Custom-made AFOs
Custom-made AFOs are indicated in the
presence of complex gait abnormalities
and for best control of triplanar foot
deformity with knee and hip involvement.
Custom AFOs should be designed by the
orthotist and take into account shortening
of gastrocnemius. The primary aim of an
AFO is to control the foot and ankle, but
a poorly designed AFO can affect other
joints such as the knee that could create
instability. This type of AFO can be customised
further with adjustments to the
trimlines, straps and footplate length.
The orthotist is responsible for fitting,
alignment adjustment, delivery and initial
review of custom-made AFOs, with subsequent
reviews being the shared responsibility
of the multidisciplinary team.
Some AFOs may not be suitable if oedema
is present and not well-managed, in
which case a conventional AFO may be
required. Conventional AFOs tend to be
heavier and more bulky and often provide
less control that custom-made AFOs.