Dear all
Thanks for the comments.
Are we as practitioners relying on the cast too much. We teach a slightly
different approach at my lab for casting the foot.
1. Assess the foot, then replicate the frontal plane alignments in the
cast. i.e. make the cast look like the foot and try not to rely too much
on the lab being able to then add plaster of paris additions to get the
foot to where it should be - the plantar surface of the FFO should be an
approxiamation of how the foot should be at midstance .
This can be difficult in the high tone CP patient but most of the time it
improves the quality of the cast we receive. The reason for this may be
that people spend too much time 'chasing' the STJ neutral or maximum talar
neck congruency.
This approach gets rid of the need to add large fore foot platform
balances which result in the positive and negative casts looking very
different.
If a cast is 'balanced' then an extrinsic post of 10 degrees, as Clive had
stated he uses, is applied, will the eversion moment produced as the foot
moves 'off' the rear foot section of the FFO negate what we have tried to
do in the cast or is it an essential part of how FFO's work.
Just a few thoughts based on my experience of creating a CAD/CAM FFO
system that is based on replicating existing POP manufacturing methods -
it has really made me think and question what we do.
Phil
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