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Fabricating for Tone Reduction

Learn advanced techniques for fabricating orthotics to reduce muscle activation and correct foot tone. Explore methods for cast correction, mold modification, and material selection. Contact Tony Wickman at Freedom Fabrication for expert advice.

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Fabricating for Tone Reduction

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  1. Fabricating for Tone Reduction • Tony Wickman R.T.(O,P) • freedom fabrication inc.

  2. What Is Tone? • Tone literally means activation of a muscle. • Spasticity is derived from the Greek word meaning to pull or draw.

  3. Cast Correction: • Cast may require greater than normal correction • Make sure to correct cast at the articulating surfaces

  4. Dorsiflexion Angle • Maximum dorsiflexion deviation should be no more than 20 degrees. • Watch for cavus arch !

  5. Plantarflexion Angle • Plantarflexion angle should be no more than forty degrees. • Watch for plantarflexed metatarsals

  6. Inversion/Eversion Angle • +/- 15 degrees • Cast corrections are difficult

  7. Mold Modification • The model must accurately mimic the patients physiology • You have to have intimate knowledge of skeletal structures!

  8. Maleoli Buildups • Buildups should be more “extreme” than usual • Take into consideration varus valgus tendencies

  9. Medial Maleoli/Navicular • Two apexes • Blend well into surrounding soft tissue

  10. Calcaneal Cuboid Buildup • Include achilles tendon extension • Be sensitive to prominent heels

  11. Heel Buildup • Heel should be rounded • Heel should be symmetrical

  12. S.T. Groove • Anatomy rules • Blend into longitudinal arch

  13. Medial/Lateral Arches • Smooth transition • Connect around to plantar surface of calcaneus

  14. Cuboid/ Lateral Fifth Met Head • Relieve 1.5-3.0 mm • Be careful to maintain radius of plantar lateral surfaces

  15. Metatarsal Relief • Proximal edge relief • Distal edge relief

  16. Padding Techniques • Bony prominences only • Blend edges smoothly • Colored foams

  17. Material Selection • Polypropylene • Polyethylene • Copolymer

  18. Pulling Plastic • Focused stretch • Proper temperature • Maximum vacuum

  19. Trimming Plastic • Establish trim lines • Poly posting is ground first • Trim lines must be smooth

  20. Finishing & Decorating • Colored Velcro • Foams • Ribbon • Transfers

  21. For additional information on this subject: • Tony Wickman at Freedom Fabrication 815-B north main St. Havana Fl. 32333 • 1800.304.3733 • freedomfab@aol.com • or visit our web site at: www.freedom fabrication.com

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