alignmentmanual.pdf

8/11/2019 alignmentmanual.pdf

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Alignment of

Prostheses and Orthoses

ORTHOMANUAL

Written by: Markus Thonius OMM / CPO

ICRC - Afghanistan Orthopaedic Workshop 1992This manual may be freely reviewed, abstracted, reproduced or translated, in part or in whole

but not for sale o r for use in conjunction with commercial purposes


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Alignment of Prostheses

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Normal Position

acc. to

Braune - Fischer

Glutaeus

Maximus

QuadricepsFemoris

TricepsSurae

Passive

Passive

Active

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Alignment

Trans - Tibial

short

medium

long

1/2 + 1cm

1/2 1/2

1/2 + 1cm 1/2 1/2

5

1/2

1/2

2/3

1/3

3


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Reaction of a

Trans - Tibial Socket

by increasing

Flexion

5-90

1/2 1/2

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Medio - Lateral

Static Mistakes

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Anterior - Posterior

Static Mistakes

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Hyper

Extension - Flexion

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Alignment

Knee - Disarticulation

10

2/3 1/3

1/3 2/3

5

1/2

8


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Alignment

Trans - Femoral

5

1,5 cm

8-10

10

41/2

1/2

0,5 0,5

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Reaction of a

Trans - Femoral Socket

by increasing

Flexion or Abduction

5-90 45 Abd.

- 10 Add.

1,5 cm

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Alignment

Hip - Disarticulation

1/2 1/2

1/2 1/2

45

1,5 cm

1/2 1/2

Foot

Knee

Hip

10

5- 8

10

4

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Alignment of Orthoses

for

Paraplegic Patients

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Symbols

Centre of Gravity

Joint

Joint - Free Movement

Joint - Fixed

Joint - One Side Resistant Passive

Joint - One Side Resistant Active

Joint - One Side Resistant Passiveas well as Lock

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For Paraplegic Patients arethe same rules of value like

for the static of prostheses

Glutaeus

Maximus

QuadricepsFemoris

Triceps

Surae

Passive

Passive

Active

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Normal Positionof a

Paraplegic Patient( high level )

Hyper Extension

of the

Spinal Cord

Increased Distance gives

increased Standing Stability

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Orthotic Management

ofParaplegic Patients on

Different Spinal Levels

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Deficit

Peronaeus Muscles

Plantar Stiff

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Deficit

Peronaeus Muscles

M. Triceps Surae

M. Quadriceps Femoris

Lock

Dorsal Free

Plantar Stiff

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Deficit

Peronaeus Muscles

M. Triceps Surae


M. Glutaeus Maximus

Lock

Stiff

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Deficit

Peronaeus Muscles

M. Triceps Surae


M. Glutaeus Maximus

Lower Trunk Muscles

Lock

Stiff

Corset

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Thoughts about Stability

> >

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Thoughts about Stability

limit of stability > stabil stabil>stabil

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Reaction of

Kafo'sduring

Heel Strike

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Orthotic Management

of the

Ankle

Model: Model: Model: Model:

PP 8 -10 mm stiff Plantar free Sarmiento free Ferrari plantar free

PP 3 - 4 mm (Dorsal Free)(Plantar Stiff)

8-10

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Orthotic Management

of

Leg Length Discrepancy

1/3 2/3 3/3

1- 1,5

Normal Stand Shoe Raise Plantar Flexion AFO Extension Prosthesis

2-4 cm 5-10 cm 11 - ?

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References

HOHMANN D. - UHLIG R.

Orthopdische Technik; 7. Auflage;

Enke - Verlag; Stuttgart - Germany

BUNDESFACHSCHULE fr Orthopdie - Technik

Orthetik fr Auszubildende der Orthopdie - Technik

Bundesinnungsverband; Verlag Orthopdie - Technik; Dortmund 1991 - Germany

DITTMER K.

Orthesenkonzept nach Dr. Ferrari

Orthopdie - Technik 4/88

KAPANDJI

Funktionelle Anatomie - Untere Extremitt

Keywords: Alignment, Prostheses, Orthoses, Trans, Femoral, Tibial, Knee, Hip,

Disarticulation

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