Dean Walsh wrote:
> 
> >Has anyone had a lot of experience usuing these in children.  Can you give
> >me a more acurate description of them and how they work.  Thanks

Craig Payne replied: 
> They are "shits" of things to get right - they work by brute force on the
> medial side of the foot - so often hurt. HOWEVER - sometimes you have no
> option to use them. We had a 12yr old in clinic recently which seemed like
> the STJ axis was so medial that it was not even located "within" the foot -
> ie pressure on the plantar medial side of the rearfoot PRONATED it - at the
> end of the day the only two realistic options were surgery or a UCBL. - had
> lots of problems with the UCBL - blistering; pain on medial side of
> navicular - BUT the kids back and leg pains went - he can now run again etc.
> 
> Best ref I have on how to make them and how they allegedly work is an oldy
> but worth a look:
> 
> Martin-Colson J & Berglund G: An effective orthotic design for controlling
> the unstable subtalar joint. Orthotics and Prosthetics 38(1)39-49 1979
> 
> There are a number of other refs that that I have, that used UCBL's - but
> they don't have any info on how to make them like the above.
> 
> Kind Regards
> CP

Dean and Craig,

I suspect that "true" UCBL's are used more frequently by Orthopods than
by DPM's.  Many podiatry labs manufacture a modified version of the
UCBL.  It is a cross between a functional orthosis and a UCBL.

The UCBL components are a very deep medial and lateral heel cup (often
in excess of 30 millimeters), a lateral clip (which is an anterior,
lateral extension of the deep heel), and a high medial arch.

The functional orthotic components are a rearfoot post (either with
motion or using a flat rearfoot post to restrict STJ/MTJ motion as much
as possible, intrinsic or extrinsic forefoot correction which supports
osseous deformities of the forefoot such as forefoot varus which can
cause excessive STJ pronation, and a neutral STJ suspension casting
technique which captures the plantar non-weightbearing contour of the
foot.

The modified UCBL can do a remarkable job of improving gait
abnormalities in children provided that the device is indicated to begin
with and that the casting and orthoses are done in a proper manner.

Respectfully,

Jeff



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