OC Product Catalogue - 2018 - Screen Version PDF

A Thuasne Group Company
PRODUCT GUIDE|2018
PREFABRICATED & CUSTOM LOWER LIMB ORTHOTIC RANGE
CONTENTS
Introduction 5
Mission Statement 5
Materials 5
Design 5
Communication 5
Fitting 5
Product Guide 5
Footdrop Pathology Tree 6
Products | Prefabricated 8
Carbon Fibre Footplates 9
SpryStep Flex AFO 10
SpryStep Original AFO 10
SpryStep Plus AFO 11
SpryStep Max AFO 11
Prefabricated Product Selection Guidance 12
Stiffness Comparison 12
Products | Ankle Foot Orthoses (AFO) 13
Helix AFO 14
Prescription Form 15
Helix Plus AFO 16
Vector AFO 18
AFO Test & Definitive Orthosis Fitting Guidelines 22
AFO Casting Guideline 24
Products | Knee Ankle Foot Orthoses (KAFO) 27
KAFO Hyperextension 28
KAFO Flexion 29
KAFO Valgus 30
KAFO Varus 31
KAFO Test & Definitive Orthosis Fitting Guidelines 34
KAFO Casting Guideline 36
Components 41
The Orthotic Composites Fibonacci Joint System 41
Business Terms & Conditions 42
Contact Information 42
2 P 020 8693 3990 / F 020 8693 5811 / info@orthoticcomposites.com / www.orthoticcomposites.com P 020 8693 3990 / F 020 8693 5811 / info@orthoticcomposites.com / www.orthoticcomposites.com 3
INTRODUCTION
MISSION STATEMENT
Orthotic Composites Ltd is a design and

To apply modern,
manufacturing company with a focus on
technologically
composite materials.
advanced processes
and materials to
improve options Our team of composite fibre Engineers
for Prosthetic and are dedicated to high quality, clinically effective
Orthotic clinicians manufacturing in support of the Prosthetic
and outcomes for and Orthotic industry.
end users.
MATERIALS
PROCESSES
Orthotic Composites have independently developed
and utilise a Patented pre-preg manufacturing process.
DESIGN
Orthotic Composites maintains focus on three modern
design features for optimal outcomes.
1: The combined properties of the constituent parts
2: The geometry, size and length of the fibres
3: The ratio of fibre to matrix
Our team of experts, inclusive of HCPC registered
clinicians assist in the application of engineering
principles to Prosthetic and Orthotic science.
FITTING
Orthotic Composites fully supports the clinical fitting
COMMUNICATION process. We recommend the use of check devices.
Our technical team prefer anatomical, clinical language.
Our clinical support team can visit facilities for PRODUCT GUIDE
collaborative working and we encourage VoIP meetings
to improve communication. This product guide demonstrates the scope
of composite products, materials and processes.
We follow data protection rules as guided by GDPR. It’s contents are tested standardised designs.
FOOTDROP PATHOLOGY TREE
Parkinson’s Cauda
Disease Equina
Multiple Cauda Spina

Brain Huntingdon’s Acquired
Sclerosis Equina Bifida
Injury
Central
Non Spinal Cord
Nervous
Accidental Pathology
System
Brain Injury
Spinal
Acquired Spine Cord
Brain Injury Trauma
Myopathies
Cerebral Trauma
Palsy
Muscular
Dystrophies
“Dropfoot” Referral CVA
CVA
Invariably includes referral for LargestGroup
(Biggest clinicalbygroup
Miles)
non-addressed,
nonaddressed or orassessed
assessedplantarflexor
plantarflexor
Muscular Knee extensor
or knee extensor weakness.
weakness
Joint
surgery
Peripheral Charcot Inorganic

Diabetes Marie-Tooth
Trauma myopathies
Peripheral
Surgical Sensory and Inorganic
Complications /or Motor Causes
Temporary or Neuropathy
Motor
permanent requirement Neurone Mysathenia Alcoholic Toxic
depending on acquired Direct Disease Gravis Neuropathy neuropathy
pathology (ALS)
Vincristine
Axontmesis, Spinal
Neuropathy
Neuropraxia or Muscular
+General
Transection Atrophy
Chemo
CARBON FIBRE FOOTPLATES
Footplate 1
INDICATIONS
• Hallux rigitus
• Morton’s neuroma
PRODUCTS • Stress fractures
• Toe walking
Prefabricated DESCRIPTION
Full flat • Pre-preg based carbon fibre footplates
• Very thin
Footplate and AFO products that can be
ordered via a size chart. • Extremely lightweight
• Strong and durable
Footplate 2
• Can be used inside the shoe or set between the sole unit
• Textured surface for adhesion of covers
• Profiled footplates suitable for 10mm-20mm heel pitches
• Can be custom made to drawn templates or to footwear
ORDERING CODES
UK
FULL FULL MORTONS MORTONS
Full profiled SHOE
FLAT PROFILE FLAT PROFILE
SIZE
2 FF02 FP02 MF02 MP02
4 FF04 FP04 MF04 MP04

Footplate 3 6 FF06 FP06 MF06 MP06
8 FF08 FP08 MF08 MP08
10 FF10 FP10 MF10 MP10
12 FF12 FP12 MF12 MP12
14 FF14 FP14 MF14 MP14
Mortons flat
Footplate 4
Mortons profiled
SPRYSTEP FLEX AFO SPRYSTEP PLUS AFO
FEATURES FEATURES
• Pre-fabricated item ordered from size chart • Pre-fabricated item ordered from size chart
• Custom option available = Vector AFO • Custom option available = Helix Plus
• Trimmable with scissors at toes • Trimmable with scissors at toes
• Fully assembled on delivery • Anatomically embossed padding
• Very flexible dynamic structure • Fully assembled on delivery
• Posterior calf cuff • Medium to firm rigidity
• Lateral strut sweeping upwards to medial calf. • Anterior calf cuff
• Sweeping lateral strut into peroneal area.
CALF CIRCUMFERENCE*
FOOT LENGTH (MM) CALF CIRC
FOOT LENGTH (MM) 25MM BELOW FIBULA HEAD HEIGHT
HEIGHT SIZE VARIENCE
SIZE (MM)
MIN MAX (MM) MIN MAX MIN MAX + OR -
XS 215 245 300 XS 215 245 215 245 330 40
S 230 260 320 S 230 260 230 260 360 40
M 245 275 340 M 245 275 245 275 395 40
L 260 290 360 L 260 290 260 290 425 40
XL 290 305 380 XL 290 305 290 305 455 40
*If measures fall outside variance please see the custom made Helix Plus option
SPRYSTEP ORIGINAL AFO SPRYSTEP MAX AFO

FEATURES FEATURES
• Pre-fabricated item ordered from size chart • Pre-fabricated item ordered from size chart
• Custom option available = Helix Original • Custom option not available
See Vector AFO for other options
• Trimmable with scissors at toes
• Trimmable with scissors at toes
• Fully assembled on delivery
• Anatomically embossed padding
• Medium rigidity
• Fully assembled on delivery
• Posterior calf cuff
• Firm rigidity
• Lateral strut sweeping upwards to posterior.
• Anterior calf cuff
• Lateral strut forward of lateral malleoli.
FOOT LENGTH (MM) FOOT LENGTH (MM)

HEIGHT HEIGHT
SIZE SIZE
MIN MAX (MM) MIN MAX (MM)
XS 215 245 300 XS 195 215 335
S 230 260 320 S 210 230 370
M 245 275 340 M 230 255 395
L 260 290 360 L 255 275 420
XL 290 305 380 XL 275 290 420
Sprystep SpryStep SpryStep SpryStep Custom
PREFABRICATED PRODUCT SELECTION GUIDANCE
Flex Original Plus Max Option
Proprioception P P P
Fatigueable footdrop P P P P
Footslap P P P P
Footdrop P P P
Excessive plantarflexion during swing phase
PRODUCTS
P P P
(secondary to weak dorsiflexors)
Weakness of the pretibial muscles <=3
Custom Ankle Foot
P P P
Ankle
Plantar flexor strength 4 P P P P
Orthoses (AFO)
Plantar flexor strength 3 or 4 P P P
Plantar flexor strength 2 P P
Pain in movement toward dorsiflexion P P
Partial foot amputation (Chopart or more distal) P P
Composite materials lend themselves to AFO
Partial foot amputation (Chopart) P P intervention by being lightweight strong and
Plantar flexor strength 0 or 1 P P energy storing.
Knee Hyperextension P P
Mild Knee instability during stance phase P P P P
Knee Conditions
Mild Quad weakness P P P

Excessive knee flexion during stance phase
P P P
(secondary to weak planter flexors)
Moderate Knee instability during stance phase P P P
Pronounced Knee instability during stance phase P P
Moderate Quad weakness P P
Pronounced Quad weakness P
Plantarflexion contracture P
Knee hyperextension caused by calf muscle spasticity P
High tone P
Inconsistent oedema P
Non-correctable triplanar instability P
High pitched footwear
Other
P
Compromised footwear choice P
Running/High impact Activities P P
Circumduction P P P P
Vaulting P P P
High Knee Gait P P P
Hip Hiking / Contralateral trunk lean P P P
STIFFNESS COMPARISON: RESISTIVE LOAD INTO DORSIFLEXION SpryStep Max SpryStep Plus SpryStep SpryStep Flex
70 LOAD (lbs)
60
50
40
30
20
10
DORSIFLEXION
0
0˚ 15˚ 30˚
HELIX AFO PRESCRIPTION FORM
HELIX AFO
ADMINISTRATIVE DETAILS
Date / / Facility PO No.
INDICATIONS Orthotist E-mail Appointment Date / /
• Fatigueable footdrop
END USER DETAILS
• Footslap
Client Reference Left Right
• Footdrop
End User Relevant Medical History
• Excessive plantarflexion during swing phase
(secondary to weak dorsiflexors) Weight Height
• Weakness of the pretibial muscles <=3

BIOMECHANICAL OBJECTIVES
• Plantar flexor strength 4 > 3
Control Dorsiflexion Weakness Control Plantar Flexion weakness Control Ankle Varus Instability
• Knee Hyperextension
Control Ankle Valgus Instability Resist Knee Hyperextension in Stance Resist Knee Flexion in Stance
• Mild Knee instability during stance phase
Other
• Circumduction
• Vaulting
OPTION 1 | MADE TO CAST
• High Knee Gait
Negative Cast is correct
• Hip Hiking / Contralateral trunk lean
Negative Cast imperfect - Describe
DESCRIPTION
The Helix AFO is a custom posterior calf shell PITCH MEASURE (OPTION 1 ONLY)
composite AFO, manufactured to a cast.
Flat or cupped footplates can be incorporated into
the design.
The strut originates form the lateral posterior side
of the footplate and straightens in the posterior
midline to a semi rigid calf cuff.
The geometry allows easy donning whilst being Rear foot MM
geometrically strong. Helix with Cupped Footplate (DEFAULT) Helix with Flat Footplate Forefoot MM
OPTION 2 | MADE TO MEASUREMENT

PLEASE NOTE: Flat Footplate only - No cupped option. 13mm heel pitch.
NOTES

Calf Height MM
Calf Circumference MM
Foot Length MM

STRAP OPTIONS SHOE SIZING

Velfoam wrap with crocodile clip (DEFAULT) Calf Shoe Size

Leather Returning (DEFAULT) Calf Match Template traced on form

Other Shoe provided to match
Include floating pads on straps
Include a spare set of straps
HELIX PLUS AFO PRESCRIPTION FORM
HELIX PLUS AFO

INDICATIONS Orthotist E-mail Appointment Date / /
• Fatigueable footdrop
END USER DETAILS
• Footslap
• Footdrop
• Excessive plantarflexion during swing phase
Weight Height
• Weakness of the pretibial muscles <=3
• Plantar flexor strength 3 or 4 BIOMECHANICAL OBJECTIVES
• Mild Knee instability during stance phase Control Dorsiflexion Weakness Control Plantar Flexion weakness Control Ankle Varus Instability
• Mild Quad weakness Control Ankle Valgus Instability Resist Knee Hyperextension in Stance Resist Knee Flexion in Stance
• Excessive knee flexion during stance phase Other
• Circumduction
• Vaulting
CAST
• High Knee Gait
• Hip Hiking / Contralateral trunk lean
Negative Cast imperfect - Describe
DESCRIPTION
The Helix Plus AFO is a custom anterior calf shell

composite AFO, that is manufactured to a cast.
Flat or cupped footplates can be incorporated into
the design. Helix Plus with Cupped Footplate (DEFAULT) Helix Plus with Flat Footplate
The strut originates form the lateral posterior side

of the footplate.
PITCH MEASURE SHOE SIZING STRAP OPTIONS
The strut curves around to the posterior midline
Shoe Size Velfoam wrap with crocodile clip (DEFAULT) Calf
before returning to the lateral proximal anterior
calf cuff. Match Template traced on form Leather Returning Calf
The geometry allows easy donning whilst being Shoe provided to match Other
geometrically strong.
Include floating pads on straps
Include a spare set of straps
Rear foot MM
Forefoot MM
NOTES

VECTOR AFO
INDICATIONS
The Vector AFO is a custom AFO which can be
prescribed with five different stiffness of strut.
The custom made and variable stiffness design
makes the Vector AFO inclusive in its indications.
DESCRIPTION
The Vector AFO is a custom shell composite AFO,
that is manufactured to a cast.
Calf and footplate copolymer shells are supported
by a composite fibre superstructure.
The composite fibre trim avoids boney prominences
allowing a high margin of fitting error.
A choice of five different strut stiffnesses allow the
Vector to address a wide range of pathologies.
The strut originates from the lateral posterior side
of the footplate.
The strut curves around to the posterior mid-line.
A rigid carbon anterior shell can be chosen as
an option if ground reaction forces are of high
importance.
VECTOR AFO PRESCRIPTION FORM
WEIGHT (KGS) HEIGHT (CM) MUSCULAR STRENGTH TESTS
Quadriceps strength 0 1 2 3 4 5
RANGE OF MOTION Hamstrings strength 0 1 2 3 4 5
a) Knee ROM ° shy of full extension Dorsiflexion strength 0 1 2 3 4 5
Orthotist E-mail Appointment Date / /
b) With knee extended, ankle ROM, from ° to ° Plantar-flexor strength - no. of single limb heel raises
END USER DETAILS (PLEASE FILL BACK OF FORM)

DEFORMITY
Describe any deformity if present
Correctable Semi-rigid Rigid

ACTIVITY LEVEL (CHECK ONE)

Household ambulation, sit to stand and transfers only.
Control Dorsiflexion Weakness Control Plantar Flexion weakness Control Ankle Varus Instability
Active household ambulator, with walker or cane, cares for self.
Limited community ambulator, walks at slow cadence with
Other walker or cane on level surfaces.
Active community ambulator, walks with or without cane at Quadricepts Strength Test Hamstring Strength test
CAST varying cadence on level and un even paved surfaces with

curbs and ramps.
Independent ambulator, variable cadence, uneven surfaces
Negative Cast imperfect - Describe both paved and unpaved.
Very active ambulator, runs and jumps and may participate
DEFAULT VECTOR DESIGN in sporting activities.
Overwrite to indicate any desired changes from the default designs shown
OBSERVATIONAL GAIT ANALYSIS (CHECK ALL THAT APPLY)
Drop foot (poor swing phase clearance)
Foot slap (rapid movement from initial contact to loading response)
Knee wobble in early stance
Knee hyperextension in early stance
Ankle Dorsiflexion strength test Heel Rise Test
Limited tibial advancement in second rocker
Knee flexion in mid-stance
Knee hyperextension in mid stance
Knee buckles at end of stance NOTES
Internal rotary deviation
External rotary deviation

Default Vector Anterior Shell Option Lateral Varus Pad Option
DEVICE SHOULD ALLOW

Controlled motion in both dorsi and plantarflexion and
allows a smooth transition from initial contact to loading
response with very mild control of tibial advancement.
Good control of inversion and eversion, limited control in
STRAP OPTIONS SHOE SIZING PITCH MEASURE
transverse plane. This level of control guides the limb.
Leather Returning (DEFAULT) Calf Ankle Shoe Size
Moderate support to control the knee throughout stance
Velfoam wrap with crocodile clip Calf Ankle Match Template traced on form phase with moderate control of transverse plane. This level
provides complimentary level of control, that is it complements
BOA Tunnel Strap Calf Ankle Shoe provided to match the individuals existing alignment and muscle control.

Other Firm support to add high level of control in all planes.
This level provides moderate control and begins to affect the
Include floating pads on straps FOOTWEAR DESCRIPTION Rear foot
position of the knee and the ankle in all three planes.

Include a spare set of straps Type of footwear client typically wears Forefoot
High level of control for very large or very active patients.
This level applies a level of stiffness that can completely block
movement in some planes.

AFO TEST & DEFINITIVE ORTHOSIS FITTING GUIDELINES
10 Sagittal Plane control (Dependent on the Treatment model being used)

Orthotic Composites requires that the end-user dynamically tests the device in walking.
a Ground clearance on swing phase?
If changes are required we require the adjustment of check devices. This could include heating out or padding within the
device. A physical representation of the shape is the ultimate purpose of the check fitting process. b CVA AFO Best Practice
i Ensure stance yield knee flexion is optimal.
SAFETY ii Mid-stance shank angle?
Consider appropriate risk management procedures. iii Does the toe break/point loading rocker function as desired?
1
Use parallel bars or similar patient safety measures to protect the end user during the fitting process.
iv Is a full length stride possible?’
BENCH ANALYSIS OF ORTHOSIS • Catch angle or velocity dependant hypertonicity?
2 Check that the orthosis matches requested specification. c Ankle joints or Helix where available ROM is utilised.
3 Check for stability of the device in the shoe. i Is weight acceptance smooth without causing rapid knee flexion at initial contact?
a Does the heel height match the pitch originally requested? ii Control of transverse plane motion related to Ankle joint type?
Trim the footplate of the Diaclear Test Orthosis or the aramid footplate (Consider the health and safety document on the iii Is second rocker controlled as desired?
b
Orthotic Composites website).
• Mid-stance shank angle.
c Test/Definitive Orthosis rocking over the waist of the shoe?
iv Is a full length stride possible?’
d Shank angle as documented?
11 Transverse plane control
e Prepare padding materials for use in dynamic fitting.
a Consider intrinsic control or posting.
SEATED FITTING b Consider reviewing prescription if excessive internal rotation occurs.
4 Donning and doffing. c Ankle joint choice appropriate for control goals?
a Can it be managed, trained, or practiced, affording later success?
SUMMARY CHECKS (Carried out on each of the steps above)
b Will physio or ADL support help?
12 Are the ankle joints in the correct position?
5 Knee flexion.
13 Tissue clearance/rubbing during gait?
a Consider minimal plastic trimming or heating out to reduce tissue pinching.
a Please pad or heat out as required to optimise dynamic hydrostatic fit.
6 The patient must now safely stand in the orthosis.
14 Pressure marks?
This action can be made safe with the use of the definitive shoe.
a a Consider heating out, functional control changes.
Failing this, a prosthetic slipper or post-operative shoe with pitch compensation can suffice.
b Trim material
SIT TO STAND FUNCTION
c Consider alignment before considering return curves.
7 Does the test orthosis catch any areas of the leg in standing.
a Cast alignment or rectification issue? COMPLETION
i Cast under or overcorrected during cast taking? 15 On Test Orthosis
ii Consider alignment before return curves. a Mark the strap fastening point.
8 Static Alignment Minimise errors by making actual changes to check device (padding or flaring out) to achieve a dynamically tested fit.
b
As opposed to writing on the device.
a Is the End User comfortable in quiet stance?
c Mark any impractical to adjust areas to communicate with technician.
i Forefoot to rearfoot weight distribution?
d Mark any other areas that need modified.
b Hyperextension or flexion beyond desired position?
e Document fully everything that is required to be done and that has been done.
i Tune static alignment as necessary to enable dynamic alignment to take place.
f Supply anonymised photos of issues if possible: if local policy allows and if the end user agrees to this.
FUNCTION IN GAIT
REVIEW
9 Does the test orthosis provide enough frontal plane control?
16 All AFOs must be checked by a certified clinician every six months in line with industry standards.
a Requirement for intrinsic and/or extrinsic modifications?
i Composite (rectified in) or padding (adjustable)?
AFO CASTING GUIDELINE
Plaster bandage should be wrapped from above the

intended proximal trim distally. Three layers at the top edge
Please ensure the Guidelines & Prescription Form CASTING will provide sufficient strength and when wrapping down
are close to hand. incorporate at least 50% of the previous layer.
Avoid having the cutting strip running along any area that
After a full clinical assessment, you should have detailed and requires high definition shape capture. Perhaps consider a
clear clinical goals which can be communicated to us on the lubricated removable cutting tube, if using shears.
prescription form.These goals, along with biomechanical
data, will be reflected in what corrections are appropriate Also try to avoid placing the cutting strip/tube on area
during negative cast taking and manual rectification. where the definitive orthosis will interface with the leg.
Depending on the treatment model being used; you should Cling film may assist with demoulding the cast and protecting
consider both sagittal and frontal plane control (Intrinsic the end user from residue – but should not be applied in a
and extrinsic) and the effect that this will have on the way that deforms soft tissue.
transverse plane, Range of Movement, V2 Catch and shank
inclination goals.
Each cast for AFO should have clearly differentiated clinical
and functional goals, that your end user is fully subscribed
to.
PRE-CASTING
Plaster bandage is the process preferred for AFO shape
capture. This is due to the ability to manipulate the foot
position during setting and the capability to highlight
complex anatomical shape.
Footwear choice is symbiotic with a good clinical outcome.
Appropriate footwear should be extra depth fitting, stable
and fastenable. Athletic/Cross Trainer Shoes are often the
best example of such footwear. Application of Cling film protection
Mark position of bony landmarks on the stockinette
Understanding the heel sole differential of the footwear
Stockinette can be used to hold the cutting strip in place and
choice allows an improved AFO/ Shoe fitting interface. The Knowledge of the anatomical land mark positions assist
heel sole differential is the difference between the height of with the placement of the major AFO components such as
the sole at the heel and the height of the sole at the ball of the foot trims and strut position. This can be achieved by
the foot. marking the stockinette. Plantigrade neutral position on pitch board
A semi-weightbearing cast using a casting board is preferred. Anatomical landmarks of importance include:
Appropriate risk analysis should be undertaken by the • Tibial tuberosity
clinician to ensure the end user is not likely to be injured or
• Line of tibial crest
be too quickly fatigued during the casting process.
• Head of the fibula
• Lateral malleoli
• Medial malleoli
• Base of 5th metatarsal
• Head of 5th metatarsal
• Head of 1st metatarsal
• Navicular
Stickinette with cut off strip away from orthosis interface points
if possible, use a pitch board to accurately replicate the

footwear and raise combinations to be used with the
definitive orthosis. Ensure subtalar neutral
With the pitch board in use please decide if you want the
shank at 90 degrees or another assessed and clinically Once the plaster is wrapped a pitch board can be used
validated sagittal plane angle that replicates your mid- to influence the shape of the plantar surface to match the
stance goal. Maintain this throughout the casting session. footwear.
Also consider the desired frontal plane alignment in mid- The leg should be vertical from the saggital angle. The
stance. Your cast should represent this and approach as close midline of the leg should be vertical. On most normal legs
to neutral coronal plane alignment as clinically possible. the leading tibial crest should be in approximately 7° of
inclincation.
If high proximal trim lines are to be used then please
consider extending the back of the cast to encapsulate the The aim is a fully correctable foot and ankle complex to
hamstring insertions. encourage a sub talar neutral position whilst the sagittal
Wrap evenly from the proximal trim distally.
angle is plantigrade. This can be assessed by palpating the
Safe and prepared environment medio-lateral head of the subtalar bone and ensuring they
are equally palpable on each side.
Once removed the negative cast can be sealed with extra
plaster bandage to keep it strong for transport.
When preparing a cast for transport try not to seal it in a
non-breathable material like plastic bubble wrap or plastic
bags as it will remain wet and weak.
The best packing materials are cardboard based, strong
and tolerant enough of some abuse during shipping. PRODUCTS
Knee Ankle Foot

Orthoses (KAFO)
NOTES

Orthotic Composites production processes create
lightweight low profile KAFOs.
Our KAFOs can be fully manufactured and finished

to weigh as little as 750gm whilst supporting an
average sized adult.

Cutting off the cast

Once set the cast can be removed according to the
clinicians preferred cutting methodology.
Using a sharp scalpel is often the cleanest, easiest and

safest way to remove newly set plaster bandage despite

there being obvious sharps risk when the safety is poorly
considered.

Removing and sealing the complete negative cast

KAFO HYPEREXTENSION KAFO FLEXION
HYPEREXTENSION RESIST KAFO FLEXION RESIST KAFO

The primary observable gait deviation during stance The Flexion resist KAFO designs primary role is
phase is that of Genu Recurvatum. to combat excessive knee flexion in stance phase
through the development of structurally applied
This may be secondary to quads weakness or corrective forces.
proprioceptive issues which prevent the quadriceps
from firing appropriately. The shank is supported by an anterior shell that
creates a knee extension moment in stance phase
The structurally applied force patterns are designed in a locked or posteriorly offset KAFO. This is
to combat this primary presentation as this is the augmented by a lateral spring and full footplate
most efficient method of applying correction to that, along with the correct shoe combination, help
satisfy the assessed biomechanical goals. to set up the appropriate force pattern.
Below the knee, a calf cuff supports against The ankle spring is designed to provide smooth
declination of the shank. This force application is progression from early stance to late stance, and in
managed by the Helix spring construction which starting to walk; where it is often difficult to initiate
provides a balanced application of correction via the centre of pressure progression.
forefoot and the shoe fastening system.
Above the knee is a posterior cuff arrangement that
Above the knee, the anterior shell provides a interacts with the knee extension moment set up
maximal moment arm, or force application, allied by the shank section. This functions both statically,
to the structural integrity of the calf cuff to actively when locked, and in a dynamic fashion when used
correct the genu recurvatum. as a posterior offset KAFO.
This simple force system acts statically, in weight The limits to cast flexion ranges on this type of
bearing, and dynamically in gait by manipulation of system are 0-10 degrees of flexion when using our
the ground reaction force throughout stance phase. “Standardised OC Designs Range.”
We recommend using a full-length footplate in these If you wish to provide your patient with a KAFO that
KAFOs to enable GRF manipulation, if prescribed as is outside these ranges then we invite you to take
a posterior offset KAFO. advantage of our Consultation and Design service.
Secondary functions are supported by strapping
arrangements.
Regrettably, we cannot accept hyperextended casts
within the remit delivered by our “Standardised OC
Designs Range”. They should be positioned at 0-5
degrees of knee flexion.
If you wish to provide your patient with a
Hyperextended kafo, then we invite you to take
advantage of our Consultation and Design service.
KAFO VALGUS KAFO VARUS
VALGUS RESIST KAFO VARUS RESIST KAFO

This minimalist design can be augmented with the This minimalist design can also be augmented with
flexion or hyperextension resist KAFOs to provide the flexion or hyperextension resist KAFOs.
the most elegant solution for your end-user.
In its purest form it utilises a helix spring and the
This orthosis uses a helix spring on the shank and shank and presents with generous trimlines and
presents with generous trimlines and surface areas surface areas that are relevant for correction of
that are relevant for correction of knee valgus. We knee varus. We use high Medial trimlines on the
use high lateral trimlines on the thigh, allied to a thigh allied to a medial heelcup to create laterally
lateral heel cup to create medially directed forces. deviated forces.
There are generous support areas around the There are generous support areas around the
superior shank and inferior thigh, medially, to create proximal shank and distal thigh, laterally, to create
the 3rd point of summative force that applies the the 3rd point of summative force that applies the
moments required to hold the corrected leg in an moments required to hold the leg in an optimal and
optimal and comfortable position. corrected position.
The limit to cast angle on this type of system is The limit to cast angle on this type of system
17 degrees of absolute valgus when using our is 5 degrees of absolute varus when using our
“Standardised OC Designs Range.” “Standardised OC Designs Range.”
Absolute angle is the relative angle of the femur and Absolute angle is the relative angle of the femur and
tibia ignoring the ‘Q’ angle. tibia ignoring the ‘Q’ angle.
If you wish to provide your patient with a KAFO that If you wish to provide your patient with a KAFO that
is outside these ranges then we invite you to take is outside these ranges then you can take advantage
advantage of our Consultation and Design service. of our Consultation and Design service.
*Sections marked with an asterisk MUST be completed
KAFO PRESCRIPTION FORM otherwise manufacturing will not proceed.
COMPONENT CHOICE
Fibonacci Free Fibonacci Locked Other
Date / / Facility PO No. STRAPPING OPTIONS Thigh Calf LININGS
Orthotist E-mail Appointment Date / / Velcro return external to shell (DEFAULT) None (DEFAULT) Thigh Calf
Velcro return integrated within shell Description
END USER DETAILS
Client Reference Left Right FITTING (CLEAR CHECK FIT ORTHOSIS IS SUPPLIED TO ALLOW VOLUMETRIC MATCH AND DYNAMIC ALIGNMENT)
End User Relevant Medical History* See our Fitting Guide and Casting Guide.
Weight* Height Please FULLY modify the Diaclear at your appointment. Cut, trim ,heat in/out, pad etc. This modified and validated orthosis will
be used as your dynamically tested and aligned plaster model for definitive manufacture. All volume modifications must be
tested dynamically by you, before the definitive orthosis is manufactured.
All KAFO designs are constructed in the Line Of Progression by default. If non-line of progression construction is required then
Control Dorsiflexion Weakness Control Plantarflexion weakness Control Ankle Varus Instability
please highlight this in Notes, below. You must use a 60/40 for this or be assured that your marking technique is accurate.
Knee valgus control Control Knee varus Posterior/Anterior Knee Drawer Control
Other
CAST
Negative Cast is correct Negative Cast imperfect - Describe
FOOTPLATE LENGTH Full Length (DEFAULT) ¾ Length FOOTPLATE SHAPING Cupped (DEFAULT) Flat and pitched
PRIMARY TREATMENT GOAL* Please tick
HYPEREXTENSION RESIST VALGUS RESIST VARUS RESIST FLEXION RESIST
NOTES

CAST ANGLE LIMITATIONS (If client presents outside limit contact with OC Consultant required)

0-5˚ flexion
≤ 17˚ absolute valgus ≤ 5˚ absolute varus 0-5˚ flexion
(no hyperextention)

MARK PRIMARY TRIMLINES* Draw any desired changes on trimline chart in pen.
Hyperextension KAFO Valgus Resist KAFO Varus Resist KAFO Flexion KAFO (Managed Ankle Rockers)

KAFO TEST & DEFINITIVE ORTHOSIS FITTING GUIDELINES
b Too much return curve in the medial perineal area?

Orthotic Composites requires that the end-user dynamically tests the device in walking.
c Consider trim line height after the above points.
If changes are required we require the adjustment of check devices. This could include heating out or padding within the
device. A physical representation of the shape is the ultimate purpose of the check fitting process. d Please pad or heat out as required to optimise dynamic hydrostatic fit.
11 Posterolateral aspect of the Shell?
SAFETY a Sufficient posterolateral stabilisation?
Consider appropriate risk management procedures. b Sufficient force couple to limit flexion collapse?
1
Use parallel bars or similar patient safety measures to protect the end user during the fitting process.
i If the cuff moves back and forward, more than minimally, on the leg during walking then the answer is usually, “no.”
BENCH ANALYSIS OF ORTHOSIS 12 Does the test orthosis provide enough frontal plane control?
2 Check that the orthosis matches requested specification. a Requirement for intrinsic and/or extrinsic modifications?
3 Check for stability of the device in the shoe. i Composite (rectified in) or padding (adjustable)?
a Does the heel height match the pitch originally requested? 13 Sagittal plane control?
Trim the footplate of the Diaclear Test Orthosis or the aramid footplate (Consider the health and safety document on the a Knee stability at heel strike to mid-stance on flat and sloping ground?
b
Orthotic Composites website).
i Consider level of posterior offset that is utilised.
c Test/Definitive Orthosis rocking over the waist of the shoe?
d Shank angle as documented? SUMMARY CHECKS (Carried out on each of the steps above)
e Prepare padding for use in dynamic test and fitting. 14 Are the ankle joints in the correct position?
15 Are the knee joint centres in the correct position (Sagittal, Coronal and Transverse)?
SEATED FITTING
a Line of Progression alignment.
4 Donning and doffing.
i In SCOs: medial or lateral whipping?
a Can it be managed, trained, or practiced, affording later success?
b Minimise errors by making actual changes to check device (padding or flaring out) to achieve a dynamically tested fit. As
5 Knee flexion.
c Mark any other areas that need modification.
d Anatomical Alignment.
6 The patient must now safely stand in the orthosis.
i Joints follow the transverse plane alignment of the knee?
e Joints too high?
SIT TO STAND FUNCTION i Tightness in the posterodistal cuff?
7 Locking (If applicable). ii Posterior offset joints?
a Easy to lock/unlock? f Joints too low?
i If not, cast may be too extended. i Anterodistal cuff pressure.
ii GRF manipulated effectively?

COMPLETION
8 Does the test orthosis catch any areas of the leg in standing?
16 On Test Orthosis
a Cast alignment or rectification issue?
a Mark the strap fastening point.
i Cast under or overcorrected during cast taking?
b Mark any other areas that need modified.
ii Consider alignment before return curves.
c Document fully everything that is required to be done and that has been done.
9 Static Alignment?
d Supply anonymised photos of issues if possible: if local policy allows and if the end user agrees to this.
a Hyperextension or poorly controlled flexion?
REVIEW
i Consider tuning ankle joints or AFO pitch to gain desired static alignment.
17 All KAFOs must be checked by a certified clinician every six months in line with industry standards.
FUNCTION IN GAIT
10 Is the perineal area comfortable?
a Is underwear causing impingement?
i Supportive underwear is recommended.
KAFO CASTING GUIDELINE
CASTING
Footplate: Apply the wet, strained and smoothed slab to
Please ensure the Guidelines & Prescription Form
the plantar surface of the foot, with the longitudinal cut
are close to hand.
located at the heel. Position on pitch board.
After a full clinical assessment, you should have detailed and
Fold the rear sections of the footplate together so that they
clear clinical goals which can be communicated to us on the
meet and mate smoothly together without forming any holes.
prescription form.These goals, along with biomechanical
data, will be reflected in what corrections are appropriate Apply any required intrinsic or extrinsic corrections and
during negative cast taking and manual rectification. then position the foot back on the pitch board.
Depending on the treatment model being used; you should
consider both sagittal and frontal plane control (Intrinsic
and extrinsic) and the effect that this will have on the
transverse plane, Range of Movement, V2 Catch and shank
inclination goals.
Each cast for KAFO should have clearly differentiated
clinical and functional goals, that your end user is fully
subscribed to.
PRE-CASTING
Cutting tube: The preferred technique is to utilise a
lubricated 10mm outside diameter vacuum hose positioned
away from any bony areas.
The use of flat polypropylene strips is not recommended,
especially in anterior shell designs, as it can hide or wipe Medial Long Slab preperation
out important anatomical information.
Smooth the forefoot of the slab into the pitch board.
If casting in a shoe to replicate a complex shoe pitch then
omit the Foot Slab section as it will be too thick for most Lateral Long Slab preperation If required, create a tunnelling effect to the sidewalls.
shoes to accommodate.
Mark the required footplate length and width, and the heel
Calf Slab preperation Posterior Reinforcement Slab: 4 layers thick and added
cup sidewalls.
after all wraps have been done.
SLAB PREPARATION
Medial Long Slab: 4 layers thick. It SHOULD NOT be Mark a 25mm extension to the required footplate length
Foot Slab: 8 layers of plaster bandage. A pitch board of positioned over the cutting tube, as this will make cast and trim to this extended line.
some form should be utilised to ensure that the footplate is removal challenging.
Trim the heelcup to the desired shape.
fully shank dependent.
Posterior Reinforcement Slab preperation
Medial Long Slab preperation

Trimming heel cup
Foot Slab preperation
Lateral Long Slab: 4 layers thick. It SHOULD NOT be
Calf Slab: 4 layers thick and fitted when the knee is bent positioned over the cutting tube, as this will make cast Calf Slab: Apply the slab to the calf and ensure that it forms
at 90 degrees and the leg represents mid-stance position removal challenging. contact with the heelcup of the footplate.
(single leg support) of your end user in the frontal plane.
Leg slabs pre-prepared and concertina folded.
Now wrap with plaster from below the Tibial Tuberosity to
the Met heads taking care not to deform the forefoot plate
edges. Ensure that the required shank alignment in frontal
and sagittal planes is maintained as the plaster hardens.
Position your client on the plinth and apply the Medial Slab
as previously discussed.
Application of Knee Slab
To finishing off the cast, position the leg so that it

represents the patient’s unique single stance, including toe-
out. It should not be abducted or flexed at the hip or knee
unless your goal is this position in standing.
Apply pressure to the medial aspect of the thigh, Apply
Application of Medial Slab posterolateral cupping pressure under the gluteal fold. This
can also be applied to the ischium if desired.
Apply the Lateral Slab as previously discussed.
Applying the slab to calf
Marked line of progression

Now wrap with plaster from below the Tibial Tuberosity to
the Met heads taking care not to deform the forefoot plate
edges. Ensure that the required shank alignment in frontal Remove the cast - we advise the use of plaster shears.
and sagittal planes is maintained as the plaster hardens. Mark the cast with the PO Number and ordering source/
Hospital/Clinic.
Application of Lateral Slab
Wrap: Apply plaster bandage in a a slightly abducted and

flexed hip position. Do not wrap tightly as this will increase
the amount of positive model rectification that is required.
Removing and sealing the complete negative cast
Seal the cast with small plaster tabs or staple the cast in a
Finishing off Cast closed position using an industrial stapler.
Mark the line of progression on the sole of the cast and Do not wrap in plastic, bubble wrap or anything non-
cutting marks as desired. breathable. These casts will not be accepted due to
deformation potential.
Only wrap your cast in breathable and absorptive paper
or packing. Ensure that cast is well protected and that the
shipping box is labelled as “Fragile.”
Application of plaster bandage
Ensure all relative information is supplied with the cast.
Please refer to our T & C’s for manufacturing times.
Lastly apply the Knee Slab, positioned as previously
Checking shank alignment
discussed. Be careful not to deform the Hamstring relief.
COMPONENTS
THE ORTHOTIC COMPOSITES
FIBONACCI JOINT SYSTEM
Fibonacci spirals are found in many aspects of nature. One Features

example being the synergistic motion of human knee joints.
• Uniquely designed for use in pre-preg composite
manufacturing.
The Fibonacci
• Locked in stance or Free moving versions available
• Standard or heavy duty versions available.
movement closely • Finished orthoses are incredibly low profile.

• Full serviceability assures the end-user of long term use.
reflects the naturally • Serviceability makes the Fibonacci knee system a cost
effective and clinically effective tool.
elegant simplicity of • Manufactured from aircraft quality Titanium, and
finished with high quality composite fascia’s.
the anatomical knee • Weak spots normally associated with metal side bar
bolting, bonding or shaping, are eradicated.
joint with its slide, • Supported by the UK’s leading authority on composite
construction, lower limb biomechanics, clinical
glide and roll actions. effectiveness and education.
The Fibonacci system rids us of the

problems of orthotic joint growth during knee
flexion. Sitting comfort is increase whilst maintaining
overall congruence. Suspension against the limb remains
stable throughout knee movement.
This elegant Patent Pending joint system has an abundance
of further features that make it stand out from the crowd.
BUSINESS TERMS & CONDITIONS NOTES

1. Clinical responsibility a. These visits will be charged at a pro rata i. Orthotic Composites requires a total of
You have clinical responsibility. proportion of our daily Consultation rate; twenty days manufacturing time.
plus travelling time; made available on
a. Where Orthotic Composites Ltd provides b. Please tell us the date of the next booked
request and you will also be advised of these appointment, or give us an approximation of
clinical support services it is on the implicit in advance of any collaboration. when this will be.
understanding that the sole decision maker
in any environment is the incumbent b. We aim to provide the highest quality of
autonomous Prosthetic and Orthotic Allied service for complex patient needs. We may 9. Warranty
Health Professional. We guide, based on send more than one clinical representative
A structural warranty will be applied
extensive experience and the evidence base, on occasion. You will only be charged for one
conditionally upon the prescription suiting the
but you must make the decision to accept representative.
presentation, Activity of daily living and use of
our advice or utilise your own experience, c. If we recommend that our services are not the product within planned parameters by the
knowledge, evidence-based practice or local the best for your patient then the daily end user.
consensus. charge remains payable. To avoid the
above scenario occurring then we would
a. 6 months is included with all OC standardised
design custom orthoses.
2. Measurement forms recommend that your clinical staff attend one
or more of the KAFO courses run throughout b. 2 months is offered on non-standardised
a. Users of Orthotic Composites Ltd services designs.
the country by our staff.
will only use the Orthotic Composite
Measurement form located in our product i. We will, of course, aim to provide c. If failure occurs at any level then we would
catalogue. The forms are also located on our evidence-based advice on what might welcome the opportunity to investigate
Website under the heading “Downloads”. be appropriate for any agreed goals and clinically appropriate methods of achieving
outcomes. the original goals.
b. Service users must sign, name and date the
Orthotic Composites measurement or fitting ii. You are responsible for accepting this This warranty is dependent on all manufacturing
form. Whether a specific box is visible or not, advice or not. up to the completion of the definitive orthosis
due to printer failure or any other reason for being done by us. See point 10.
its being omitted. 6. Fitting charges
10. Identification
c. Service users can order OC standardised a. Non-standardised orthoses will be subject
designs of composite lower limb orthoses. to post fitting modification fees and Any Custom Orthosis manufactured by us is
Consultation fees at each step of an episode. warranted only if it remains identifiable as being
i. Only OC standardised designs can be
developed and built by Orthotic Composites Ltd.
ordered with the order form presented on b. All OC standardised design orthosis orders
our website and product catalogue. assessed as following our guidelines for a. In line with the Medical Devices Association,
information provision and cast quality will be all of our products are immediately
ii. We will only accept the order form
afforded two post fitting modifications, free identifiable as being manufactured by
presented on our website and product
of charge. After this point is reached they will Orthotic Composites.
catalogue.
be charged appropriately through our normal i. This identification relates to its condition
invoicing system. on completion, by us, or of the last
3. Data collection during assessment
i. If more fittings are required then this will episode of servicing or modification by us.
The patient assessment data collected by the
be chargeable, based on the scales held by ii. If any modification of the orthosis is
clinician must adhere strictly to the functional
Orthotic Composites Ltd. carried out by an external manufacturer
and physical characteristics set out in our
standard Assessment/Measurement forms c. Fitting fees are non-refundable as they then our identification mark must be
designed for manufacture of a OC standardised represent our real manufacturing and covered by one from the group or
orthosis design. handling costs. individual that authorised and carried out
these modifications. See point 9.
4. Missing or unclear information 7. Prescription changes b. Orthotic Composites have no White Labelled
Our Assessment/Measurement forms must be Any change of prescription will require the Custom Fabrication rebadging agreements
fully and accurately completed. If a measure, raising of a new order. But if we can manage to in place. Any form of this will invalidate any
indicated as required, is not completed then satisfy change requests in your favour then we guarantee, inferred or otherwise.
we will not proceed with the order until this will. These changes include but are not limited
to: 11. Intellectual property

information is made available. We cannot make
approximations. a. Changing trim lines, by adding material. We reserve the right to, and will, protect our IP
via legal channels.

a. No manufacturing progress will be made b. Changing joints or side member material.
whilst we await further information. This
information requirement will be recorded c. Changing fastening type. 12. Invoicing and ownership
and auditable. It can be made available, on d. Alteration of cast alignment once at the All orthoses remain the property of Orthotic
request, to The Service User. This point is positive model stage. Composites Ltd until any chargeable sum is in

covered in our Terms of Business: Part 2. i. This immediately requires a total remake settled in full.
Custom Orthosis Fabrication, Clinically Based or major adjustment of the orthosis. i.e. General invoicing is done on a 30 days net basis.

Clauses, point 6. changing shank alignment.
b. Casts or information sheets not meeting Payments to be made to Orthotic Composites
e. Any change of medical status and, parent company: Thuanse UK Ltd
our requirements will be returned to you, if subsequently, presentation in end-user.
information requests are not fulfilled, within
f. A change in perspective on a differentially 13. We reserve the right to review the content of

20 working days.
diagnosed presentation and requirements. this and all documents periodically and it will
i. We reserve the right to pass the charges
i. This is often seen in changes of clinical be held on our Website in its most updated
for this on to you.
staff taking over a patient ep and amended form for reference, download
5. Consultation charges
and dissemination.
8. Manufacturing time
OC standardised design orthoses will not draw
any consultation charges. Please see point 6 on We will manufacture your device and dispatch it
fitting charges. to you within four weeks (twenty working days)
of receiving and booking the orthosis into our
If a non-standardised design is required by you for system.
your end-user then a support consultation with an
Orthotic Composites clinical representative will be a. If the clock stops due to communication and
required at each step (appointment). Please see information requirements then this timescale
point 6 on fitting charges. will extend in line with the number of days lost.

Unit 2, 4C Tyrrell Road, London, SE22 9NA

P 020 8693 3990 / F 020 8693 5811 / info@orthoticcomposites.com

www.orthoticcomposites.com
A Thuasne Group Company
Unit 2, 4C Tyrrell Road, London, SE22 9NA

P 020 8693 3990 / F 020 8693 5811 / info@orthoticcomposites.com
www.orthoticcomposites.com

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A Thuasne Group Company

Orthotic Composites Ltd is a design and

Multiple Cauda Spina

Peripheral Charcot Inorganic

4 FF04 FP04 MF04 MP04

8 FF08 FP08 MF08 MP08

10 FF10 FP10 MF10 MP10

12 FF12 FP12 MF12 MP12

14 FF14 FP14 MF14 MP14

XS 215 245 300 XS 215 245 215 245 330 40

S 230 260 320 S 230 260 230 260 360 40

M 245 275 340 M 245 275 245 275 395 40

L 260 290 360 L 260 290 260 290 425 40

XL 290 305 380 XL 290 305 290 305 455 40

SPRYSTEP ORIGINAL AFO SPRYSTEP MAX AFO

FOOT LENGTH (MM) FOOT LENGTH (MM)

XS 215 245 300 XS 195 215 335

S 230 260 320 S 210 230 370

M 245 275 340 M 230 255 395

L 260 290 360 L 255 275 420

XL 290 305 380 XL 275 290 420

Plantar flexor strength 4 P P P P

Mild Quad weakness P P P

INDICATIONS Orthotist E-mail Appointment Date / /

• Weakness of the pretibial muscles <=3

OPTION 2 | MADE TO MEASUREMENT

Include a spare set of straps

HELIX PLUS AFO

INDICATIONS Orthotist E-mail Appointment Date / /

The Helix Plus AFO is a custom anterior calf shell

The strut originates form the lateral posterior side

END USER DETAILS (PLEASE FILL BACK OF FORM)

ACTIVITY LEVEL (CHECK ONE)

CAST varying cadence on level and un even paved surfaces with

Internal rotary deviation

External rotary deviation

10 Sagittal Plane control (Dependent on the Treatment model being used)

i Ensure stance yield knee flexion is optimal.

SAFETY ii Mid-stance shank angle?

a Cast alignment or rectification issue? COMPLETION

i Cast under or overcorrected during cast taking? 15 On Test Orthosis

i Composite (rectified in) or padding (adjustable)?

Plaster bandage should be wrapped from above the

if possible, use a pitch board to accurately replicate the

Knee Ankle Foot

Our KAFOs can be fully manufactured and finished

Using a sharp scalpel is often the cleanest, easiest and

HYPEREXTENSION RESIST KAFO FLEXION RESIST KAFO

VALGUS RESIST KAFO VARUS RESIST KAFO

PRIMARY TREATMENT GOAL* Please tick

HYPEREXTENSION RESIST VALGUS RESIST VARUS RESIST FLEXION RESIST

b Too much return curve in the medial perineal area?

11 Posterolateral aspect of the Shell?

SAFETY a Sufficient posterolateral stabilisation?

SIT TO STAND FUNCTION i Tightness in the posterodistal cuff?

7 Locking (If applicable). ii Posterior offset joints?

a Easy to lock/unlock? f Joints too low?

i If not, cast may be too extended. i Anterodistal cuff pressure.

ii GRF manipulated effectively?

10 Is the perineal area comfortable?

a Is underwear causing impingement?

i Supportive underwear is recommended.