waterproof walking aids · orthoses and prostheses restore the body‘s function and thus serve to...

Waterproof walking aids | Ottobock 1

Waterproof walking aidsFor special requirements in wet areas

Information for Practitioners

2 Ottobock | Waterproof walking aids

Quality waterproof walking aids General requirements .......................................... 3

Legal basis ............................................................ 5

Waterproof orthoses ............................................ 7

Waterproof prostheses ....................................... 11 Silicone partial foot prostheses ............................13 Transtibial prostheses ..........................................14 in exoskeletal design ......................................14 in modular design ..........................................14 Transfemoral prostheses in modular design ........17 The 3WR95 Aqualine knee joint .....................17 3R80 prosthetic knee joint .............................19 Genium X3 .....................................................21

Overview ............................................................ 22 Waterproof orthosis components

and order forms ....................................................22 Waterproof orthosis components

and order forms ....................................................25


Waterproof walking aids are essential devices, both for everyday personal hygiene and for participating in healthy activities. However, activities in wet areas present a special challenge for prosthesis and orthosis wearers as well as non-amputees. For example, the walking speed needs to be adjusted. People with physical limitations require devices that are designed to meet their special needs and which they can trust.

Ottobock has optimised and matched together prosthesis and orthosis components specifically for the challenges presented by wet areas.

• Water resistanceThe prosthesis and orthosis components must be permanently resistant to water and corrosion, and contact with chlorine or soap should not impair their functionality.

• SafetySince the risk of slipping is especially high in wet areas, mechanisms for stance phase control are particularly important.

• Natural appearanceSwimwear exposes the prosthesis or orthosis. High expectations are therefore placed on appearance, which should be as natural and discreet as possible.

Quality waterproof walking aidsGeneral requirements


Legal basis

Orthoses and prostheses restore the body‘s function and thus serve to compensate directly for a disability. The German Federal Social Court, in its consistent and established case law, has determined that in such cases compensation for disability must place a person on equal footing with a healthy individ-ual. Meanwhile, the Federal Social Court has also decided that ensuring mobility for people with disabilities in wet areas is a basic need, which as such must be provided for by health insurers. Those cases involved waterproof prostheses. Accord-ingly, prostheses for bathing and swimming must compensate for disability in the same manner as regular day-to-day prostheses do, which are not suitable for wet areas, however:

„Prostheses for swimming and bathing practically compensate for the functional deficit of day-to-day prostheses in wet areas.“ (Federal Social Court decision BSG B 3 KR 19/08 R)

Therefore, there must not be any qualitative difference between day-to-day prostheses and those for wet areas. After all, where would one draw the line when the Federal Social Court has already come down in favour of the widest possible compensa-tion for any functional deficit? This becomes even more apparent in cases where a physician has prescribed specific orthoses for therapeutic purposes and where any orthoses of lesser quality would jeopardise the success of therapy. Orthoses for wet areas must therefore be equal to day-to-day orthoses in terms of quality. Thus, health insurers must provide the insured with the functionally best possible equipment.

This information was compiled by Ralf Müller, a solicitor and barrister specialised in medical law and social law, in Gütersloh, Germany.

Waterproof walking aids are covered by compulsory health insurance

In three appeal proceedings, the German Federal Social Court decided on the question of whether the compulsory health insurance had to supply a leg amputee with a waterproof prosthesis in addition to a running prosthesis. The right to be fitted with a waterproof prosthesis, also known as a bathing or swimming prosthesis, was categorically affirmed by the deciding Senate. The use of a waterproof walking aid is necessary to allow for safe walking and standing in wet areas. A more cost effective, yet equally suitable alternative to a waterproof prosthesis is currently not evident.

BSG (German Federal Social Court), decision dated 25 June 2009, reference numbers B 3 KR 2/08 R, B 3 KR 10/08 R and B 3 KR 19/08 R


Waterproof walking aids are essential devices for orthosis wearers, both for everyday personal hygiene and to partici-pate in healthy activities such as water aerobics.


Waterproof orthoses

Shower aids such as handles or seats are often not found in everyday life, while travelling or at pools, not to mention that showers are frequently too cramped and only accessible via steps.

In wet areas, users depend on an orthosis that is designed for the conditions. The waterproof walking aid should minimise skin contact, be easy to dry, and should be made of antibacterial materi-als. These considerations can of course be influ-enced by the design of the orthosis.

Adequately meeting these requirements has not been possible in orthotics to date. However, new production technologies have made it possible to develop special orthosis joints for wet areas.

For example, carbon fibre technology has been combined with the advantages of plastic injection moulding. The result is a high-strength joint structure made of water resistant material.


The Aqualine orthosis systemSpecial product features

• 17PK1-WR waterproof Carbon IQ knee joint with wedge lock • Concealed lock with pull-release cable for a high level of safety

• 17PA1-WR waterproof Carbon IQ ankle joint • Ankle joint with nine different adjustment and combination possibilities

• Waterproof – function not impaired by chlorine, salt or soapy water

• Resistant to corrosion

• Antibacterial ThermoLyn polypropylene that does not retain water

• Reduced component weight • 17PK1-WR Carbon IQ knee joint: Approx. 120 g weight reduction compared to 17B23.

• 17PA1-WR CarbonIQ ankle joint: Approx. 180 g weight reduction compared to 17B66 (incl. foot stirrup).

• Durability comparable to metal joints through the use of fibre-reinforced high-performance plastic

• The joints are approved for bilateral fittings up to a weight of 100 kg


Multiple waterproof prosthesis components permit users to be active in wet areas without any problems.


Waterproof prostheses

Ottobock has optimised and matched together com-ponents of the modular system specifically for the challenges presented by activities with prostheses in wet areas.

Numerous waterproof prosthesis components such as knee joints, feet and various waterproof parts such as valves, shuttle locks and liners are available. A visually attractive cosmetic solution in the form of the Aqualine cover is offered as well.


Thanks to the use of silicone, we’re able to recreate the colour of the skin surface perfectly, and also capture the smallest details such as small veins, skin pigments or hair.

You can customise the design of the prosthetic socket to ensure a perfect fit, while obtaining even pressure distribution and compression of the residual limb. Thanks to the thin-walled socket design, your users can also wear standard shoes again.


Silicone partial foot prostheses Detailed and functional

“Basic” silicone partial foot prosthesis “Classic” silicone partial foot prosthesis “Natural” silicone partial foot prosthesis

• Individual socket design• Anatomical shape• Silicone foot in one colour• Silicone nails in skin colour• Basic surface structure

• Individual socket design• Individual, anatomical shape• 2–3 individual skin tones, matching the sound side• Detailed surface structure• Custom nail design

• Individual socket design• Individual, anatomical shape• 6–8 individual skin tones, matching the sound side• Detailed surface structure• Custom, multicoloured nail design

Silicone partial foot prostheses from Ottobock Service Fabrication harmonise the gait pattern and contribute to the foot’s natural rollover. Three versions are avail-able, differing only in terms of the outside appearance.


Waterproof transtibial prostheses

The exoskeletal design is a common method for the fabrication of bathing prostheses. Specially designed components such as the 1WR95 prosthetic foot are available for this purpose.

With its grid-shaped sole tread and a special material composition, the 1WR95 features excellent traction. It has a natural shape and a separate big toe.

The selection of waterproof components for the modular design is larger, which means better adaptation to the user’s needs is possible. In addition to structural compo-nents, waterproof prosthetic feet such as the Triton Low Profile and Triton Heavy Duty can be used as well.

Both prosthetic feet are based on the excellent functionality of the 1C60 Triton and set them-selves apart with harmonious rollover charac-teristics and outstanding dynamic response. Thanks to the use of a titanium adapter and corrosion-resistant screws, the 1C64 Triton Heavy Duty and 1C63 Triton Low Profile are especially robust and water-resistant. They are suitable for users with mobility grade 3 and 4 up to a maximum body weight of 150 kg.

• 1WR95 Aqua Foot

• 1C63 Triton Low Profile


Waterproof transfemoral prostheses

3WR95 Aqua-KneeIt is small, lightweight and equipped with a miniature hydrau-lic unit as well as a lock: the Aqua-Knee. The lock can be activated for more security in the stance phase. For use in the unlocked state, it is possible to adjust the dynamic flexion and extension resistances separately from one another for swing phase control according to the individual needs of the user.

6R95 Aqualine CoverDesigned especially for use with the 3WR95 Aqua-Knee and the 1WR95 Aqua-Foot, this attractive cosmetic cover is also suitable for use in water. This is based on the resistant material and the ability to flood the cover. For this reason it does not become buoyant when stepping into water. It drains quickly and unobtrusively via openings on the inside at ankle height. The cover is individually adapted to the patient by Ottobock. • 3WR95 Aqua Knee

• 6R95 Aqualine Cover


Waterproof transfemoral prostheses

3R80 prosthetic knee jointThe 3R80 with its unique rotation hydraulics principle is now also approved for prosthesis wearers with a body weight of up to 150 kg. With the 3R80, both the stance and the swing phase are controlled by the hydraulics. Users can walk down stairs step-over-step and go down inclines with it. The 3R80 closely approaches a physiological gait pattern even at different walking speeds.

Starting with serial number 201330001, the 3R80 is waterproof and can also be immersed in salt water. The newly integrated manual lock also offers improved safety in wet areas and is more comfortable when standing for extended periods. In combination with the 1C63 Triton Low Profile and 1C64 Triton Heavy Duty, it constitutes an ideal waterproof walking aid for highly active prosthesis wearers.

• 3R80 prosthetic knee joint


The water and corrosion resistance of the Genium X3 is impressive. Selected materials such as titanium, hard anodised aluminium, stainless steel and high-end coatings, combined with specially sealed components, protect the joint’s sensitive sensor technology and electronics.

Showering, swimming, playing at the pool with the kids or working in wet conditions – the Genium X3 opens up possibilities that until now were unthinkable.

Genium X3Reclaim all you want to be.

• 3B5-2 Genium X3


501S84=M4x8 stainless steel

screw

605P8=20 aluminium splint coated with 618T40=* sintering powder

170Z4=* loop strap with 170D21=*

Y-hook and loop and micro hook and loop

(removable for drying)

17PK1=L/R20-WR waterproof

Carbon IQ knee joint616T420=* antibacterial ThermoLyn (PPH)

17PA1=20-WR waterproof Carbon IQ ankle joint

17PF1 foot stirrup 29F18=* double vacuum-formed foot component

with sole

17PK1-WR waterproof Carbon IQ knee joint

with wedge lock

17PA1-WR waterproof Carbon IQ ankle joint

• Concealed lock with pull-release cable for a high level of safety

• User-friendly• Lightweight• Used in pairs• Reinforced plastic• Max. body weight

100 kg

• Ankle joint with nine different adjustment and combination possibili-ties

• Lightweight• Used in pairs• Reinforced plastic• Max. body weight

100 kg

Overview Waterproof orthosis components

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1 / 2

ContactCustom

er num

berDate

ContactCustom

er num

berDate

Aqualine orthosis systemFax order to: +49 5527 848-1585

Padding dumm

y

Prepare the orthosis directly on the positive model, w

ithout allowing for any padding distance.

The model is shaped w

ithout padding distance. Please take into account a padding distance for the:

Thigh

of m

m

Low

er leg of

mm

Foot of

mm

Joints

Knee joint: yes

17PK1=L20-WR

no 17PK1=R20-W

RAnkle joint:

yes 17PA1=20-W

R

no

Sole

Rollover

without

Dynamic

Spring stiff ness

resistance Partial foot

1 soft 2

3 4

5 6 stiff

characteristics:

1 soft

3

5 6 stiff

Heel:

Example sketch: K

AFO

with stiff heel bedding

Closures

(Please mark closure positions on the plaster m

odel.)

On foot

Number:

unitsOn low

er leg

Number:

unitsOn thigh

Num

ber: units

Comm

ents:

Prepreg splints

Thermo-

plastic "PE" sleeves

Prepreg foot part with

anti-slip "rubber sole"

2 / 2

Date

............................................................................ Place ................................................................................................................................ Signature

.........................................................................................................................................


Overview Waterproof prosthesis components

Recommendations for selecting adapters• For transfemoral fittings with the 3WR95, we recommend using the

4WR95=1 lamination anchor. In this case, the connection to the knee joint is formed directly by the lamination anchor. Gaps that may need to be bridged must be closed by filling the socket with foam.

• The 4WR95=1 is only suitable for use in the thigh area.

• We recommend using the 2WR95=1 angled tube adapter to achieve the full range of adjusting options for bench alignment of the waterproof walking aid using the 1WR95 Aqua-Foot on 0 mm heel height, according to the Ottobock alignment recommendations.

i

Adapters

Article number 2WR95 2WR95=1 4WR95=1 4WR95=2 4WR95=3Designation Tube adapter Tube adapter,

angledLamination anchor with pyramid receiver and offset arm

Lamination anchor with pyramid adapter

Tube clamp adapter

Diameter 34 mm 34 mm - - 34 mmSystem height - - 44 mm 2 mm 33 mmMin. system height 77 mm 78 mm - - -Max. system height 472 mm 473 mm - - -Weight 330 g 330 g 165 g 165 g 105 gAngle - 6° - - -Material Titanium Titanium INOX1 INOX1 TitaniumMax. body weight 150 kg 150 kg 150 kg 150 kg 150 kg

1 Stainless steel

Article number 4R119=T 4R119=NTDesignation Lamination anchor

with threaded connector

Lamination anchor with pyramid receiver

System height 13 mm 44 mmWeight 80 g 165 gMaterial INOX1 INOX1

Max. body weight 150 kg 150 kgField of application In transfemoral

prosthesesIn transfemoral prostheses


Overview Waterproof prosthesis components

Structural components

6A30=20 Shuttle Lock 21Y14 Push Valve

• Lightweight design• Integrated locking unit

makes it easy to unlock even under tension

• Continuous locking without “clicking” noises while walking

• For use with the 6Y43 Skeo Pure liner

• Threadless design/ easy to use

• Audible signal indicates safe position of the valve

6Y43 Skeo Pure

Article number 6Y43Connection with distal connectionWall thickness from approx. 4.5 mm

distally, tapering to 2.5 mm proximally

Sizes (in mm, see also distal circumference)

120, 140, 160, 180, 200, 210, 220, 235, 250, 265, 280, 300, 320, 340, 360, 380, 400, 420, 450

Order example

Article no. = Size

6Y43 = 280

• Durable transparent silicone liner with distal connection

• Thin-walled, making it flexible and easy to don and doff

• In waterproof walking aids, use only in combination with the 6A30=20 Shuttle Lock

• Textured inner surface that avoids the residual limb skin is irritated and hair gets caught in the liner


Overview of waterproof prosthesesMechanical knee joints

3WR95 Aqua Knee

Article number 3WR95Weight approx. 400 gSystem height 62 mm

Proximal system height up to the alignment reference point

6 mm

Distal system height up to the alignment reference point

56 mm

Knee flexion angle 135°Proximal connection Pyramid adapter

Distal connection Tube clamp ⌀ 34 mm

Max. body weight 150 kg

3R80 knee joint

Article number 3R80 3R80=STWeight 1240 g 1255 gSystem height 163 mm 179 mm

Proximal system height up to the alignment reference point

28 mm 44 mm

Distal system height up to the alignment reference point

135 mm

Knee flexion angle 150°Proximal connection Pyramid adapter Threaded connector

Distal connection Tube clamp ⌀ 34 mm

Tube clamp ⌀ 34 mm

Max. body weight 150 kg 150 kgMobility grade 3 + 4 3 + 4

For further information, please refer to the 647G403=1 instructions for use

i


1WR95 Aqua Foot

Article number 1WR95Heel height 0 mmSides left (L), right (R)Sizes 24 cm 25 cm 26 cm 27 cm 28 cmSystem height with adapter 61 mm 64 mm 67 mm 70 mm 72 mmWeight with adapter ~ 507 g ~ 556 g ~ 629 g ~ 671 g ~ 704 gStructural height without adapter 72 mm 75 mm 78 mm 81 mm 83 mm

Weight without adapter ~ 437 g ~ 486 g ~ 559 g ~ 601 g ~ 634 gMax. body weight 150 kgColours beige (4)

Ordering example 1WR95 Aqua-Foot

Article no. = Side Size - 0 - Connection / Colour

1WR95 = L 26 - 0 - W / 4 Version for exoskeletal design

1WR95 = L 26 - 0 - P / 4 Version with adapter for modular design

Overview of waterproof prosthesesProsthetic feet

1C63 Triton Low Profile 1C64 Triton Heavy Duty

Article number 1C63 1C64Heel height 15+/-5 mm and 10+/-5 mm 15+/-5 mm and 10+/-5 mmSides left (L), right ( R) left (L), right ( R)Sizes 21 – 30 cm 21 – 30 cm System height 35 – 55 mm 116 – 156 mmWeightwithout footshell 300 – 555 g 430 – 615 g

Stiffness 1 – 5 1 – 5Max. body weight up to 150 kg up to 150 kgColours beige (4), light brown (15) beige (4), light brown (15)Instructions for use 647G823 647G824For exact product information, please see the 646K2 catalogue

Ordering example 1C63 Triton Low ProfileArticle no. = Side Size - Stiffness - P / Colour Shape1C63 = L 27 - 3 - P / 4 N

Ordering example 1C64 Triton Heavy DutyArticle no. = Side Size - Stiffness - P / Colour Shape1C64 = L 27 - 5 - P / 4 N

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1C64 Triton Heavy Duty

Order fax no.: +49 5527 848-1414

Selection table

SizeB

ody weight

21 cm22 cm

23 cm24 cm

25 cm26 cm

27 cm28 cm

29 cm30 cm

up to 55 kg

11

11

11

––

––

56 –

75 kg 2

22

22

22

22

2

76 – 100 kg

33

33

33

33

33

101 – 125 kg

––

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44

44

4**4**

126 – 150 kg

––

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55

5*5*

5*5*

Order exam

ple1C

64=R27-3-P/4N

SideRight

RLeft

L

Size [cm]

21, 22, ..., 30ColourB

eige4

Light brow

n15

Foot shapeN

ormal

NSlim

S

Ordering a 1C

64 Triton Heavy D

uty includes a Spectra protective sock, a set of 2F60 heel w

edges and the 2C6 functional footshell.

Slim footshell available

(15 mm

heel height)B

oth footshells availableN

ormal footshell available (10 m

m)

Quantity

Article num

berQ

uantityA

rticle number

Additional com

ponents

Quantity

Article no.

SideSize

-Stiffness

-P

/Colour

Shape

1C64=

-P

/

1C64=

-P

/

Customer

Shipping address (if diff erent from custom

er address)

Customer no.

Customer no.

Company

Company

StreetStreet

Postal code/cityPostal code/city

Orthopaedic technicianSales person

* W

hen combining this configuration w

ith the C-Leg, please contact O

ttobock Custom

er Service. ** W

hen combining this configuration w

ith the C-Leg or C

-Leg compact, please contact O

ttobock Custom

er Service.

Date

............................................................................ Place ................................................................................................................................ Signature

.........................................................................................................................................


Waterproof and attractive Aqualine Cover

With the Aqualine Cover, Ottobock is offering a natural cosmetic solution for waterproof transfemoral modular pros-theses.It is specially designed for use with the 3WR95 Aqua-Knee and the 1WR95 Aqua-Foot and can be obtained exclusively via the service production department of Otto Bock HealthCare Germany GmbH.

With the Aqualine Cover, the different base sizes are customised to the indi-vidual user and the calf component is coated with SuperSkin. This coating is water-resistant and provides the cover with a very appealing surface.

The cover consists of a proximal and a distal connecting part, both of which are fully or partially covered by a calf component that is simultaneously impact-resistant and flexible. The plug connection between the calf component and the distal connecting part gives the cover sufficient flexibility to compensate for user-specific alignment. The Aqual-ine Cover can be donned and doffed by the user making it easy to clean, too.

• Modular construction of the cover

Use

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dat

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____

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Mea

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24S

(330

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____

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(37

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____

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____

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____

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(410

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____

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(410

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____

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Furt

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com

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(mod

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des

ign)

Incl

ude

com

pone

nts

C

ompl

ete

asse

mbl

y

6

35Z5

6 Su

pers

kin

repa

ir se

t

6Y4

3= S

keo

Pure

___

____

(siz

e)

or

21Y

14 P

ushV

alve

2

1Y21

Clic

kVal

ve

6A3

0=20

Shu

ttle

Lock

4W

R95=

1 la

min

atio

n an

chor

with

pyr

amid

rece

iver

4

WR9

5=2

lam

inat

ion

anch

or w

ith p

yram

id a

dapt

er

3W

R95

Aqua

-Kne

e

4W

R95=

3 tu

be cl

amp

adap

ter

2W

R95

tube

ada

pter

2W

R95=

1 tu

be a

dapt

er, o

ff set

1W

R95=

Aqu

a-Fo

ot (w

ith p

yram

id co

nnec

tor)

Side

: le

ft ri

ght

Foot

size

: ___

____

Knee

axis

–

heel

(460

– 5

60 m

m)

Knee

axis

– fo

ot

atta

chm

ent s

urfa

ce

Aqua

line

Cove

r Mea

sure

men

t For

mFa

x ord

er to

: +49

552

7 84

8-15

85

Cont

act

Cust

omer

nu

mbe

rDa

te

Cust

omer

Ship

ping

add

ress

(if d

iff er

ent f

rom

cust

omer

add

ress

)

Com

pany

Firm

a

Stre

etSt

raße

Post

al co

de/

city

Post

al co

de/

city

Sale

s per

son

Tele

phon

e

Dat

e ..

......

......

......

......

......

......

......

......

......

......

......

......

.. P

lace

.......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

. Si

gnat

ure

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

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Fax order form Aqualine

Fax order to: +49 5527 848-1414

Com

ponents for modular design

Designation

Article num

berQ

uantity

Silicone liner6Y40 = _______ Size

Shuttle Lock6A30=20

oder

1C

lickValve21Y21

2Lam

ination anchor with

pyramid receiver

4WR95=1

3Lam

ination anchor with

pyramid adapter

4WR95=2

4M

odular knee joint3W

R95

5Tube clam

p adapter4W

R95=3

6Tube adapter

2WR95

7Tube adapter, angled

2WR95=1

8Foot (w

ith pyramid connector)

1WR95=

Side: left

right

Foot size:

Colour:

4 beige

Please order the cosmetic cover w

ith a separate order form.

Our custom

er service department w

ill be glad to answer any questions you m

ay have. T (0049) 05527 848-3411.

1

23

4567

8

Customer


er address)

Customer no.

Customer no.

Company

Company

StreetStreet


Orthopaedic technicianSales person

Date ......................................................... Place ............................................................................................... Signature .....................................................................................................

Cont

act

Cust

omer

nu

mbe

rDa

te

Silic

one

parti

al fo

ot p

rost

hesi

sM

easu

rem

ent s

heet

Mea

sure

men

ts (i

n m

m)

Res

idua

l lim

bPl

aste

rM

odel

OT

Otto

bock

Bow

-sha

ped

circ

umfe

renc

e(b

elow

med

ial a

nd la

tera

l ank

le ti

p)m

mCi

rcum

fere

nce

heel

/bac

k of

foot

(h

-mea

sure

men

t)m

mH

oriz

onta

l res

idua

l lim

b ci

rcum

fere

nce

an b

reite

ster

Ste

llem

mm

-l w

idth

mea

sure

men

t be

low

the

late

ral a

nkle

mm

Over

all r

esid

ual l

imb

leng

thm

m

Circ

umfe

renc

e (m

m)

Res

idua

l lim

bPl

aste

rM

odel

To b

e fil

led

out b

y pro

sthe

tist

To b

e fil

led

out b

y Otto

bock

Littl

e to

e –

big

toe

ball

Littl

e to

e ba

ll –

big

toe

ball

Circ

umfe

renc

e in

fro

nt o

f ins

tep

Inst

ep ci

rcum

fere

nce

Over

all f

oot l

engt

h in

mm

:

Com

men

ts:

ContactCustom

er num

berDate

Customer


er address)

Company

Company

StreetStreet


E-mail

Telephone

Patient ID

Silicone partial foot prosthesisO

rder form

Age:

Gender: fem

ale m

ale H

eight:

Weight:

Aff ected side: left

right Activity level:

1 2

3 4

Configuration

88A

31=2 trial prosthesis

88A31=1 defi nitive prosthesis “Basic” – colour code per 89D4

88A

32=1 defi nitive prosthesis “Classic”

88A32=3 defi nitive prosthesis “Natural”

Silicone toenails (one colour)

88A

32=S silicone toenails (multicoloured)

88A

32=A acrylic toenails

For the “Classic” and “Natural” versions,

the following are also required:

Colour determ

ination sheet

Photos with photo background (647F285=D)

Cast of contralateral side

Diagnosis

Accident

Diabetes

Dysm

elia

Other

Leg length discrepancy

Accompanying diseases

1

23

4

< 75

< 100< 125

> 125

m°

kg

Comm

ents:

Cont

act

Cust

omer

nu

mbe

rDa

te

Colo

ur d

eter

min

atio

nU

se p

en to

mar

k sk

in c

olou

rs o

n th

e sk

etch

Colo

ur s

ampl

e –

colo

ur s

tren

gth

IVIII

*II

IPe

nCo

lour

sam

ple

Colo

ur st

reng

th

1 2 3 4 5 6 7 8 Mod

el b

lood

ves

sels

: y

es

no

* Thi

ckne

ss II

I is

reco

mm

ende

d fo

r the

prim

er.

Nai

ls A

cryl

ic

Sili

cone

Nai

l len

gth

Lik

e ph

oto

mm

long

er

Silic

one

parti

al fo

ot p

rost

hesi

sC

olou

r det

erm

inat

ion

shee

t

Colo

ur

Nail

tipDi

stal

edg

eCe

ntra

lPr

oxim

al e

dge

Moo

n

Gene

ral f

ax o

rder

form

Fax o

rder

to: +

49 5

527

848-

1414

Art

icle

num

ber

Des

igna

tion

Qua

ntity

Dat

e ...

......

......

......

......

......

......

......

......

...... P

lace

......

......

......

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......

......

......

......

......

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......

......

......

......

..... S

igna

ture

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

......

.....

Cust

omer

Ship

ping

add

ress

(if d

iff er

ent f

rom

cust

omer

add

ress

)

Cust

omer

no.

Cust

omer

no.

Com

pany

Com

pany

Stre

etSt

reet

Post

al co

de/c

ityPo

stal

code

/city

Orth

opae

dic t

echn

icia

nSa

les p

erso

n

© O

ttobo

ck ·

646D

810=

EN-0

2-16

01 ·

Tech

nica

l mod

ifica

tions

and

prin

ting

erro

rs re

serv

ed.

www.ottobock.com

waterproof walking aids · orthoses and prostheses restore the body‘s function and thus serve to...

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