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 ½”-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 ¼” 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
