Upload
others
View
5
Download
0
Embed Size (px)
Citation preview
C‐Brace®
1
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
C‐Brace® ‐ Technical Information
– 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 plaster cast
5C‐Brace® ‐ Technical Information | Academy Vienna
C‐Brace® ‐ Technical Information
– 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
Negative plaster cast
6C‐Brace® ‐ Technical Information | Academy Vienna
• : 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
C‐Brace® ‐ Technical Information
7
Negative plaster cast
C‐Brace® ‐ Technical Information | Academy Vienna
• : 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
C‐Brace® ‐ Technical Information
8
Negative plaster cast
C‐Brace® ‐ Technical Information | Academy Vienna
C‐Brace® ‐ Technical Information
• : 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
9
Negative plaster cast
C‐Brace® ‐ Technical Information | Academy Vienna
• : 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
C‐Brace® ‐ Technical Information
10
Negative plaster cast
C‐Brace® ‐ Technical Information | Academy Vienna
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
C‐Brace® ‐ Technical Information
– 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
12C‐Brace® ‐ Technical Information | Academy Vienna
• : 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
C‐Brace® ‐ Technical Information
13
Negative fiberglass cast
C‐Brace® ‐ Technical Information | Academy Vienna
• : 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
C‐Brace® ‐ Technical Information
14
Negative fiberglass cast
C‐Brace® ‐ Technical Information | Academy Vienna
C‐Brace® ‐ Technical Information
• : 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.
15
Negative fiberglass cast
C‐Brace® ‐ Technical Information | Academy Vienna
• : 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
C‐Brace® ‐ Technical Information
16
Negative fiberglass cast
C‐Brace® ‐ Technical Information | Academy Vienna
C‐Brace® ‐ Technical Information
• 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!
Negative plaster cast
17
C‐Brace® ‐ Technical Information | Academy Vienna
C‐Brace® ‐ Technical InformationTrimlines testorthosis
18
Decision
Spring Sensor Ankle
Decision
Spring Sensor Ankle
C‐Brace® ‐ Technical Information | Academy Vienna