Alignment of

Prostheses and Orthoses

ORTHOMANUAL
Written by: Markus Thonius OMM / CPO
ICRC - Afghanistan Orthopaedic Workshop 1992
This manual may be freely reviewed, abstracted, reproduced or translated, in part or in whole
but not for sale or for use in conjunction with commercial purposes
Alignment of Prostheses
1
Normal Position
acc. to
Braune - Fischer
Glutaeus
Maximus
Quadriceps
Femoris
Triceps
Surae
Passive
Passive
Active
2
Alignment
Trans - Tibial
short
medium
long
1/2 + 1cm
1/2 1/2
1/2 + 1cm
1/2 1/2
5
1/2
1/2
2/3
1/3
3
Reaction of a
Trans - Tibial Socket
by increasing
Flexion
5-90
1/2 1/2
4
Medio - Lateral
Static Mistakes
5
Anterior - Posterior
Static Mistakes
6
Hyper
Extension - Flexion
7
Alignment
Knee - Disarticulation
10
2/3 1/3
1/3 2/3
5
1/2
8
Alignment
Trans - Femoral
5
1,5 cm
8-10
10
4
1/2
1/2
0,5 0,5
9
Reaction of a
Trans - Femoral Socket
by increasing
Flexion or Abduction
5-90 45 Abd.
- 10 Add.
1,5 cm
10
Alignment
Hip - Disarticulation
1/2 1/2
1/2 1/2
45
1,5 cm
1/2 1/2
Foot
Knee
Hip
10
5- 8
10
4
11
Alignment of Orthoses
for
Paraplegic Patients
12
Symbols
Centre of Gravity
Joint
Joint - Free Movement
Joint - Fixed
Joint - One Side Resistant Passive
Joint - One Side Resistant Active
Joint - One Side Resistant Passive
as well as Lock
13
For Paraplegic Patients are
the same rules of value like
for the static of prostheses
Glutaeus
Maximus
Quadriceps
Femoris
Triceps
Surae
Passive
Passive
Active
14
Normal Position
of a
Paraplegic Patient
( high level )
Hyper Extension
of the
Spinal Cord
Increased Distance gives
increased Standing Stability
15
Orthotic Management
of Paraplegic Patients on
Different Spinal Levels
16
Deficit
Peronaeus Muscles
Plantar Stiff
17
Deficit
Peronaeus Muscles
M. Triceps Surae
M. Quadriceps Femoris
Lock
Dorsal Free
Plantar Stiff
18
Deficit
Peronaeus Muscles
M. Triceps Surae
M. Quadriceps Femoris
M. Glutaeus Maximus
Lock
Stiff
19
Deficit
Peronaeus Muscles
M. Triceps Surae
M. Quadriceps Femoris
M. Glutaeus Maximus
Lower Trunk Muscles
Lock
Stiff
Corset
20
Thoughts about Stability
<<<< Limit of stability >>>> <<<< Limit of stability >>>>
21
Thoughts about Stability
limit of stability <<<< > >>> stabil stabil<<<< >>>>stabil
22
Reaction of
Kafo's
during
Heel Strike
23
Orthotic Management
of the
Ankle
Model: Model: Model: Model:
PP 8 -10 mm stiff Plantar free Sarmiento free Ferrari plantar free
PP 3 - 4 mm (Dorsal Free)
(Plantar Stiff)
8-10
24
Orthotic Management
of
Leg Length Discrepancy
1/3 2/3 3/3
1- 1,5
Normal Stand Shoe Raise Plantar Flexion AFO Extension Prosthesis
2-4 cm 5-10 cm 11 - ?
25
References
HOHMANN D. - UHLIG R.
Orthopdische Technik; 7. Auflage;
Enke - Verlag; Stuttgart - Germany
BUNDESFACHSCHULE fr Orthopdie - Technik
Orthetik fr Auszubildende der Orthopdie - Technik
Bundesinnungsverband; Verlag Orthopdie - Technik; Dortmund 1991 - Germany
DITTMER K.
Orthesenkonzept nach Dr. Ferrari
Orthopdie - Technik 4/88
KAPANDJI
Funktionelle Anatomie - Untere Extremitt
Keywords: Alignment, Prostheses, Orthoses, Trans, Femoral, Tibial, Knee, Hip,
Disarticulation