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Foot Abduction Orthosis Setup for Idiopathic Clubfoot

Michelle Hall, BSE, Orthotist

 

1.      Device components:

a.       Fillauer night split 9-15 #012204

                                                                           i.      This comes with all the parts that you need

                                                                         ii.      They sell all of the replacement parts separately

b.      Markell #1644 size 000M/N – 6M/N, #2644 size 7M/N – 8M/N

                                                                           i.      These are straight last shoes

                                                                         ii.      They come in M (medium) and N (narrow) widths

                                                                        iii.      We add a plastazote heel counter (see tracings)

1.      Use Barge cement to attach the pad to the inside of the shoe

                                                                       iv.      They do not yet sell the shoes with the counters built-in

2.      Setup of orthosis

a.       Dorsiflexion:  10-15 total, need to bend the bar as close to the joints as possible

b.      Shoe size: Length from heel to longest toe plus ”-3/4”

                                                                           i.      Measure shoe from inside heel to very end of the shoe sole

c.       Abduction: 70 for the affected foot, 25 for the unaffected foot

d.      Width of bar:  outside shoulder width equals width between the center of the heels (after shoes are abducted)

1.      Heel counter

a.       Note that this is necessary for Markell #1644 shoes without a bulbous heel built into them already

b.      Order from Wrymark “Iowa Heel Counters #1 & #2” (made of ” plastazote)

                                                                           i.      Two sizes can be ordered

1.      Iowa Heel Counter #1 (under size 3 shoes)

2.      Iowa Heel Counter #2 (size 3+ shoes)

                                                                         ii.      The arc is the superior edge

                                                                        iii.      Cut on an angle from the inferior lateral edge to medial inferior arc, so it is no longer a horseshoe shape.  The medial corners of the horseshoe cause sores on wide heels.

                                                                       iv.      Skive lateral and inferior edges, leaving superior edge full thickness

                                                                         v.      Glue the skived side to shoe with Barge cement, so that superior edge is flush with shoe