately when discussing orthotic devices. With this article we will be discussing a brace design that incorporates the two to create a more effective device for the patient. Specifically, a PDE system that can be used for a variety of conditions and diagnoses.
Before discussing the design of the brace, it is important to understand the components that are either going to be part of the modular or custom system. Starting proximally, we have the calf cuff section. This part of the brace provides support and weight bearing potential. Depending on pain levels and ability to bear weight through different areas of the calf, determines design style – this can be plastic or carbon and will be created (custom) according to the cast or scan taken by the clinician. A dial for tightening this calf cuff will also be added according to patient’s ADLs (activities of daily living) and other activities. Next, is the PDE strut. This strut comes in multiple different spring levels according to the patient’s needs and functionality. This will be evaluated and determined by the clinician from the modular system. Finally, we have the footplate. This is a solid ankle custom made area of the brace made of carbon fiber, plastic or 3D printed out of PA-12, again determined by the clinician at time of evaluation.
Offloading and pain management with the Ortho model.
The Ortho model is designed for patients who require “everyday use in situations where pain and offloading of weight may be key factors” (FabTech). This modular design is for those patients who are still high activity but have diagnoses of complex fractures of the foot or lower limb, limb salvage, failed fusion, nerve/muscle impairment or loss below the knee, dorsiflexion and/or plantarflexion deficit or loss, soft tissue injury or loss, high body weight CVA, MS (Multiple Sclerosis), Osteo Arthritis, Charcot Marie tooth disease, partial foot amputations, Chopart amputation (FabTech). Being able to switch strut stiffness to alter walking mechanics along with the other variables parts of the brace, creates a scenario for an effective brace for high activity users with a necessity of offloading the foot. This design type is typically created with carbon fiber calf and foot components.
Nerve and muscle loss management with the Neuro model.
The Neuro design more closely relates design wise to traditional types of orthotic devices such as those who would benefit from a custom posterior leaf spring AFO where pain and offloading of weight are not a key factor. Dorsiflexion and plantarflexion weakness can also be addressed with this brace. Some examples of conditions that are indicated for this brace are nerve/muscle impairment below the knee, soft tissue injury or loss, nerve/muscle loss below knee, deficit or loss of dorsiflexion and/or plantar flexion, patients who desire return to recreational sports, conditions such as: Guillain-Barre Syndrome, Spina Bifida, Spinal Cord Injury, CVA, MS, CMT, CP, Polio, and other conditions. This design type is typically made from plastic calf and foot components.
Meeting and exceeding patient outcomes and goals.
In conclusion, these combined modular and custom systems allow for a dynamic device that helps patients regain mobility and independence through combining different aspects of the device to fit their individual needs. It is important for patients to speak with a clinician in order to determine which style of brace would be right for them. The adaptability and flexibility in changing these devices allow for continuing to help the patient improve and succeed in reaching their goals. We are seeing great potential in what we are able to create for our patients with utilizing this technology. Contact Team Tillges today to speak to one of our certified clinicians about this modular AFO.
RESOURCES
- https://fabtechsystems.com/
- https://www.teamtillges.com/