Additions

Amputation Accommodation
Description
  • Block built for surgically or trauma induced amputation of forefoot anatomy
Location
  • Missing anatomy
Material
  • EVA block
Indications
  • Surgically or trauma induced amputation of forefoot anatomy
Contraindications
  • No missing anatomy
  • No accommodation required if missing middle digits or 5th only
Cuboid Pad
Description
  • For Chronically sub fluxing cuboid
Location
  • Sub base of 5th metatarsal/cuboid
Material
  • 3mm EVANote: Custom orthoses will most often support the lateral column adequately as the contour of the LLA is captured in the negative cast
Indications
  • Chronically sub fluxing cuboid
Contraindications
  • Inappropriate use may prematurely lock calcaneal-cuboid joint, possibly resulting in midtarsal ligament strain, cuboid contusion, and/or lateral plantar nerve entrapment
Dancer's Pad
Description
  • For Sesamoiditis, fractured or contused sesamoids
Location
  • Forefoot extension starting at the base of the metatarsals, extending to level of sulcus with a cutout to the 1st MPJ (1st Met cutout in shell automatically performed with this addition)
Material
  • 3mm Cushion Cork extension to sulcus
Indications
  • Rigid, severely plantar flexed 1st ray
  • Sesamoiditis
  • Fractures sesamoid
  • Contused sesamoid
Contraindications
  • Hallux rigidus/limitus
  • 1st MPJ O/A
Forefoot Extensions
Description
  • Extension from end of device to sulcus or toes to provide extra forefoot cushioning
Location
  • Distal from edge of device to sulcus or to toes, as requested
  • Feathered to reduce bulk
Material
  • Per work order. Available choices include Poron, EVA, ReKoil, etc in various thicknesses ranging from 1.5 mm to 6 mm. See Covers page for more details on Forefoot Extension choices.
Indications
  • Reduced fibro-fatty pad under MPJs
  • O/A
  • Frequently used to manufacture other additions
Contraindications
  • insufficient room in the footwear to accommodate additional thickness
Hallux Rigidus Splint
Description
  • Padding placed in the heel of the orthotics to protect the heel and add comfort
Location
  • Inside heel cavity of orthotic
Material
  • Orthotic shell
  • Heel plug (3 or 6 mm)
Indications
  • Heel spur
  • Reduced fibro-fatty pad
Contraindications
  • No extrinsic rear foot stabilizer
Heel Lifts
Description
  • Additional material added to the bottom of the device in the heel area to increase heel height
Location
  • Bottom of device in the heel area
Material
  • 55 durometer EVA in requested thickness (maximum 12 mm)
Indications
  • Leg length discrepancy
Contraindications
  • Footwear which cannot accommodate the additional height of the device. (most extra depth shoes can accommodate 6 mm)
Heel Plugs
Description
  • Padding placed in the heel of the orthotics to protect the heel and add comfort (also known as Heel Spur Accommodation)
Location
  • Inside heel cavity of orthotic
  • Medial calcaneal
  • Tubercle
Material
  • Cavity in shell material, filled with Poron and contoured to shape of heel cupl
  • Heel plug (3 or 6 mm)
Indications
  • Heel spur
  • Reduced fibro-fatty pad
Contraindications
  • No extrinsic rear foot stabilizer
Horseshoe Spur
Description
  • For heel spur and reduced fibro-fatty pad
Location
  • As heel pad, “u-shaped” cutout in area of medial calcaneal tubercle
Material
  • 3mm Poron, tapered at edges with a “u-shaped” cutout to medial calcaneal tubercle
Indications
  • Heel spur
  • Reduced fibro-fatty pad
Contraindications
  • No extrinsic rear foot stabilizer
Kinetic Wedge

also known as Hallux Limitus

Description
  • For functional hallux limitus
  • Cutout to┬árelieve pressure on the first met head as well as its sesamoid bones.
  • Can be used to pre-load the first met head resulting in increased mobility
Location
  • Applied form distal/plantar aspect of shell to sulcus, trapezioid-shaped cut out to 1st MPJ (1st Met cutout in shell automatically performed with this addition)
  • Functional hallux limitus: (Normal 1st MPJ ROM non-weight-bearing becomes reduced when weight-bearing dorsiflexes 1st ray)
Material
  • 3 mm EVA
Indications
  • Hallux limitus
Contraindications
  • Anatomical hallux rigidus/limitus 1st MPJ O/A with osteophytic lipping
Lateral Arch Fill
Description
  • Padding placed in the heel of the orthotics to protect the heel and add comfort
Location
  • Inside heel cavity of orthotic
Material
  • Orthotic shell
  • Heel plug (3 or 6 mm)
Indications
  • Heel spur
  • Reduced fibro-fatty pad
Contraindications
  • No extrinsic rear foot stabilizer
Met Bars
Description
  • Metatarsal domes for metatarsalgia and forefoot callusing
Location
  • Centered on the 2-4┬ámetatarsal with the thickest portion in line with the edge of the orthotic
Material
  • Orthotic shell
  • Met pad (3-10 mm and sm, med, lg and poron or v-phoam)
Indications
  • Metatarsalgia
  • Forefoot callousing
Met Pads
Description
  • Metatarsal domes for reduced transverse arch, EVA or Poron pad placed strategically under mets to raise them and stop them from dropping down
Location
  • Centered on the 3rd metatarsal with the thickest portion in line with the edge of the orthotic
Material
  • Orthotic shell
  • Met pad (3-10 mm and sm, med, lg and poron or v-foam)
  • tear drop shaped
Indications
  • Reduced transverse arch
  • Metatarsalgia
  • Dropped lesser metatarsal
  • Forefoot callousing
  • Interdigital neuroma
  • Intermetatarsal-phalangeal bursitis
Contraindications
  • Rigid or immobile forefoot
Met Cutout
Description
  • Cutout of sulcus to relive pressure for persistent and painful corns, calluses or plantar warts or dropped mets
Location
  • Forefoot extension tapered onto distal-dorsal aspect of shell extending to level of sulcus (1-5) with cutout to lesion site (as marked on negative cast or on work order)
Material
  • 3 mm 55 durometer EVA or Poron (6 mm if requested)
Indications
  • Persistent/painful corn, callus or plantar warts
  • Dropped metatarsal-phalangeal joint
Contraindications
  • Footwear that cannot adequately accommodate the added forefoot thickness
Morton's Extension
Description
  • Extension along 1st met for short metatarsal in relation to length of 4th/5th metatarsals
Location
  • Along 1st phalanges
  • Sub 1st meta tarsal-phalangeal joint extending from distal end of shell to sulcus
Material
  • 3 mm EVA
Indications
  • Short 1st metatarsal in relation to length of 4th/5th metatarsals
  • Dorsiflexed 1st ray
  • Hallux limitus (mild)
Contraindications
  • Long 2nd metatarsal in relation to all metatarsals
Neuroma Pad
Description
  • pad for interdigital neuroma and intermetatarsal bursitis
Location
  • Centered between 3rd-4th metatarsals (unless otherwise specified)
Material
  • 3 mm Poron
Indications
  • Interdigital Neuroma
  • Intermetatarsal bursitis
Reverse Morton's Extension

Also known as a 2-5 Bar

Description
  • Soft extension under 2-5 metatarsals for plantar-flexed 1st ray
Location
  • Applied to distal/dorsal aspect of shell to level of sulcus 2-5 MPJ (no EVA sub 1st MPJ)
Material
  • 55 durometer EVA – 3 mm
Indications
  • Plantar-flexed 1st ray
Contraindications
  • Hallux limitus/rigidus
Scaphoid Pad
Description
  • Material placed under the top cover to add extra cushion/support to the medial longitudinal arch of the foot
Location
  • Material applied to the shell along the medial longitudinal arch of the foot
  • Feathered out from the high spot of the arch to surrounding area
Material
  • 3 mm V-Phoam or Poron by special request
Indications
  • Pes cavus foot with high arch sensitivity where direct shell contact is not tolerated
Contraindications
  • ?
Toe Crest/Sulcus Crest
Description
  • Pad that supports the central segments of 2-5 digits
Location
  • Applied in area of sulcus to support the central segments of 2-5 digits
Material
  • 6 mm Poron or EVA, tapered and reduces to follow anatomy
Indications
  • Fixed clawed/hammer toe deformities
  • Apical lesions (corn, callus, ulcerations due to pressure)
Contraindications
  • Top length cover less than ‘to toes’

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