hanger pdr

Physician’s Desk RefeRenceProsthetics & orthotics

The strength that comes from 150 years of providing prosthetic and orthotic services combined with a commitment to superior care and innovative technology is what sets hanger apart.

Understanding a patient’s needs and experiences is deeply rooted in hanger’s way of doing business. in 1861, James edward hanger became the first amputee of the civil War. When a satisfactory solution to help him walk again was not available, he fashioned an artificial leg for himself—a device constructed of barrel staves and a hinge at the knee. hanger’s ingenuity and desire to help other wounded veterans became the foundation for the company that today provides individualized prosthetic and orthotic care for hundreds of thousands of patients at more than 600 facilities nationwide.

The specialized care programs offered by hanger are designed around the needs of the patient and are able to meet the challenges of the most complex cases. staffed by some of the world’s leading prosthetic and orthotic practitioners, each program delivers the best and most comprehensive plan for care.

The hanger Difference

Hanger prostHetics & ortHotics

inTRoDUcTion

www.Hanger.com 1

What could be better for a patient than the personalized service and attention of a local practice combined with the resources of the nation’s leading orthotic and prosthetic company in the world? This is what hanger offers every patient.

each hanger practice is locally operated under the direction of a board-certified practice manager ensuring individualized care and attention. Practitioners work closely with patients, physicians and the entire rehabilitation team to develop the best plan of treatment and support. The added benefit of a national network of internationally-renowned professionals available for consultation provides an unparalleled level of clinical expertise.

hanger believes continuing education and training is critical to providing excellent service. every hanger practitioner is required to participate in annual training programs on subjects ranging from the latest technological advancements to compliance issues. as a result, hanger practitioners are some of the most highly-trained in the industry.

and if a patient should move or travel, hanger’s extensive network of care centers—nearly 600 nationwide—offers quality continuum of care throughout their lives.

hometown care. nationwide Resources.


inTRoDUcTion

Upper extremity Prosthetics Program: hanger’s Upper extremity Prosthetics Program is the largest and most reputable in the world. compared to the average independent prosthetic clinic, which only sees one or two cases a year, hanger sees hundreds of upper extremity cases each year. Because of this, hanger is able to bring world-class expertise and experience to a very specialized field.

Lower extremity Prosthetics Program: hanger’s Lower extremity Prosthetics Program provides patients with the most advanced and clinically appropriate technology to help them meet their goals and regain independence. hanger practitioners are especially skillful dealing with patients who have complex amputations or fitting needs.

orthotics Program: The specialties of hanger’s orthotics Program span from complex bracing systems to splints and foot orthotics, to cranial helmets and mastectomy services.

These specialized programs, combined with our cutting edge technologies, such as the comfortflex socket system™, insignia™ and the Walkaide® system, have propelled hanger to the forefront of the industry.

The hanger Difference

inTRoDUcTionHanger prostHetics & ortHotics

2 877-4Hanger www.Hanger.com 3

insignia™, hanger’s exclusive 3D laser imaging system, easily and comfortably creates a precisely fit, customized prosthesis or orthosis. This alternative to plaster molding ensures a more accurate fit, creates permanent patient records and assists in documentation for medical or insurance needs.

The insignia™ logo throughout this guide indicates products made using the insignia™ system.

This prosthetic and orthotic product guide is intended to be used only as a reference. While comprehensive in scope, every product currently on the market could not be included. additionally, because technology is constantly evolving, the products shown are subject to change.

it is the responsibility of the prescribing physician to select the correct device which will meet the needs of a patient. consultation with a board-certified prosthetist or orthotist helps ensure that the most appropriate product is prescribed.


inTRoDUcTion

hanger was founded on clinical innovation and since its beginning has been a leader in introducing state-of-the-art prosthetic and orthotic components to patients. hanger continues to develop innovative technology only available through hanger practitioners.

The patented comfortflex™ socket system sets a new standard in socket technology. The comfort flex™ gives the user maximum comfort by incorporating the unique shape of the residual limb with channels and grooves that support the underlying anatomy. The result is a socket that provides maximum comfort and promotes muscle growth and better circulation for the residual limb.

hanger’s latest innovation, the Walkaide®, gives unprecedented mobility to people who have had a stroke or suffer from multiple sclerosis, spinal cord injuries, traumatic brain injuries or cerebral palsy. This fDa cleared device uses functional electrical stimulation to produce a safer and more natural gait.

innovative Technology innovative Technology

inTRoDUcTionHanger prostHetics & ortHotics


orthotics

9 spinal orthoses

21 Lower extremity orthoses

59 Pediatric orthoses

73 Upper extremity orthoses

83 Mastectomy

6 877-4Hanger 7www.Hanger.com

sPinal orthoses

10 soft cervical collar

10 Philadelphia cervical collar

11 Rigid Two Piece/Bivalve cervical collar

11 Miami JTo cervical orthosis

12 Minerva cervical orthosis

12 soMi cervical Thoracic orthosis

13 cTLso (cervico-Thoraco-Lumbo-sacral-orthosis)

13 cervical halo

14 spinomed

14 Thoracolumbar corset/support

15 hyper-extension orthosis

15 cash (cruciform anterior spinal hyper-extension) orthosis

16 Wrap around–Boston style TLso

16 custom TLso (Thoraco-Lumbo-sacral orthosis) Body Jacket

17 custom soft TLso (Thoraco-Lumbo-sacral orthosis)

17 custom Lso (Lumbo-sacral orthosis) Body Jacket

18 chairback orthosis

18 Lso (Lumbo-sacral orthosis) Pull cord Design

19 Lumbosacral corset

19 elastic Lumbosacral Binder

20 si (sacroiliac) orthosis


ortHotics

– DX: cervical and high thoracic injuries, stable fractures, post-operative stabilization, degenerative pathologies, arthritis

– Restricts flexion, extension, lateral bending

– X-ray, cT, and MRi compatible components

– Rigid Miami J collar combined with thoracic extension for additional control and stabilization

– Rigid plastic two piece frame with bivalve opening, Velcro closures and removable inner lining

– Removable inner lining can be washed and/or replaced

– available in varying heights and neck circumferences

Rigid Two Piece/Bivalve cervical collar

Miami JTo cervical orthosis

sPinaL oRThoses

– DX: Post-operative stabilization, stable cervical fractures, degenerative pathologies, arthritis


– X-ray, cT, and MRi compatible components

– Rigid plastic two piece frame with bivalve opening, Velcro closures and removable inner lining

– Removable inner lining can be washed and/or replaced

– available in varying heights and neck circumferences

– aka: Miami J, aspen

– DX: Mild cervical sprain, strain, whiplash, muscular weakness

– soft foam collar offers support and some limitations of flexion, extension, lateral bending

– hook and loop Velcro closures

soft cervical collar

sPinaL oRThoses

– DX: Post-operative stabilization, stable cervical fractures, degenerative pathologies


– Latex free, non toxic, hypo-allergenic

– Plastizote two piece bivalve design with hook and loop Velcro closures

– Water resistant, can be used in the shower, bathing and aqua therapy

– available in varying heights and circumferences

Philadelphia cervical collar

ortHotics


ortHotics

– DX: Unstable cervical fractures, post-operative stabilization

– Two piece thoracic vest with lambs wool liner, rigid super structures, buckle closures, and cPR break for emergent issues, traction bar optional

– MRi compatible– sterilized ring, skull pin,

and application kit

– available in pediatric and adult sizes x-small thru xx-large

cTLso (cervico-Thoraco-Lumbo-sacral-orthosis)

cervical halo

sPinaL oRThoses

– DX: Low cervical and thoracic fracture or injury management, stable fractures, post-operative stabilization, arthritis, degenerative pathologies

– Rigid plastic exterior shell with soft aliplast lining, closed cell foam does not absorb moisture, water resistant

– Bivalve design with mandibular and occipital extension modified to accommodate varying anatomical alignment

– custom-made to patient model

– DX: Low cervical and high thoracic fracture or injury management, stable fractures, post-operative stabilization, arthritis, degenerative pathologies

– Two piece design restricts flexion, extension, lateral bending

– Mandibular and occipital extensions modified to accommodate varying anatomical alignment

– available in pediatric and adult sizes small thru large

Minerva cervical orthosis

sPinaL oRThoses

– DX: Low cervical and high thoracic fracture or injury management, stable fractures, post-operative stabilization, arthritis, degenerative pathologies

– Mandibular and occipital extensions modified to accommodate varying anatomical alignment

– anterior design allows supine donning


soMi (sub-occipital Mandibular immobilization) cervical Thoracic orthosis

ortHotics


ortHotics

– DX: Thoracic and lumbar compression fractures, post-operative stabilization, osteoporosis

– Restricts flexion– Rigid cross-shaped

metal design with three point biomechanical stabilization, adjustable horizontal and vertical bars

– optional articulated sternal and pubic pads

– available in pediatric and adult sizes x-small thru x-large

hyper-extension orthosis

sPinaL oRThoses

– DX: Thoracic and lumbar compression fractures, post-operative stabilization, osteoporosis

– Restricts flexion and lateral bending

– Rigid metal frame design with three point biomechanical stabilization, adjustable horizontal and vertical bars

– available in pediatric and adult sizes x-small thru x-large

– aka: Jewett, 3-point hyper-extension orthosis

cash (cruciform anterior spinal hyper-extension) orthosis

– DX: Thoracic and lumbar compression fractures, hyper-kyphosis, chronic back pain, osteoarthritis

– Low profile design aids to decrease pain and increase patient mobility

– Velcro closures for ease of donning/doffing

spinomed

sPinaL oRThoses

– DX: Thoracic and lumbar chronic back pain, osteoarthritis

– available in cotton and nylon designs, Velcro or hook and eye anterior closures, optional removable moldable metal stays

– Padded adjustable shoulder straps

– available in sizes x-small thru xx-large or sized to hip and waist circumference measurements

Thoracolumbar corset/support

ortHotics


ortHotics

– DX: Lumbar fracture management, post-operative stabilization, spinal stenosis, degenerative pathologies

– Restricts flexion, extension, and lateral bending


– available with bivalve or one piece design

– available in off-the-shelf stock sizes or custom-made to patient model

– aka: Body jacket, turtle shell brace

custom soft TLso (Thoraco-Lumbo-sacral orthosis) Body Jacket

custom Lso (Lumbo-sacral orthosis) Body Jacket

sPinaL oRThoses

– DX: Thoracic and lumbar fracture management, post-operative stabilization, spinal stenosis, degenerative pathologies

– semi-rigid foam exterior with soft aliplast lining, and rigid internal or external frame closed cell foam does not absorb moisture, water resistant




– aka: soft body jacket, turtle shell brace

– DX: spondylolisthesis, lysis, losis, post-operative stabilization, disc herniation


– Wrap around plastic design with anterior Velcro closures provides maximum abdominal compression for biomechanical control

– Rigid posterior stays available for additional stabilization


Wrap around–Boston style TLso (Thoraco-Lumbo-sacral orthosis)

sPinaL oRThoses

– DX: Thoracic and lumbar fracture management, post-operative stabilization, spinal stenosis, degenerative pathologies





– aka: Body jacket, turtle shell brace

custom TLso (Thoraco-Lumbo-sacral orthosis) Body Jacket

ortHotics


ortHotics

– DX: Low back pain, lumbar stenosis, post-operative stabilization, lumbar strains/sprains

– flexible elastic binder with optional moldable rigid posterior panel

– single or double pull Velcro anterior closure options

– available in xx-small thru xx-large sizes

Lumbosacral corset

elastic Lumbosacral Binder

sPinaL oRThoses


– Washable cotton construction with removable moldable metal stays

– Velcro, hook and eye, anterior closure options

– available in men’s and women’s styles, sized to waist and hip circumference

– DX: Low back pain, lumbar stenosis, post-operative stabilization, lumbar strains/sprains, disc herniations

– Rigid anterior and posterior frame design with abdominal compression panel

– Pulley system available– Lightweight, breathable

design

– available in sizes x-small thru x-large

chairback orthosis

sPinaL oRThoses


– Pull cord design for optimal abdominal compression and ease of donning

– Two and three piece designs, available with rigid abdominal and posterior panels

– available in men’s and women’s sizes x-small thru xx-large

– aka: california compressor, cybertech, DonJoy Boa, aspen Lso, aspen Quick Draw

Lso (Lumbo-sacral orthosis) Pull cord Design

ortHotics


lower extremity orthoses

Foot orthoses

24 accommodative foot orthosis

24 Medicare accommodative foot orthosis

25 functional foot orthosis

25 UcBL foot orthosis

shoes and cast boots

26 healing shoe

26 surgical cast shoe/Boot

26 Pressure Relief shoe/Boot

27 answer 2 shoes

27 extra Depth shoes

27 custom shoes

ankle Foot orthoses (aFo)

28 fracture Walking Boot

28 Mid-calf fracture Boot

28 Pressure Relief afo

29 Lace-Up ankle orthosis

29 Lace-Up ankle orthosis with stays

29 air stirrup ankle orthosis

30 articulated ankle orthosis

30 Plantar fasciitis night splint

31 off-the-shelf Posterior Leaf spring afo

31 carbon fiber Dynamic afo

32 custom articulated ankle orthosis

32 Molded Leather ankle Gauntlet

33 Double Upright Metal afo (ankle foot orthosis)

– sacroiliac dysfunction– Wrap around Velcro closure

belt design– Latex free– available in sizes 30”

thru 60”– aka: si Belt

si (sacroiliac) orthosis

sPinaL oRThosesortHotics

continued



43 Townsend Premier

43 cTi—innovation sports

44 Breg X2k

44 DonJoy Defiance

osteoarthritis (oa) knee orthoses

45 Generation ii

45 V-Vas anatomical concepts

46 DonJoy oa everyday

46 DonJoy oadjuster

47 DonJoy Defiance oa

47 Breg X2k counterforce

knee ankle Foot orthoses (kaFo)

48 knee ankle foot orthosis (kafo)

49 Laminated knee ankle foot orthosis (kafo)

50 stance Phase Locking (sPL) kafo—fillauer

51 stance control knee orthotic Joint (sckoJ) kafo—horton

52 e-knee stance control kafo— Becker

53 freeWalk stance control kafo— ottoBock

54 UTX stance control kafo— Becker

hip orthoses

55 hip abduction orthosis

hip knee ankle Foot orthoses

56 hip knee ankle foot orthosis (hkafo)

reciprocating gait orthoses

57 Reciprocal Gait orthosis (RGo)


33 neuropathic Walking Boot (cRo)

34 custom Posterior Leaf spring afo

34 custom semi-solid afo

35 custom solid ankle afo

35 custom articulated afo

Fracture orthoses

36 Patellar Tendon Bearing orthosis (PTBo)

36 Tibial fracture orthosis

37 femoral fracture orthosis

contracture orthoses

37 ankle foot contracture orthosis

38 knee ankle foot contracture orthosis

38 knee contracture orthosis

knee orthoses

39 knee immobilizer

39 Post-op knee orthosis

40 Post-op knee orthosis

40 Bledsoe Post-op knee orthosis

40 elastic knee sleeve

41 neoprene Patellar stabilizing knee sleeve

41 Lateral J Buttress knee orthosis

41 hinged Patellar stabilizing knee orthosis

42 hanger select knee orthosis

42 Breg X2k oTs

42 hinged neoprene knee orthosis

43 hinged neoprene knee orthosis


Lower extremity ortHoses

– DX: hyper-prontation, posterior tibial tendon dysfunction, tibial tendonitis

– semi-rigid orthosis encompassing medial and lateral borders of the calcaneous, may include navicular, fabricated from plastic (polypropylene designs)

– fabricated in non or semi weight bearing positions to achieve neutral or functional alignment (subtalar neutral alignment)


functional foot orthosis

fooT oRThoses

– DX: Biomechanical insufficiencies, plantar fasciitis, hyper pronation/supination, neuromas, metatarsalgia,

– Multi-density semi-rigid or rigid orthosis inclusive of plastic (polypropylene variations) and carbon fiber designs

– fabricated in non, semi and full weight bearing positions to achieve neutral or functional alignment (subtalar neutral alignment)


UcBL foot orthosis

– DX: Diabetes, vascular and sensory insufficiencies

– Multi density semi-rigid orthosis


– non-Medicare patients

accommodative foot orthosis

fooT oRThoses

– DX: Diabetes, vascular and sensory insufficiencies

– Multi-density semi-rigid orthosis


– Medicare compliant

Medicare accommodative foot orthosis



shoes anD casT BooTsLower extremity ortHoses

– DX: accommodative shoes for orthotic designs i.e. UcB, afo, kafo and custom foot orthoses

– contemporary styled shoes with removable multi-layer inserts

– Wide, extra depth toe box for increased comfort and reduction of shear/pressure forces

– available in pediatric and adult sizes

– DX: Diabetes, vascular and sensory insufficiencies, biomechanical instabilities, also used in conjunction with accommodative/functional foot orthoses, orthotic designs i.e. UcB, afo, kafo.

– available with lace and Velcro closures, plastizote foam lining

– available in sizes 6.5 thru 16– aka: Diabetic shoes

extra Depth shoes

– DX: acquired and congenital foot deformity, charcot, amputations

– available in multiple styles, colors, lace and Velcro closures

– Made from semi-weight bearing cast or insignia 3D scan of the patient’s feet

custom shoes

answer 2 shoes– DX: stable fractures, ulcers,

post-operative management– Provides immobilization of

the forefoot, metatarsals, and toes

– available in sizes small (size 4) thru x-large (size 14)

– Wedged sole with non-skid shock absorbing surface and nylon mesh upper

– aka: fracture boot, off loading or pressure relieving shoe

shoes anD casT BooTs

– DX: stable fracture, soft tissue injury, post operative management

– Provides immobilization of the forefoot, metatarsals, and toes

– non-skid sole with nylon mesh upper

– available in sizes x-small thru large

– aka: Darco shoe

surgical cast shoe/Boot

– DX: Plantar surface ulcers, skin breakdown and/or irritation

– Removable shock absorbing segments, removable toe piece, soft mesh upper

– Velcro closure– available in sizes small (size

6) thru x-large (size 14)– aka: Puzzle shoe

Pressure Relief shoe/Boot

Lower extremity ortHotics

healing shoe


ankLe fooT oRThoses (afo)Lower extremity ortHoses

– DX: Medial and lateral ankle instability

– Bilateral semi-rigid inserts provide additional medial and lateral support.

– available in women’s sizes: 6 thru 12, mens: 7 thru 13

– Lace up design allows for increased stability and ease of donning

– aka swede o


– Bilateral low profile molded ankle stays combined with adjustable nylon “figure 8” straps provide additional stability and support

– available in women’s sizes: 6 thru 12, mens: 7 thru 13

– aka: figure 8 ankle orthosis

Lace-Up ankle orthosis with stays

– DX: Medial and lateral ankle instability, ankle sprains/strains

– anatomical medial and lateral pre-inflated air struts provide stability and patient comfort

– Graduated compression available

– available in pediatric and adult sizing

– aka: aircast ankle splint

air stirrup ankle orthosis

Lace-Up ankle orthosis– DX: stable fracture, soft

tissue injury (grade 2 or 3 sprain) post-operative management

– Provides ankle and foot immobilization

– Plastic or aluminum uprights, solid or controlled range of motion ankle joint, pneumatic or static options


– aka: Walker boot, caM walker

ankLe fooT oRThoses (afo)

– DX: stable fracture, soft tissue injury (grade 2 or 3 sprain) post operative management


– Plastic or aluminum uprights, solid or controlled range of motion ankle joint


– aka: short walking boot

Mid-calf fracture Boot

– DX: heel ulcerations, plantar fasciitis, achilles tendonitis

– Provides ankle immobilization and resists plantar flexion

– Large area of relief for hind foot and calcaneous

– soft sheep skin liner can be laundered and replaced

– available in sizes small thru large

– aka: PRafo


fracture Walking Boot

Pressure Relief afo



– DX: Drop foot, cVa, cMT, Ms, peroneal palsy

– carbon fiber dynamic afo available with medial or lateral strut provides stability and energy return for weakened or damaged muscular structures

– off-the-shelf design custom fit to the patient fits easily into most lace up or Velcro shoe styles

– available in women’s size: 5 thru 14 and mens size 4 thru 14

– aka: Toe-off, Walk-on afo, Dynamic afo

off-the-shelf Posterior Leaf spring afo


– DX: Drop foot, cVa, Ms, peroneal palsy

– Thermoplastic custom fit posterior leaf spring afo

– Provides dorsi flexion assist during swing phase of gait for stability and safety

– available in size small thru x-large

carbon fiber Dynamic afo


– articulated ankle orthosis with light low profile design allows for adequate range of motion and maintains medial/lateral stability

– fits easily into most athletic and extra depth shoes

– available in x-small to x-large sizes

– aka: Velocity ankle brace, arch Loc, sure step

articulated ankle orthosis


– DX: Plantar faxciitis, tight gastroc-soles complex, achilles tendon injuries

– Rigid posterior frame with a soft foam lining and bilateral adjustable straps allows for variable plantar/dorsi flexion settings

– available in sizes small thru large

Plantar fasciitis night splint




– DX: charcot foot, diabetes, chronic wound care and/or ulcerations, arthritis, degenerative joint disease

– Total contact custom-made bivalved plastic ankle foot orthosis with rigid anterior lined panel

– available with molded foam inner boot that can be modified for ongoing anatomical changes


– aka: cRo Walker

Double Upright Metal afo


– DX: foot drop, diabetes, charcot foot deformities, edema and/or volumetric, anatomical changes, and plantar ulcers

– custom-made double metal uprights can be fabricated from aluminum, stainless steel, or titanium

– Molded leather calf strap can be attached with Velcro or buckle closures

– ankle joint variations include: solid ankle, variable range of motion, dorsi and plantar flexion assists and stops


neuropathic Walking Boot (cRo)

– DX: Posterior tibial tendonitis and deformities, pes planus, hyper pronation, ankle and/or foot injuries, medial/lateral ankle instabilities

– custom-made ankle orthosis with UcBL style foot bed, articulated ankle joint, with padded uprights

– available with custom and custom fit uprights

– available with various ankle joints to include adjustable range of motion, free range of motions, dorsi/plantar flexion stops and dorsi flexion assist


– aka: custom Richie brace, custom sure step

custom articulated ankle orthosis


– DX: Posterior tibial tendonitis and deformities, pes planus, hyper pronation, ankle and/or foot injuries, medial/lateral ankle instabilities

– custom-made molded leather ankle gauntlet with molded polypropylene inner shell

– available with lace and/or Velcro closures

– available with various leather colors and thickness and various style inner afo plastic shells


– aka: arizona style leather gauntlet

Molded Leather ankle Gauntlet




– DX: Medial/lateral instabilities, plantar flexion and dorsi flexion muscular weakness and imbalance, valgus/vaurs instabilities, mild knee instability, arthritis, cVa, cMT, Ms, spinal cord injury, plantar flexion tightness, and hypertonicity

– Plantar flexion and dorsi flexion stops available

– custom-made plastic ankle foot orthosis with bilateral ankle joints allowing for variable range of motion, fixed range of motion, free range of motion


custom solid ankle afo


– DX: Medial/lateral instabilities, plantar flexion and dorsi flexion muscular weakness and imbalance, valgus/vaurs instabilities, mild knee instability, arthritis, cVa, cMT, Ms, spinal cord injury, plantar flexion tightness, and hypertonicity

– custom-made plastic ankle foot orthosis with trim lines anterior to the malleoli to provide maximum medial/lateral and plantar/dorsi flexion stability

– available with various foot plate configurations, additional medial and lateral support flanges, and with/without soft interface


custom articulated afo

– DX: Drop foot, cVa, cMT, Ms, peroneal palsy, spinal cord injury, lower extremity weakness and/or instability

– custom-made plastic ankle foot orthosis aids in dorsi flexion during the swing phase of gait for increased toe clearance and safety


custom Posterior Leaf spring afo


– DX: Drop foot, cVa, cMT, Ms, peroneal palsy, spinal cord injury, lower extremity weakness and/or instability, mild medial/lateral instability, mild plantar flexion weakness

– custom-made plastic ankle foot orthosis with trim lines just posterior to the medial and lateral malleolus adds additional strength and stability for the patient during the gait cycle


custom semi-solid afo




– DX: Joint contracture and/or tightness

– incorporates a custom tone reducing foot plate, static and dynamic controls for conservative management of spasticity

– improves muscle length, flexibility, balance and correction of postural deformities

– Dynamic components minimize skin breakdown and irritation secondary to neuropathy and vascular disease

– aka: contracture afo

femoral fracture orthosis

fRacTURe/conTRacTURe oRThoses

– DX: femoral fractures– available with quadrilateral

brims, narrow M/L brims to aid in weight distribution and maintaining rotational control

– available with various style knee and ankle joints for fixed, variable, and free range of motion

– Removable design allows for inspection of the skin and/or wound care


ankle foot contracture orthosis

– DX: Tibia and fibula fractures, non-union, mal-union, chronic wound care and/or ulcers

– custom-made patellar tendon bearing orthosis provides circumferential compression and aids in the reduction of axial loading

– Padding on posterior and anterior shells optional

– available with various style ankle joints for fixed, variable, and free range of motion


Patellar Tendon Bearing orthosis (PTBo)

fRacTURe oRThoses

– DX: Tibia and fibular fractures, non-unions, mal-unions

– Bivalved design for total contact and circumferential compression, aids in the reduction of axial loading and maintaining anatomical alignment of the injured site

– Padding on posterior and anterior shells optional

– available with various style ankle joints for fixed, variable, and free range of motion


Tibial fracture orthosis




– DX: Post operative knee stability

– incremental range of motion control

– Buckles for ease and consistency of donning/doffing

– Reduced foam coverage for increased comfort and “cooler” fit

– aka: RoM knee orthosis, post-op knee orthosis

knee immobilizer

knee oRThoses

– DX: knee instability– contoured posterior, medial

and lateral aluminum stays– comfortable wide elastic

strapping, trimmable foam– easy applications– available sizes 14”, 17”,

20”, 24”, 27”

Post-op knee orthosis


– incorporates a custom tone reducing foot plate, static and dynamic controls for conservative management of spasticity

– Provides stretch and control across knee and ankle complex

– improves muscle length, flexibility, balance and correction of postural deformities

– Dynamic components minimize skin breakdown and irritation secondary to neuropathy and vascular disease

– aka: contracture kafo

knee ankle foot contracture orthosis

conTRacTURe oRThoses


– Provides low load, prolonged stretch across the knee

– flexion and extension assist in one unit

– Rigid lightweight, aluminum frame, easy application and re-application by the patient without change in tension setting

– Machine washable, breathable liners for increased patient comfort

– aka: Dynasplint, contracture ko

knee contracture orthosis



knee oRThosesLower extremity ortHoses

– DX: Patello-femoral dysfunction, mild osteoarthritis

– Medial and lateral spiral stays

– Tubular buttress for additional support

– Proximal and distal straps for support and suspension

– available in sizes small thru xx-large

– aka: neoprene knee sleeve with knee buttress

neoprene Patellar stabilizing knee sleeve

– DX: Lateral tracking patellar disorder/dislocations

– Medial and lateral spiral stays

– Tubular buttress for patellar stabilization and tracking


– available in sizes x-small thru xx-large

Lateral J Buttress knee orthosis

– DX: Patello-femoral dysfunction, mild medial/lateral instability

– Lateral buttress for patellar stabilization

– Medial and lateral hinges



– aka: PTo

hinged Patellar stabilizing knee orthosis

– DX: Post-operative knee stability

– Telescoping medial and lateral bars

– Variable range of motion, free motion, or locked positioning full knee extension

– custom fit and trimmed to patient


knee oRThoses

– DX: Post-operative knee stability

– Polycentric knee with range of motion 0 – 120 degrees

– Rigid medial and lateral stays, molded posterior supports

– available sizes 20”, 22’, 24”, 26”, 28”, 30”


– DX: Patello-femoral dysfunction, mild osteoarthritis

– Lightweight knit orthosis – silicone insert optional– osteoarthritis version

optional

– available in sizes small thru xx-large

– aka: Genutrain, Genumedi


Post-op knee orthosis

Bledsoe Post-op knee orthosis

elastic knee sleeve


knee oRThosesLower extremity ortHoses

– DX: Mild medial/lateral instability

– Lightweight, neoprene alternative material

– Wrap around styles optional

– available in x-small thru xx-large

– DX: Moderate to severe acL, PcL, McL, LcL, ligament instability

– Low profile lightweight composite frame

– 3 polycentric hinge style options available

– 4 shell length options– custom-made to

patient model

Townsend Premier


– Low profile lightweight composite frame

– Motocross, equestrian options available


hinged neoprene knee orthosis

cTi—innovation sports

– DX: Moderate to severe acL, McL, and LcL instabilities

– aluminum lightweight rigid frame

– Polycentric hinges with contoured condyle shells

– custom fit– available in sizes small thru

x-large

hanger select knee orthosis

knee oRThoses


– aluminum lightweight rigid frame


– available in men’s and women’s sizes: small thru x-large





Breg X2k oTs

hinged neoprene knee orthosis



– DX: Unicompartmental knee osteoarthritis

– Long axis, adjustable off loading double upright joint

– auto-aligning, low profile, polycentric knee joint


Generation ii

osTeoaRThRiTis (oa) knee oRThoses


– Wide carbon frame for increased surface area and patient comfort

– Dynamic corrective strap, conforming shell material, and polycentric adjustable dynamic joint®


V-Vas anatomical concepts


– Lightweight low profile aluminum frame design

– custom fit to patient’s leg – custom-made to

patient model

Breg X2k

knee oRThoses


– Lightweight carbon composite frame

– acL/PcL option with 4-point dynamic strap/leverage system


DonJoy Defiance





– aluminum frame with telescoping hinge


DonJoy Defiance oa



– carbon fiber frame with telescoping hinge


Breg X2k counterforce


– 3 point loading system reduces degenerative knee joint compression

– Telescoping condyle pad allows for patient adjustments according to activity level

– Lightweight aluminum frame

– swiveling, quick release buckles allow for easy donning/doffing

DonJoy oa everyday



– Lock and off-Load Technology™ reduces degenerative knee joint compression

– Lightweight aluminum frame

– oa-key enables patient controlled load and alignment adjustment

DonJoy oadjuster




knee ankLe fooT oRThoses

– DX: Muscular imbalance and/or weakness, knee instability, genu recurvatuum, genu valgum/varum, polio, post-polio, spinal cord injury, Ms, cVa, spina bifida, cerebral palsy, Guillain Barre syndrome, trauma, total knee replacement

– Provides stability and/or assists functionality of the knee ankle and foot complex

– fabricated from laminate carbon fiber and fiberglass configurations

– Provides rigid support to the anatomical structures and reduces torsion of the orthosis and components

– Various style knee joints available for free, variable range of motion, or locked range of motion

– Various style ankle joints incorporated per patient presentation/diagnosis

knee Joint options– free knee– Drop lock– stance control– off set knee – extension assist– electronic control– Variable range of motion– fixed range of motion

ankle Joint options– solid– semi-solid– articulated– Posterior leaf spring– free motion– Double action– Variable range of motion– Plantar and dorsi flexion

assists and stops

Laminated knee ankle foot orthosis (kafo)


– DX: Muscular imbalance and/or weakness, knee instability, genu recurvatuum, genu valgum/varum, polio, post-polio, spinal cord injury, Ms, cVa, spina bifida, cerebral palsy, Guillain Barre syndrome, trauma, total knee replacement

– Provides stability and/or assists functionality of the knee, ankle and foot complex

– can be fabricated from plastic, carbon composites, hybrid variations, leather and metal



– Various style ankle joints incorporated per patient presentation/diagnosis

knee Joint options– free knee– Drop lock– stance control– off set knee – extension assist– electronic control– Variable range of motion– fixed range of motion


assists and stops

knee ankle foot orthosis (kafo)





– DX: Muscular imbalance and/or weakness, knee instability, quadriceps weakness, genu recurvatuum, genu valgum/varum, polio, post-polio, spinal cord injury, Ms, cVa, spina bifida, trauma, total knee replacement

– Provides locking knee control during stance phase of gait while allowing free knee flexion during the swing phase of gait

– Locks in any degree of knee flexion providing maximum stability from sit to stand

– Requires ankle joint/foot plate activation


– fabricated from plastic, laminate carbon fiber, fiberglass, hybrid configurations, metal and leather


– Various style ankle joints incorporated per patient presentation

ankle Joints– solid– articulated– Double action– Variable Range of motion– Plantar and dorsi flexion

assists and stops

stance control knee orthotic Joint (sckoJ) kafo—hortonsTance Phase knee ankLe fooT oRThosis (kafo)




– Does not require any ankle joint or foot plate activation, can be used as a knee orthosis





ankle Joints– solid– semi-solid– articulated– Posterior leaf spring– free motion– Double action– Variable Range of motion– Plantar and dorsi flexion

assists and stops

stance Phase Locking (sPL) kafo—fillauer


sTance Phase knee ankLe fooT oRThosis (kafo)




– DX: Muscular imbalance and/or weakness, knee instability, quadriceps weakness, spinal cord injury, Ms, cVa, spina bifida, trauma, total knee replacement


– Requires 10 degrees of passive ankle dorsi-flexion to disengage knee joint lock


– fabricated from tubular metal configurations with unique strapping design

– Lightweight design, straps and bands can be moved from anterior to posterior upon request

freeWalk stance control kafo— ottoBocksTance Phase knee ankLe fooT oRThosis (kafo)




– electronic lock allows for stability in any degree of knee flexion providing maximum stability from sit to stand

– Requires foot plate activation





ankle Joints– solid– articulated– Double action– Variable Range of motion– Plantar and dorsi flexion

assists and stops

e-knee stance control kafo— Becker





hiP oRThoses

– DX: hip dislocations, subluxations, post-operative management, surgical revisions

– Rigid pelvic section, adjustable for various hip and waist development measurements

– available in low profile or high profile pelvic designs per patient presentation/diagnosis

– easy Velcro/snap closures for ease of donning/doffing

– hip joint options include variable, static, and free range of motion for abduction, adductions, flexion, and extension.

– aka: newport hip orthosis

hip abduction orthosis


– DX: Muscular imbalance and/or weakness, knee instability, quadriceps weakness, spinal cord injury, Ms, cVa, spina bifida, trauma, total knee replacement


– Requires 5 degrees of passive ankle dorsi-flexion to disengage knee joint lock


– fabricated from tubular metal configurations with unique strapping design

– Lightweight design, straps and bands can be moved from anterior to posterior upon request

UTX stance control kafo—Becker





ReciPRocaTinG GaiT oRThoses

– DX: Muscular imbalance and/or weakness, paralysis (spinal cord injury, spina bifida, myelomeningocele)

– allows for reciprocal ambulation, hands free standing balance and support, and dynamic hip stretching

– Pelvic components include: isocentric (rocker bar design), cable driven designs, plastic and/or metal

– Pelvic section can be fabricated from various colors, body jacket style available

– internal or external afo designs

– Various styles of hip, knee, and ankle joints per patient presentation

– Growth extensions available for pediatric patients

– hip joint options include: locked, pre-selected, abduction hinge, and quick disconnect

Reciprocal Gait orthosis (RGo)

hiP knee ankLe fooT oRThoses

– DX: Muscular imbalance and/or weakness, paralysis (spinal cord injury, spina bifida, myelomeningocele), cerebral palsy, muscular dystrophy, Ms

– Provides maximum stability at the hip, knee, foot and ankle complex


– Various styles of hip, knee, and ankle joints per patient presentation and diagnosis

hip Joint options– free– Variable range of motion – flexion – extension – abduction – adduction– fixed/locked – off-set

knee Joint options– free knee– Drop lock– stance control– off-set knee– extension assist– electronic control– Variable range of motion– fixed range of motion

ankle Joint options– solid– semi-solid– articulated– Double action– Variable range of motion– Plantar and dorsi flexion

assists and stops

hip knee ankle foot orthosis (hkafo)



Pediatric orthoses

60 Dennis Brown Bar/straight Last

60 foot orthoses

61 UcBL

61 answer 2 shoes

62 fracture Walking Boot

62 supramalleolar orthosis (sMo) custom-made

63 Dynamic ankle foot orthosis custom-made

63 semi-solid ankle foot orthosis (afo) custom-made

64 solid ankle afo custom-made

64 articulated afo custom-made

65 2 stage afo custom-made

65 Pavlik harness

66 Tubingen hip abduction orthosis



67 sWash

68 knee ankle foot orthosis (kafo) custom-made

69 hip knee ankle orthosis (hkafo) custom-made

70 Reciprocal Gait orthosis (RGo)

70 Boston style scoliosis orthosis

71 nocturnal scoliosis TLso

71 Milwaukee cTLso scoliosis orthosis

72 soft scoliosis orthosis

72 hanger cranial orthosis


ortHotics

– DX: accommodative shoes for orthotic designs i.e. UcBL, afo, kafo and custom foot orthoses

– Wide low Blucher opening allows for ease of donning/doffing, accommodates orthotic designs without excessive shoe modifications

– Triple layer removable inserts provide ease of fitting and accommodations for orthotic applications

– Wide, extra depth toe box allows for increased comfort and reduction of shear/pressure forces

UcBL

PeDiaTRic oRThoses

– DX: hyperpronation, posterior tibial tendon dysfunction, calcaneal inversion/eversion, accessory navicular and collapse of mid tarsal joint

– semi-rigid orthosis encompassing the medial and lateral borders of the calcaneous, may include navicular, fabricated from plastic (polypropylene designs)

– fabricated in non or semi-weight bearing positions to achieve neutral or functional alignment (subtalar neutral alignment)


answer 2 shoes

– DX: club foot/feet, tibial torsion and congenital deformity

– Provides correction for rotational, torsional, and angular deformities of the lower extremity

– available in various width bars and shoes sizes

Dennis Brown Bar/straight Last

PeDiaTRic oRThoses

– DX: Biomechanical insufficiencies, hyper-pronation/supination, calcaneal inversion/eversion

– Multi-density semi-rigid orthosis, rigid orthosis inclusive of plastic (polypropylene variations) and carbon fiber composite materials

– fabricated in non, semi and full weight bearing positions to achieve neutral or functional alignment (subtalar neutral)


foot orthoses

ortHotics


ortHotics

– DX: Drop foot, neurological or neuromuscular imbalance, cerebral palsy, spina bifida, muscular dystrophy, ligament laxity, mild medial lateral instability, mild plantar flexion weakness


– custom-made plastic ankle foot orthosis with trim lines just posterior to the medial and lateral malleolus adds additional strength and stability for the patient during the gait cycle

Dynamic ankle foot orthosis custom-made

PeDiaTRic oRThoses

– DX: neurological or neuromuscular imbalance, cerebral palsy, spina bifida, ligament laxity, calcaneal inversion/eversion, severe pes planus or hyper pronation/supination

– assists in controlling medial and lateral ankle instability, mild control of knee instability

– Tone reducing foot plate options available

– Provides rear and fore foot control for optimal positioning during gait cycle

– aids in controlling hyper pronation/supination of the foot ankle complex


– aka: scoot3, Dafo

semi-solid ankle foot orthosis (afo) custom-made

– DX: stable fracture, soft tissue injury (grade 2 or 3 sprain) post-operative management


– Plastic or aluminum uprights, solid or controlled range of motion ankle joint

– Pediatric sizes available– aka: Walker boot, caM

walker

fracture Walking Boot

PeDiaTRic oRThoses

– DX: neurological or neuromuscular imbalance, cerebral palsy, spina bifida, muscular dystrophy, ligament laxity, calcaneal inversion/eversion, severe pes planus or hyper pronation/supination

– assists in controlling medial and lateral ankle instability

– Provides rear and fore foot control for optimal positioning during the gait cycle

– aids in controlling hyper pronation/supination of the foot ankle complex


supramalleolar orthosis (sMo) custom-made

ortHotics


ortHotics

– DX: congenital hip dysplasia, developmental hip dysplasia

– strapping design allows for variable hip flexion and abduction position

– soft interface to avoid skin breakdown or abrasions

– can be laundered– available in sizes 0–9

months of age

2 stage afo custom-made

PeDiaTRic oRThoses

– Medial/lateral instabilities, neurological or neuromuscular imbalance, cerebral palsy, spina bifida, muscular dystrophy, ligament laxity, medial lateral instability, dorsi and plantar flexion weakness

– custom-made plastic ankle foot orthosis with trim lines anterior to the malleoli provide maximum medial/lateral and plantar/dorsi flexion stability

– available with various foot plate configurations, additional medial and lateral support flanges, and with/without soft interface

– Removable flexible inner boot with rigid outer shell

– ideal for patients with plantar flexion contractures and hypertonicity


– aka: scoot3, Dafo

Pavlik harness

– Medial/lateral instabilities, neurological or neuromuscular imbalance, cerebral palsy, spina bifida, muscular dystrophy, ligament laxity, medial lateral instability, dorsi and plantar flexion weakness

– available with various foot plate configuration, additional medial and lateral support flanges, and with/without soft interface

– custom-made plastic ankle foot orthosis with trim lines anterior to the malleoli provide maximum medial/lateral and plantar/dorsi flexion stability


solid ankle afo custom-made

PeDiaTRic oRThoses

– DX: Medial/lateral instabilities, neurological or neuromuscular imbalance, cerebral palsy, spina bifida, muscular dystrophy, ligament laxity, medial lateral instability, dorsi and plantar flexion weakness

– Plantar flexion and dorsi flexion stops available

– custom-made plastic ankle foot orthosis with bilateral ankle joints allowing for variable range of motion, fixed range of motion, free range of motion


articulated afo custom-made

ortHotics


ortHotics

– DX: Pre/post-operative management of the pediatric hip, cerebral palsy, spinal cord injury, hypertonicity, traumatic brain injury, cVa

– Bilateral thigh cuffs and pelvic band aid in proper positioning of the hip, reducing subluxation and/or dislocation

– aids in sitting balance, hands-free activities of daily living (aDLs), and in the prevention of scissoring gait patterns


PeDiaTRic oRThoses

– DX: Post-operative stabilization of the hip secondary to soft tissue release and osteotomies, hip subluxation and dislocation

– Rigid pelvic section, adjustable for various hip and waist development measurements

– available in low-profile or high-profile designs

– easy Velcro/snap closure for ease of donning/doffing

– hip joint options include variable, static, and free range of motion for abduction, adduction, flexion, and extension


sWash


– soft interface to avoid skin breakdown or abrasions

– Moderate abduction with hip flexion greater than 90 degrees

– spreader bar adjustable to achieve desired abduction position

– available in size 1 – 12 months of age

– aka: otto Bock hip abduction orthosis

Tubingen hip abduction orthosis

PeDiaTRic oRThoses


– Polypropylene or polyethylene shell with aliplast soft foam lining

– 90 degree hip flexion and approximately 160 degree abduction (can be altered according to patient presentation and prescription request)

– closed cell foam allow for ease of cleaning and does not absorb fluids

– available in sizes 0 – 18 months or 8lbs – 30lbs


ortHotics


– DX: Muscular imbalance and/or weakness, paralysis (spinal cord injury, spina bifida, myelomeningocele), cerebral palsy, muscular dystrophy, Ms

– Provides maximum stability at the hip, knee, foot and ankle complex


– Various style hip, knee, and ankle joints per patient presentation

hip Joint options– free– Variable range of motion – flexion – extension – abduction – adduction– fixed/locked – off-set

knee Joint options– free knee– Drop lock– stance control– off-set knee– extension assist– electronic control– Variable range of motion– fixed range of motion

ankle Joint options– solid– semi-solid– articulated– Double action– Variable range of motion– Plantar and dorsi flexion

assists and stops

hip knee ankle orthosis (hkafo) custom-made

ortHotics

PeDiaTRic oRThoses

– DX: Muscular imbalance and/or weakness, knee instability, genu recurvatuum, genu valgum/varum, spinal cord injury, Ms, cVa, spina bifida, cerebral palsy, Guillain Bane syndrome, trauma, total knee replacement






knee Joint options– free knee– Drop lock– stance control– off-set knee – extension assist– electronic control– Variable range of motion– fixed range of motion


assists and stops

knee ankle foot orthosis (kafo) custom-made

PeDiaTRic oRThosesortHotics


ortHotics

– DX: idiopathic scoliosis, cervical and high thoracic involvement, kyphosis management

– Rigid plastic shell with soft aliplast lining, counter force re-directional pads, posterior Velcro closures for maximum abdominal compression and biomechanical control

– Metal super structure with neck ring


nocturnal scoliosis TLso (Thoraco-Lumbo-sacral orthosis)

PeDiaTRic oRThoses

– DX: idiopathic scoliosis, kyphosis


– nighttime/nocturnal overcorrection orthosis


– aka: cBB (charleston Bending Brace), Providence Brace

Milwaukee cTLso (cervico-Thoraco-Lumbo-sacral orthosis) scoliosis orthosis

– Muscular imbalance and/or weakness, paralysis (spinal cord injury, spina bifida, myelomeningocele)

– allows for reciprocal ambulation, hands-free standing balance and support, and dynamic hip stretching

– Pelvic components include: isocentric (rocker bar design), cable driven designs, plastic and/or metal

– Pelvic section can be fabricated from various colors, body jacket style available

– internal or external afo designs– Various style hip, knee, and

ankle joints per patient presentation

– Growth extensions available for pediatric patients

– hip joint options include: locked, pre-selected, abduction hinge, and quick disconnect

Reciprocal Gait orthosis (RGo)

PeDiaTRic oRThoses

– DX: idiopathic scoliosis, kyphosis


– available in stock sizes or custom-made to patient model

– aka: Boston Brace, low profile scoliosis brace

Boston style scoliosis orthosis

ortHotics


uPPer extremity orthoses

74 cock-Up Wrist splint

74 Wrist hand orthosis (Who)

74 Thumb spica splint

75 Resting Wrist hand splint

75 Tennis elbow strap

75 heelbo elbow Pad

76 Genumedi elbow sleeve

76 elbow RoM (Range of Motion) orthosis

77 clavicle strap

77 arm sling

78 elastic shoulder immobilizer

78 abduction sling

79 Gunslinger orthosis

79 Wrist hand fracture orthosis

80 Ulnar/Radial fracture orthosis

80 elbow Wrist hand fracture orthosis

81 humeral fracture orthosis

81 Wrist hand contracture orthosis

82 elbow contracture orthosis

– neuropathic scoliosis, lordosis, or kyphosis, neurological disorders with poor trunk stability, post-operative stabilization

– semi-rigid foam exterior with soft aliplast lining, and rigid internal or external frame, closed cell foam does not absorb moisture, water resistant


– aka: soft Boston Brace

soft scoliosis orthosis

PeDiaTRic oRThoses

– DX: Deformational plagiocephaly, brachycephaly, scaphocephaly, post-operative orthotic management

– follow up care to ensure appropriate modifications are made as baby develops


– cranial orthoses are worn for 23 hours a day for approximately 3-6 months

– cranial remolding is not achieved by placing severe pressures on the skull. The cranial band applies a constant, static pressure over the areas of the skull that are most prominent. opposite of this, the band has open areas where the flattened section of the skull can grow

hanger cranial orthosis

ortHotics


UPPeR eXTReMiTy oRThosesortHotics

– DX: Paralysis, contracture management, spasticity, post-operative management

– Maintains wrist, hand and fingers in functional position

– Moldable plastic shell, soft interface available

– available in off-the-shelf or custom-made to patient model

– DX: Medial or lateral epicondlyitis

– Wrap around splint with Velcro closure and directional padding

– Universal sizing

Tennis elbow strap

– DX: Ulnar neuropathy– elastic elbow sleeve with

foam padding to prevent excessive pressure over bony prominences


heelbo elbow Pad

Resting Wrist hand splint– DX: carpal tunnel syndrome,

tendonitis, wrist sprain/strain– one piece design with

anterior Velcro closures – Rigid moldable stay to reduce

unwanted wrist flexion and extension

– available in variable lengths, sizes x-small thru x-large

UPPeR eXTReMiTy oRThoses

– carpal tunnel syndrome, tendonitis, wrist sprain/strain, post-fracture management

– Rigid moldable dorsal and volar stays to prevent unwanted wrist flexion and extension

– one piece design with anterior Velcro closures

– Material options include canvas, neoprene, and plastic configurations


– DX: carpal tunnel syndrome, tendonitis, wrist sprain/strain, post-fracture management

– once piece semi-rigid design incorporates the thumb for increased stability and reduced range of motion

– one piece design with Velcro closures, moldable stays

– Material options include canvas, neoprene, and plastic configurations


ortHotics

Wrist hand orthosis (Who)

cock-Up Wrist splint

Thumb spica splint


ortHotics

– DX: immobilization for mild sprains/strains, fracture management, shoulder injuries, post-operative management

– Durable canvas material with adjustable Velcro straps

– available in sizes small thru x-large

clavicle strap– DX: clavicle fracture– foam padded shoulder

straps provide increased shoulder retraction and appropriate positioning

– 3 way buckle or Velcro closure

– aka: figure 8 strap

arm sling


– DX: Medial or lateral epicondylitis, tendonitis, ulnar neuropathy

– elastic elbow sleeve with contoured silicone inserts

– Provides compression and edema control


Genumedi elbow sleeve

– DX: elbow dislocations, post-operative management, contracture management, fracture management

– Variable range of motion elbow joint for controlled elbow flexion and extension, with optional wrist hand extension if immobilization is necessary

– Rigid exterior shell with soft washable removable inner lining

– shoulder harness with adjustable straps for increased comfort and suspension

– integrated straps for additional circumferential compression


elbow RoM (Range of Motion) orthosis

ortHotics



ortHotics

– DX: Wrist and hand fractures, post-operative or post-cast stabilization

– Plastic one piece design with Velcro closures

– Provides immobilization of the wrist and hand

– soft interface and fracture socks optional

– available in off-the-shelf, custom-made to patient model

Gunslinger orthosis– DX: Rotator cuff repairs,

shoulder reconstruction, gelonhumeral dislocation and/or soft tissue injury or repair

– Upper extremity frame design with adjustable shoulder abduction, internal/external rotation, and wrist and hand extension

– Removable inner lining can be replaced or laundered

Wrist hand fracture orthosis


– DX: Rotator cuff repairs, shoulder capsule injury, glenohumeral dislocation and/or subluxation, soft tissue injury and/or repair

– elastic and neoprene waist band options with Velcro closures for ease of donning/doffing

– available in female and male sizing

elastic shoulder immobilizer

– DX: Rotator cuff repairs, shoulder capsule injury, glenohumeral dislocation and/or subluxation, soft tissue injury and/or repair

– Maintains the upper extremity in neutral position to aid in healing soft tissue injuries and/or repairs

– abduction pad can be moved to accommodate anatomical needs and biomechanical requirements

abduction sling

ortHotics



ortHotics

– DX: Wrist and hand contracture management

– Positional orthosis with dynamic wrist joint to aid in contracture and spasticity management, soft tissue release

– can be used during rest and activities of daily living

– aka: Dynasplint, Ultraflex, Dynamic flexion/extension

humeral fracture orthosis– DX: Mid humeral fractures,

post-operative or post-cast stabilization

– Plastic semi-rigid design with Velcro closures

– allows total contact with circumferential compression for increased stability and control of humeral fractures or injuries

– shoulder cap, soft interface, and fracture socks optional

– available in off-the-shelf sizes or custom-made to patient model

– aka: sarmiento fracture orthosis

Wrist hand contracture orthosis


– DX: Mid ulnar or radial fractures, post-operative or post-cast stabilization

– Plastic semi-rigid design with Velcro closures

– allows total contact with circumferential compression for increased stability and control of ulnar/radial segments

– soft interface and fracture socks optional


– aka: sarmiento fracture brace

Ulnar/Radial fracture orthosis

– DX: Distal humeral fractures, proximal radial and/or ulnar fractures, post-operative or post-cast stabilization

– Plastic semi-rigid design with unilateral or bilateral elbow joints with locked, free or variable range of motion options

– shoulder cap, soft interface, fracture socks, and ventilation optional


elbow Wrist hand fracture orthosis

ortHotics



mastectomy

84 Mastectomy forms

84 custom Mastectomy Prosthesis

85 Mastectomy Bras/Undergarments– DX: elbow contracture

management– Positional orthosis with

dynamic elbow joint to aid contracture and spasticity management, soft tissue release

– Variable range of motion elbow joints can be unilateral or bilateral

– can be used during rest and activities of daily living


– aka: Dynasplint, Ultraflex, Dynamic flexion/extension

elbow contracture orthosis

ortHotics



MasTecToMyortHotics

Mastectomy Bras/Undergarments– hanger Prosthetics and

orthotics carries all of the top mastectomy product lines

– inclusive of the latest styles, colors, camisoles, immediate post-operative garments, leisure bras, and regular support bras

– Bras available for each stage of the recovery process

MasTecToMyortHotics

– DX: Mastectomy procedures– Mastectomy forms are

available in different weights, sizes, shapes, and styles according to patient model and preference

– Breast forms can also be matched to patients bra or specialized undergarments can be ordered

– hanger Prosthetics and orthotics carries all of the top mastectomy product lines

Mastectomy forms

– DX: Mastectomy procedures– custom breast prosthesis

fabricated by duplicating chest wall and utilizing patients anatomy to select size, shape, color, weight according to patient model and preference


custom Mastectomy Prosthesis


Prosthetics

89 introduction to prosthetics

lower extremity prosthetics

93 hanger Lower extremity Prosthetics Program

94 Lower extremity functional classifications

96 hanger comfortflex™ socket system

96 Types of Prosthetic feet

97 Types of Prosthetic knees

97 immediate Post-operative care (iPocare)

amputation Levels

98 Partial foot

99 symes

100 Transtibial or Below knee (Bk)

101 Transfemoral of above knee (ak)

102 hip Disarticulation/hemipelvectomy

103 Lower extremity Prosthetics Prescriptions

upper extremity prosthetics

105 hanger Upper extremity Prosthetics Program

Upper extremity Prosthetic options

106 oppositional (Passive)

106 cable operated (Body-Powered)

107 external Powered

107 hybrid system

108 activity specificcontinued


a certified Prosthetist (cP) or certified Prosthetist/orthotist (cPo) provides clinical care to patients with amputated or congenitally absent limbs. They design, fabricate and fit prosthetic devices (artificial limbs). These devices replicate the function and appearance of a limb so that patients can resume activities of daily living and work.

significant developments in the last twenty years have dramatically advanced the field of prosthetics. improvements in material science have provided stronger and more durable lightweight materials (titanium, composites) that enable users to function and ambulate with greater ease and less stress. soft materials that absorb axial loading and shear forces are commonly used to enhance the fit and feel of the prosthesis. new designs in feet, knees, hands, arms, sockets and interface liners have brought us closer to the goal of completely restoring lost function and appearance. The future of prosthetics lies in microprocessors integrated into prostheses to assist with specific functions and computers to improve diagnosis and design. The prosthetics profession is moving toward evidence-based practice with clinical protocols based on scientific research.

advanced technology does not guarantee optimal rehabilitation outcomes. The prosthetist’s role is to provide each patient with an appropriate prosthesis and to deliver ongoing care to insure optimal fit and function. every patient has different functional and lifestyle requirements that must be met for that person to regain functional independence. The prosthetist incorporates expertise in anatomy, socket design, materials, components, gait analysis, and biomechanics in their evaluation of the

introduction to Prosthetics

prostHetics

PRosTheTics inTRoDUcTionProsthetics

upper extremity prosthetics cont.

Terminal Devices

108 Passive hand

109 Mechanical hand

109 Mechanical hook

110 electric hand

110 electric hook

amputation Levels

111 Partial hand

111 Wrist Disarticulation (WD)

112 Transradial (Be)

112 elbow Disarticulation (eD)

113 Transhumeral (ae)

113 shoulder Disarticulation (sD)


3. immediate Post-op Prosthesis (iPoP): a combination of an RRD with the addition of a pylon and foot or hand system. The iPoP allows the patient to ambulate with controlled partial weight-bearing shortly after surgery. applied early and correctly, an iPoP provides protection, volume management and early function, while preparing the residual limb for prosthetic wear and/or ambulation. This protocol is more common in a hospital or rehab facility because it requires that the patient be closely monitored by a physical therapist and rehab nurse.

4. compression Therapy: is the use of a compressive wrap or sock shrinker to control edema when none of the previous treatment protocols are appropriate. compression therapy is often utilized as part of the previous treatment protocols.

preparatory prosthesis:

following the successful use of any of the above listed post-operative processes, the physician will order the fitting of a preparatory prosthesis. The preparatory prosthesis is designed to allow the patient to begin rehabilitation before the residual limb has completely stabilized in size. its design allows the prosthetist to continuously adjust the prosthesis to mirror the progress achieved by the amputee as the patient regains strength and confidence.

a preparatory prosthesis can be used as soon as six weeks post-surgically and throughout rehabilitation until the residual limb edema has stabilized. should large reduction in limb volume occur, the modular design allows the socket segment to be replaced and refit to ensure optimal fit of the prosthesis.

prostHetics

PRosTheTics inTRoDUcTion

patient to design the most appropriate prosthestic system for each patient. Patients have the best chance for a successful rehabilitation when prosthetists work closely with doctors, therapists, social workers, and other professionals, as well as the patient’s family and insurance company.

post-operative protocols:

The physician will generally determine which prosthetic treatment protocol is utilized following surgery. These commonly include:

1. Rigid Dressing (RD): used to prevent knee flexion contracture, manage edema and protect the surgical site. a second RD is usually applied 7-10 days following surgery as part of this protocol.

2. Removable Rigid Dressing (RRD): used for the same purpose as the RD, with the added benefit of being able to remove the dressing and monitor the surgical site as needed. Prosthetic socks of increasing thickness are used to ensure continued fit as the edema in the residual limb decreases.

The kiwi, a hanger innovation for lower extremity amputations, provides all of the advantages of a traditional RRD with additional benefits provided by its unique design that includes a transparent silicone liner covered by an adjustable and removable rigid cast. The removable custom outer shell allows visual inspection of the residual limb through the transparent liner while providing continuous support and compression to the limb.

PRosTheTics inTRoDUcTionprostHetics


The hanger Lower extremity Program is comprised of practitioners certified and specifically trained in all aspects of lower extremity prosthetics. Because of hanger’s network of internationally-renowned specialists, a team of experts is readily available to work on particularly complex cases, such as hip-disarticulation and hemi-pelvectomy amputations, bi-lateral amputees, and those who face unique challenges with their residual limb.

hanger’s lower extremity specialists utilize a full spectrum of state-of-the-art prosthetic components such as microprocessor knees and feet. hanger’s comfortflex™ socket system provides a socket design that gives more flexibility to the patient and promotes a healthier residual limb. To assure that each patient receives the most appropriate prosthetic system, hanger has developed a unique Patient assessment Validation Test (PaVeT). This analysis evaluates a patient’s particular circumstances in terms of lifestyle, health, capabilities and goals and assists clinicians in delivering the best care to every patient.

hanger Lower extremity Prosthetics Program

prostHetics

LoWeR eXTReMiTy PRosTheTics

definitive prosthesis:

The design and fitting of this prosthesis is a reflection of all the rehabilitation processes that have previously occurred. The prosthetist considers the strength, motivation, functional requirements, and daily needs of the user when recommending the design, components and materials utilized for each prosthesis. The goal of the definitive prosthesis is to allow the patient to fulfill the requirements and functions unique to his or her daily activities.

all definitive prostheses are custom-made utilizing a mold of the remaining residual limb. The mold may be generated either from a plaster cast impression or through the use of insignia™, hanger’s computer imaging system. after the mold is created, a series of diagnostic test sockets are fit to ensure optimum comfort and function. Test sockets are often set up for trial as part of the dynamic alignment process.

once the alignment and proper fit of the prosthesis are determined, the definitive prosthesis is fabricated and delivered to the patient for use. cosmetic enhancements (shaped foam covers and latex skins) are usually delayed until all follow up adjustments have been made. Regular long-term follow up is essential to ensure optimal prosthetic rehabilitation for the patient.

PRosTheTics inTRoDUcTionprostHetics


prostHetics


Prosthetic components and design elements are selected based on the patient’s functional level (or “k” Levels 0 to 4). functional level is determined by the reasonable expectations of the prosthetist and the ordering physician. considering factors include, but are not limited to:

– The patient’s past history (including prior prosthetic use, if applicable)

– The patient’s current and potential abilities and condition including the status of the residual limb and the nature of other medical problems

– The patient’s desire to ambulate

clinical assessments of a patient’s functional level should be based on these classification levels:

Level 0: Does not have the ability or potential to ambulate or transfer safely without assistance and a prosthesis does not enhance quality of life or mobility

Level 1: has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. Typical of the limited and unlimited household ambulatory

Level 2: has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. Typical of the limited community ambulatory

Lower extremity functional classifications

LoWeR eXTReMiTy PRosTheTicsprostHetics

Level 3: has the ability or potential for ambulation with variable cadence. Typical of the community ambulatory who has the ability to traverse most environmental barriers and may have vocational, therapeutic or exercise activity that demands prosthetic utilization beyond simple locomotion

Level 4: has the ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high impact, stress or energy levels. Typical of the prosthetic demands of the child, active adult or athlete

note: Bilateral amputees often cannot be strictly bound by functional level classifications.


prostHetics

LoWeR eXTReMiTy PRosTheTicsLoWeR eXTReMiTy PRosTheTicsprostHetics

– Built-in relief for concentrated pressure points– Totally flexible brim and back– an aggressive, more intimate fit of the pelvic bone– improved side-to-side control– increased front-to-back stability– Reduced socket rotation on the residual limb– command and alignment of the thigh bone– anatomically correct channels & grooves– ability to increase muscle tone in residual limb– This type of prosthesis can be cosmetically finished with a

natural or custom appearance

PRoPRieTaRy TechnoLoGy

hanger comfortflex™ socket system

– an important part of iPocare is the removable rigid protective device. applied just after the patient has undergone amputation, it provides protection to the healing residual limb by reducing the risk of post-surgical infection or edema. it also plays an important role in protecting the residual limb from accidental trauma and aids in the prevention of knee flexion contractures. all are critical factors in facilitating prosthetic rehabilitation.

Types of Prosthetic knees– Manual locking– stance/weight activated locking– Polycentric– Pneumatic– hydraulic– combination of the above– Microprocessor

immediate Post-operative care (iPocare)– solid ankle cushion heel (sach)– flexible keel– single axis– Multi axial– Dynamic response– energy storing– combination of above

Types of Prosthetic feet


prostHetics


aMPUTaTion LeVeLs

symes– This amputation level,

which is an ankle disarticulation, requires a prosthetics socket which usually extends to the knee due to increased forces on the residual limb

– Utilizes an expandable wall or removable window to allow entry and suspension of the bulbous distal end

– a low profile foot is used to match the height of the opposite side


– This type of amputation can have a dramatic effect on gait due to the loss of lever arm (toes and metatarsals)

– Depending on the length of the remaining foot, a variety of prosthetics may be used from a toe filler to a tibial height prosthesis

– May require the addition of a carbon or steel plate to the plantar surface of the orthotic to stiffen the shoe

aMPUTaTion LeVeLs

Partial foot

amputation levels


prostHetics


aMPUTaTion LeVeLs

Transfemoral of above knee (ak)– The above knee prosthetic

system consists of a socket, knee joint and foot/ankle complex

– options are numerous for componentry and must be determined by a complete evaluation

– considerations for componentry selection relies on past medical history, length of residual limb, activity level, surgical issues and goals of the patient

– socket configurations range from the innovative hanger comfortflex™ socket system to ischial containment and quadrilateral shaped designs

– knee options range from microprocessor-controlled such as the c-Leg to hydraulic swing and stance phase control, to safety knees with extension assist and manual locking for stability control

– feet options are numerous as in transtibial (Bk) and include energy storing, multiaxial, flexible heel, solid ankle cushion heel (sach) and single axis feet


– The below knee unit uses several different style socket configurations with the attachment of a foot and/or ankle component

– options are numerous and must be determined by a complete evaluation

– considerations on selection include diagnosis and past medical history, the shape and length of the residual limb, activity level, surgical issues, and goals of the patient

– socket and suspension options are numerous and include, sleeve, suction with expulsion valve, suction with pin and locking mechanism or Vacuum assisted suction suspension (Vass) or supracondylar for short limbs

– foot componentry ranges from stable, for the less active patient to dynamic for active and athletic individuals. single axis, solid ankle cushion heel (sach), flexible keel, multiaxial, energy-storing and vertical shock feet are just some of the many options

aMPUTaTion LeVeLs

Transtibial or Below knee (Bk)


prostHetics


The prescription and design of a prosthesis is based on the patient’s level of amputation, functional level (k0 to k4) classification, and stage of healing (preparatory or definitive). Multiple descriptors are used to specify all the required elements of an appropriate prosthesis specific to each amputee. The most important part of any prosthesis is a comfortable socket.

usually associated prescription terms

Test socket(s)—Used to diagnosis socket fit before final fabrication

Total contact—Technique for preparing the socket to prevent skin problems

alignable system—allows for alignment adjustments and the interchange of comments

Ultra-Light Material—increases material strength without adding weight

acrylic socket—allows socket to be adjusted after fitting

flexible inner socket, external frame—Permits muscle movement and fenestration

suction socket—Provides enhanced suspension

Gel socket inserts (locking or non-locking)—Provides comfort, skin protection, suspension

Locking Mechanism or suspension sleeve—Provides suspension

Lower extremity Prosthetics Prescriptions


– socket is designed around a total contact shell that uses the opposite side for suspension and stabilization

– The hip joint provides the connection between the proximal assembly and the knee joint

– knee joint options are limited to stability-enhanced designs

– This type of prosthesis can be cosmetically finished with a natural or custom appearance

– choices in feet are similar to the more distal levels

aMPUTaTion LeVeLs

hip Disarticulation/hemipelvectomy

continued


The hanger Upper extremity Program is a unique program that utilizes the knowledge of internationally-respected experts who specialize in upper extremity prosthetics, especially hard-to-fit patients. These experts incorporate cutting-edge technology, including myoelectric components, to best address the functional requirements of each Upper extremity patient.

hanger’s highly-skilled practitioners assist clinicians in designing and implementing individualized and unique prosthetic care programs for every patient.

hanger Upper extremity Prosthetics Program

prostHetics

UPPeR eXTReMiTy PRosTheTics

foot—Based on patient’s potential functional level and expected activities

knee—Based on patient’s potential functional level and expected activities

custom shaped cover—cosmesis and protection of internal components

flexible outer surface cover (skin)—Provides moisture protection

shealths—Used by patient to make fine adjustments to socket fit

socks—Used by patient to make adjustment to socket fit

shrinkers—edema control and limb shaping

specialty prescription terms

Microprocessor control—improves stability and function

Replacement socket—Required for changes in the size or shape of residual limb.

elevated Vacuum system—optimal suspension socket fit and reduced perspiration

axial Rotation Unit—allows lower limb to rotate at the knee for sitting and dressing

Repairs—Regular follow-up necessary to ensure optimal function



prostHetics


– Used in higher levels of deficiency or amputation, it combines the technology of the above systems. Most often seen is the cable operated elbow and the external powered terminal device

– heavier duty & lighter weight than a pure electric system– Requires harness & cable to operate body-powered

components– May require harness for suspension– often times easier to operate the external powered versus

the cable operated components because lower amounts of body motion and energy are required

UPPeR eXTReMiTy PRosTheTic oPTions

external-Powered– Uses a battery to operate a terminal device– Most often controlled by eMG signals in residual limb &

electrodes to control the device (Myoelectric)– if a minimum amount of eMG can not be achieved,

sophisticated switches are used in place of the electrodes– not recommended around certain environments or for rough

activities– May require more maintenance than other systems

depending on use – a moderate amount of occupational therapy is required– increased grip forces compared to other types of devices


hybrid system

UPPeR eXTReMiTy PRosTheTicsprostHetics

– Devices meant to oppose the sound hand/or remaining digits of a partial hand

– Made for specific tasks or for high definition cosmetics– Does not provide active prehension


oppositional (Passive)

– Uses a cable and harness for control of a terminal device and suspension of the prosthesis

– can be made very heavy duty for rough environments– a minimum amount of range of motion and strength are

required for use– easily maintained– a minimum amount of occupational therapy is required


cable operated (Body-Powered)

upper extremity prosthetic options


prostHetics


– Used on cable operated devices– available as Voluntary opening (Vo) or Voluntary closing

(Vc)– highest durability of prosthetic terminal devices– Many different shapes and sizes are available to assist with

different types of vocational and avocational needs– Poor cosmetics can limit acceptance

TeRMinaL DeVices

Mechanical hand– Used on cable operated devices– available as Voluntary opening (Vo) or Voluntary closing

(Vc)– Moderate durability– Meant to provide the appearance of a hand for cable

operated devices– Moderate function allows the interchanging with other types

of terminal devices for improved function and durability– Provides better cosmetics than other types of cable operated

terminal devices

TeRMinaL DeVices

Mechanical hook


– a specialty terminal device or a device designed for a specific activity which can attach to an existing device

– Wide variety of tools and adaptations available depending on vocational and avocational needs


activity specific

– Meant to provide the appearance of a sound hand– Does not provide prehension, but can provide opposition

against the sound side or the body– can be covered with a high definition glove for maximum

cosmetics

TeRMinaL DeVices

Passive hand

terminal devices


prostHetics


– Various types of socket designs are used including a window or expandable interface

– Length of limb dictates types of components used to prevent limb length discrepancy

– Body-powered, external powered (including myoelectric), oppositional and activity specific devices all are very functional for this level

aMPUTaTion LeVeLs

Partial hand– cosmetic restorations are very life like and well accepted– Wide variety of oppositional devices for bimanual activities– advancements with body-powered and external-powered

devices provide enhanced grasping patterns

aMPUTaTion LeVeLs

Wrist Disarticulation (WD)


– Used on external powered devices– although heavier than mechanical hands, provides grip

forces of over 20 lbs with minimal effort– Provides user with a very natural appearance and the

operation of a natural hand– easily interchanged with the electric hook for heavier duty

tasks

TeRMinaL DeVices

electric hand

– Used on external powered devices– Provides very high grip force, some hooks have over 40 lbs

of force with minimal effort– Moderate durability– some specific electric hooks are environmentally resistant

around water and dirt– Provides the user with a comfort that a grasped object will

not be dropped

TeRMinaL DeVices

electric hook

amputation levels


prostHetics


– With the addition of a shoulder joint, this level incorporates all the components of a transhumeral level.

– Body-powered, external powered (including myoelectric), oppositional and activity specific devices can be fit under certain patient characteristics

– external powered controls or a hybrid of controls often provide better functional results at these high amputation levels

– experience and expertise in fitting and attaining appropriate function are key elements for positive results

– suspension is achieved by a harness system

aMPUTaTion LeVeLs

Transhumeral (ae)– incorporates either a passive, cable operated, or external

powered elbow to assist with positioning of the terminal device– Requires more body motion for control of cable operated

devices than the transradial level, therefore some patients may require an external powered terminal device for optimum function.

– a “hybrid” device, a passive or cable operated elbow combined with an external powered terminal device, provides a lightweight device with high function.

– Most often suspension is achieved by the use of a harness system, although suction and gel liners can be used as an auxiliary suspension.

aMPUTaTion LeVeLs

shoulder Disarticulation (sD)


– Various socket designs used based on length of residual limb and control system

– suspension mechanism includes self suspending sockets, suction sockets or the use of a harness.

– Body-powered, external powered (including myoelectric), oppositional and activity specific devices all are very functional for this level

aMPUTaTion LeVeLs

Transradial (Be)

– Through the elbow amputation provides a longer lever arm for axial loading and control of the prosthesis

– Length of limb can limit use of certain components and create a limb length discrepancy with non-affected side and hinder cosmetic restoration.

– outside hinges are typically used that often increase the width and overall circumference at the elbow

– components reduce cosmetic restoration and limits wearing certain types of clothing

– suspension may be obtained by self suspending socket, allowing high level of range of motion and control of the prosthesis

aMPUTaTion LeVeLs

elbow Disarticulation (eD)


indication cross reference

116 ankle

116 arm

116 elbow

117 foot

117 hand

117 hip

118 knee

118 Leg

119 neck

119 shoulder

119 spine/Back

120 Wrist


inDicaTion cRoss RefeRence

ankle contracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28, 36, 62 instability . . . . . . . . . . . . . . . . . . . . . . . . 25, 29–35, 60–65 sprain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28–30, 62 symmes amputation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Tendonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28–30, 62 Weakness . . . . . . . . . . . . . . . . . . . . . . . . 25, 29–35, 60–65

arm amputation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105

elbow amputation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 contracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61–62 Dislocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76, 80 epicondylitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75–76 fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76, 79–81 neuropathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74–76 Tightness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80, 82 strain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75–76 Tendonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75–76 Ulnar neuropathy . . . . . . . . . . . . . . . . . . . . . . . . . . . 75–76 hyperextension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76, 80


foot amputation—Partial foot . . . . . . . . . . . . . . . . . . . . . . . 98 Bunion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25–26 cellulitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24–27, 33 charcot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 27, 33 foot Drop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31, 33, 35 fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28, 36 heel spur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Pes cavus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25, 27 Pes Planus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25, 27 Plantar fasciitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

hand amputation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 osteoarthrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74–75 sprain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

hip amputation—hip Disarticulation . . . . . . . . . . . . . . . . . 102 contracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56, 69 Degenerative Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Dislocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Dysplasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55, 65–67 fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55–56 Post-op . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55



knee amputation—Below knee . . . . . . . . . . . . . . . . . . . . . . 100 arthritis . . . . . . . . . . . . . . . . . . . . . . . . . 40–41, 43, 45–47 chondromalacia . . . . . . . . . . . . . . . . . . . . . . . . . 40–41, 43 contracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Dislocation . . . . . . . . . . . . . . . . . . . . . . . . . . 39–40, 48–49 instability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39–44 Ligament Tear/strain . . . . . . . . . . . . . . . . . . . . . . . . 39–44 osgood schlatter’s . . . . . . . . . . . . . . . . . . . . . . . 40–41, 43 osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45–47 Patellofemoral . . . . . . . . . . . . . . . . . . . . . . . . . . 40–41, 43 Post-op . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39–40 hyperextension . . . . . . . . . . . . . . . . . . . . . . . 42–44, 48–52 Tendonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40–41, 43

Leg amputation—above knee . . . . . . . . . . . . . . . . . . . . . . 101 femur fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 fibular fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36–37 Tibial fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36–37 Paralysis . . . . . . . . . . . . . . . . . . . . . . . . . 31, 33, 35, 48–54 Paraplegia . . . . . . . . . . . . . . . . . . . . . . . 31, 33, 35, 48–54 Ulcers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 26–27, 33 neuropathy . . . . . . . . . . . . . . . . . . . . . . . 31, 33, 35, 48–54


neck Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10–11 strain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10–11 Torticollis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11–12

shoulder acromio sprain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 amputation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 clavicular fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Disolcation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . pg 78–79 Rotator cuff strain . . . . . . . . . . . . . . . . . . . . . . . . . . 78–79 Tendonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78–79

spine/Back arthritis . . . . . . . . . . . . . . . . . . . . . . . . . 10–12, 14, 18–19 Burst fracture . . . . . . . . . . . . . . . . . . . . . . . 11, 13, 16–17 cervical fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . 10–13 compression fracture . . . . . . . . . . . . . . . . . . 10–12, 15–16 Degenerative Disc Disease . . . . . . . . . . . 10–12, 14, 18–19 herniated Disc . . . . . . . . . . . . . . . . . . . . . . . 10–12, 15–16 kyphosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11–17, 70–71 Laminectomy . . . . . . . . . . . . . . . . . . . . . . . . 10–12, 15–16 Lumbar fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15–19 osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14–15


spine/Back continued Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18–20 sciatica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70–74 si Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 spondylolisthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 spondylosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 sprain/strain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18–19 stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14–19 Thoracic fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . 12–17 spina Bifida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Wrist amputation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 carpal tunnel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 De Quervain’s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Radial fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74, 79 sprain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Tendonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74


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