Proper casting position is critical when you are prescribing a gauntlet ankle-foot orthotic (AFO). A common error is excessive plantarflexion at the ankle in the negative cast. It’s absolutely critical to take the cast with the foot at 90 degrees to the leg. In fact, if the foot is plantarflexed to the leg in the cast, then the cast in unusable.
Having the ankle plantarflexed excessively is a common casting error because it is so easy for it to happen. When taking a cast for a gauntlet AFO, your patient will be in a sitting position with the thigh parallel to the floor, the leg at 90 degrees to the thigh and the foot at 90 degrees to the leg. If the foot simply slides forward a few millimeters during casting, then the resultant cast will have the foot plantarflexed to the leg.
When an orthotic lab receives a cast with this error, it has no choice but to throw it away and ask you to start over. This is inconvenient and costly for you and your patient.
To avoid this scenario, follow these instructions.
- Watch this video on proper casting for gauntlet AFOs.
- During casting, ensure that the foot stays at 90 degrees to the leg.
- Critically and carefully evaluate the cast before your patient leaves the office.
Editor’s note: This blog was first published at http://prolaborthotics.com/Blog/tabid/90/EntryID/267/Default.aspx and has been adapted with permission from Lawrence Huppin, DPM, and ProLab Orthotics. For more information, visit www.prolaborthotics.com .