Additions

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

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

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

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

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

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)

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

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

also known as Hallux Limitus

Description

• For functional hallux limitus
• Cutout to relieve 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

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

Description

• Metatarsal domes for metatarsalgia and forefoot callusing

Location

• Centered on the 2-4 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-phoam)

Indications

• Metatarsalgia
• Forefoot callousing

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 3^rd 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

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

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

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

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

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

• ?

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’