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23 Cards in this Set

  • Front
  • Back
What are the three general objectives when casting for orthotics?
- STJ in neutral
- MTJ locked via pronation
- All MTPJs in Neutral position
What is captured when casting for orthotics?
The only thing captured is the forefoot to rearfoot relationship, aka "the midtarsal joint deformity." Does not capture rearfoot deformity, you put RF into prescription.
What are the three advantages to casting both prone and supine?
No distortion of forefoot.
Easy to put STJ into neutral
Easy to lock MTJs
What is the advantage singular to the Supine casting position?
What is the singular disadvantage to casting supine?
Direct observation of TA and Extensors to make sure pt is relaxed.
This can become tiresome for the patient
What is the advantage singular to casting in the Prone position?
This position is not as tiresome to the practitioner.
What are the five disadvantages to casting in the prone position?
- Technical difficulty
-Can't lift 4th and 5th to elongate the tissues
-Can't see TA or EDL/EHL
-Patient discomfort.
- Tends to result in a pronated cast (dorsiflexed forefoot)
What are the two advantages to casting via Foam Box Semi Weight Bearing?
It is fast and easy.
This method casts bony prominences well.
What is the major, singular disadvantage to casting using the Foam Box Semi Weight Bearing Method?
Does not establish an accurate forefoot to rearfoot relationship.
What are the 5 disadvantages to casting Foam Box as well as Vacuum?
-Can cause soft tissue and ossseus distortion
- Can't lock MTJs
-Impossible to correctly position the MTPJs
-Impossible to find STJ neutral
-Poor Skin contact
What is the major, singular disadvantage to casting using the Vacuum Method?
costly with special equipment
What are the three general steps in Vaccum casting?
Apply cast
Put foot in bag, then shoe
Vaccum
What are the three specific steps in Vacuum Casting?
Keep knee @ 90 degrees
Put STJ into neutral
Dorsiflex the 5th met head to try to lock MTJ
What are the two advantages to casting using the vaccum technique?
Captures the foot in shoe with
-Correct heel height
-Correct heel cup shape for shoe.
What are the seven solid points to examine when evaluating an orthotic negative casting?
1- Skin lines present
2- Concave 1st and 5th met head impressions
3- concave and symmetrical heel
4- medial 2/3 curved, lateral flat
5- Straight lateral surface
6- hallux in line with metatarsal or dorsiflexed compared to 2-5th
7- Proximal 5th phalanx should be parallel with the 5th metatarsal.
It looks like a foot.
what are the 4 points of examination on the interior of the cast?
Skin lines are present
Good 1st and 5th met impressions
Symmetrical heel
Medial 2/3 slopes upward, lateral flat
What are the 2 points of examination on the plantar aspect of the cast?
Straight lateral surface
Thumb impression on the 4th and 5th toe sulcus (not any more or less than that, and NOT on the met heads, or you'll be shot)
What is the point of examination on the medial aspect of the cast?
hallux should be in-line or dorsiflexed compared to 2-5th digits
What are the two points of examination on the lateral aspect of the cast?
Proximal 5th phalanx is parallel with 5th met head.
C/C joint height should be gradual.
What if the C/C joint in your negative is flat, what caused that?
What if it is acute?
Flat- MTJ not fully pronated
Acute- MTJ not supinated.
When assessing the posterior of the negative cast what is the heel bisection supposed to do?
Heel bisection matches the degree and type of FF-RF deformity.
How would a FF varus cast, if FF is parallel on the ground, show at the heel?
Heel will look everted.
How would a FF valgus cast, if FF is parallel on the ground, show at the heel?
heel will look inverted.
What are the three errors listed in lecture that can occur when casting?
Supination of Oblique MTJ axis by dorsiflexing 4th and 5th (only extend the soft tissues, don't dorsiflex)
Supination of STJ causes laterally deviated shape of lateral column in the cast.
Pronation of STJ causes medially deviated shape of lateral column in the cast.