Test Orthosis Differences due to Brace Design?€¦ · casting technique • particular consideration of the foot bed and foot to shank positioning • correctivepositionscanbe madefor

C‐Brace®

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Negative Plaster Cast

Test Orthosis Differences due to Brace Design?

C‐Brace® ‐ Technical Information | Academy Vienna

Negative plaster castC‐Brace® ‐ Technical Information

• Plaster Parting Agent Cream 640Z5• Stocking 99B25• Cellona Plaster Bandage 699G9

Materials

• Knee Pivot Gauge 743A8• Foot Casting Aid 743A9• Pivot Point Adjustment Aid 743A7 or• Orthotic Alignement Aid 743A6• Orthotic Joint Alignment Set 743R6

Tools

• cut‐off Strip• sliding Caliper• meter Stick• blue Pencil• scissor• LASAR Posture 743L100

Additional Equipment

2 C‐Brace® ‐ Technical Information | Academy Vienna

Requirements:

Please ensure …– a physiological knee flexion in sagittal plane 0°‐ 4°– ankle position in sagittal plane equivalent to shoes heel height

– proper foot positioning in frontal plane including exterior rotation

Please note…– plaster cast should be taken in best corrective position for the patient

– prominent bony structures

Negative plaster castC‐Brace® ‐ Technical Information

3C‐Brace® ‐ Technical Information | Academy

Vienna

C‐Brace® ‐ Technical Information

•Measurements on the user:• Height measurements:

• maximum overall height medial and lateral

• distance medial tibia plateau to floor

• distance ankle joint to floor• Width measurements:

• knee joint (average of straight and bent knee)

• ankle joint• forefoot under load

Negative plaster cast

4C‐Brace® ‐ Technical Information | Academy

Vienna


– Recommended is the 3‐stage casting technique

• particular consideration of the foot bed and foot to shank positioning

• corrective positions can bemade for each segmentseparately


5C‐Brace® ‐ Technical Information | Academy Vienna


– Use plaster longuettes for better stability:

• Red 8‐layers foot• Green: 4‐layers shank• Blue: 4‐layers knee• Black:4‐layers thigh medial/lateral

over the full length



• : Foot• Define effective heel height and adjust foot casting aid• Adjust forefoot wedge to the proper position for rollover

edge and toe pitch (rollover edge parallel to knee axis)• Apply plaster parting agent cream to the foot and form the

foot cradle with an 8‐layer longuette• Position the foot on the foot plaster cast device in the

corrected/support position.• Remove the foot plaster negative from the foot once it has

set, make corrections to the foot plaster negative if necessary, trim the edges

• Reapply plaster negative to the foot and position it on the foot plaster cast device


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• : Shank • Apply plaster parting agent cream to the lower leg and

pull on the protective stocking• Insert a cut‐off strip from the tip of the foot to above the

max. height of the orthosis• Secure the foot bed to the foot with plaster bandages

and position the lower leg in a 90°angle to the foot• Place the calf longuette against the back of the calf,

smooth it, and hold it in place with plaster bandages• Continue with the plaster bandages in the area of the

foot and lower leg• Adjust for anatomic external rotation of the foot and

align the lower leg in the sagittal/frontal plane


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• : Thigh • Once the lower leg plaster has set, bring the patient

into a reclining position• Position the knee joint in the physiological 0‐4°

flexion and continue with the plaster cast• Loosely roll on a 2‐layer plaster bandage, circular up

to the proximal end• To achieve good stability in the plaster cast only

apply 4 circular layers in the leg/thigh transition area

• Apply longuettes (plaster splints) in the hollow of the knee, laterally and medially and secure with plaster bandages

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• : Thigh• Reduce all deformities in all 3 planes as much as

possible• Observe a physiological sagittal knee position for the

patient and prepare for an additional molding grip, if needed (e.g. medial supracondylar support)

• Secure the knee joint until the plaster has set• Make crosswise markings on the plaster, remove the

cutting aid, grease the plaster cast scissors if needed and carefully cut open the plaster cast

• Carefully open the plaster cast and lift out the leg


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Negative Fiberglass castC‐Brace® ‐ Technical Information

• Plaster Parting Agent Cream 640Z5• Stocking 99B25• Fiberglass Cast Tape 699G30

Materials

• Knee Pivot Gauge 743A8• Foot Casting Aid 743A9• Pivot Point Adjustment Aid 743A7 or• Orthotic Alignement Aid 743A6• Orthotic Joint Alignment Set 743R6

Tools

• cut‐off Strip• sliding Caliper• meter Stick• blue Pencil• scissor• LASAR Posture 743L100

Additional Equipment

11 C‐Brace® ‐ Technical Information | Academy Vienna


– Recommended is the 3‐stage casting technique

• particular consideration of the foot bed and foot to shank positioning

• corrective positions can bemade for each segmentseparately

Negative fiberglass cast


• : Foot• Define effective heel height and adjust foot casting aid• Adjust forefoot wedge to the proper position for rollover

edge and toe pitch (rollover edge parallel to knee axis)• Apply stocking and cut strip to foot and leg, and form foot

bed using 2 or 3 inch fiberlass cast tape doubling back around heel so anterior ankle is not too thick.

• Position the foot on the foot casting device in the corrected/support position.

• Make corrections to the foot fiberglass negative if necessary, mark first and fifth metatarsal heads with blue pencil

• Position foot on the foot casting device


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• : Shank • Secure the foot bed to the foot with fiberglass bandages

making sure to minimize thickness over cut strip and incorporate plantar heel to key in foot bed to calf section.

• Continue with the fiberglass bandages in the area of the foot and lower leg and position the leg in a 90°angle to the foot

• Adjust for anatomic external rotation of the foot and align the lower leg in the sagittal/frontal plane


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• : Thigh • Once the lower leg plaster has set, bring the patient

into a reclining position• Position the knee joint in the physiological 0‐4°

flexion and continue with the fiberglass cast• To achieve good stability in the fiberglass cast start

at mid calf lateral to the cut strip to minimize thickness over cut strip.

• Loosly wrap up the thigh with minimal overlap and then wrap back down the thigh ending at the same place on the calf that you started.

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• : Thigh• Reduce all deformities in all 3 planes as much as

possible• Observe a physiological sagittal knee position for the

patient and prepare for an additional molding grip, if needed (e.g. medial supracondylar support)

• Secure the knee joint until the plaster has set• Make crosswise markings on the fiberglass as well as

lengthwise markings at ankle and knee where fiberglass sections meet. Remove the cutting aid, grease the plaster cast scissors if needed and carefully cut open the fiberglass cast.

• Carefully open the fiberglass cast and lift out the leg


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• We recommend the orthotic alignment aid 743A6 to align and position the joint axis

• Determine the pivot points according to the measurements taken

• As joint adapters the 743Y55 Alignment Axis of the 743R6 Joint Alignment Fixture for orthosis joints should be used

Advice: Pay attention to the effective heel height and wall thickness of the plaster cast while transferring measurements to the alignment aid!


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C‐Brace® ‐ Technical InformationTrimlines testorthosis

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Decision

Spring Sensor Ankle

Decision

Spring Sensor Ankle


Documents

Test Orthosis Differences due to Brace Design?€¦ · casting technique • particular consideration of the foot bed and foot to shank positioning • correctivepositionscanbe madefor