The video above addresses some very important questions :
How does a person make a custom afo?
How is the fit of an a custom afo created?
What angle is the afo usually set at, when it comes to the ankle?
How do you seal an afo cast?
And Much More….
The following is in part a transcription from this video :
Here we are, we are now in the plaster room. So not everything is squeaky clean here, but there is a lot of good work that happens here. Now I am going to go through the process. This is plantarflexed we got to get to 90 degrees. And it does not just stay there by itself. So what will happen is in orthotist we will get it close to 90 and then currently this is how we do it. For example, this is just is what it is. Sometimes the staple does not catch but sometimes it does. That is a super important one right there, so you can see that it already wants to hold the position and that is as much as I really need. I could do more staples, maybe that would be good, maybe it is a little excessive, I do not necessarily know. But the point is we use the staples here to hold the mold, the impression where we want to be. So now, if we poured plaster into the here bad idea if we do not take care of our holes here. So you are going to watch me, just, in general, we would wrap up this area right here with the plaster bandage and it will become solidified and also up here we are going to put a strip because we do not want fluid pouring out of the mold here. I will show you what I mean.
Okay, something like this. So this is going to take care of the holes we are put in there at the ankle. We will let this set up and it takes just a minute or two. And then we will also cover the hole here at the toe because we are just going to have fluid plaster flying out of there, so we cover that up and let is get sealed. So we are going to do that very quickly. It might be too long, but that is okay, so I am just going to show you for an example what we do is to an orthotist or prosthetist to help minimize some of the fluid escaping. So we are just going to get this in here like this. Make sure the two materials meet. It is still wet but this cast right here is much more ready to go now and we are ready to pour this with some plaster. If you look really close at this, you will see some parts that are double layers, some parts like four, right here if you can see it. It is more porous, so you know what is going to happen already, plaster is going to come out of here in its liquid state, so we need to do something else to help seal that is in there as best we can. It will never be a perfect process where you do not make any mess or you never have any drips come out, but it will show you what I mean here. So we use another material that goes by a lot of different names, but some people call it a flex-wrap.
Here we go. It goes by a lot different names, but some people call it flex-wrap, just anything to hold in potential plaster that is going to come out. I like to do 2 layers, it is just me. So we are going to go all the way down. Now we have the cast in our bin here, we do not want any plaster to be coming out, so we put it in kind of a concealed kind of a scenario inside of the sand here. So our cast is ready to go, we are going to now start the process of going from the negative to the positive. This is currently how things are done. This is our conduit pipe, it is going to go in. We used this pipe before, they are great, they can be reused a lot, but the bottom of this has to be bent because we do not ever want this thing to come slightly loose and it is spinning or anything like that. So a slight bend at the bottom is crucial. So what happens here in a moment you will see me I will pour this full of plaster, we will put this inside of it. We never want the conduit to be kind of poking out of the heel, so I will actually pull it up just slightly, so when we suspend it horizontally later away, we have the conduit sticking up. That is what we are going to do, I am going to get our water and plaster and I am going to get right to here. This is kind of an experience-based thing, not the act of putting the plaster obviously into a bucket of water, but knowing how thick it needs to be. Because if you try to do this and it is thin, it will set up, but the problems that happen afterward are things that would be something you don’t want to deal with. Like it is a real kind of thin process, I should say a real thin mix that you have. What will happen is you go off later, you take this material right here off of the positive cast and it will just break at the ankle, for example. So you can have this too watery, otherwise, it presents a problem.
Alright, so this will be our mix right here. We stir it up, get it ready. You can actually see that we got other plaster here because we want to reuse. So we are ready to go, we are going to now pour our cast. When you look at this, you can see there are bubbles already coming. We are pouring that mold, we are putting our pipe in. You might be thinking we are not all the way the top yet, but I did that on purpose because I want to show you something. I am doing this process right here to get rid of the bubbles that are inside this cast. Now the whole process is that the reactions happening, whether you can really see so or not. But what you can also do is to reuse this kind of thing. We can put it inside and it will just become part of the next mold that we use. that is just a general example of what we were talking about with that TLSO cast that you can reuse kind of AFO parts in TLSO. So we are going to pour this real quick.
We will let this set up so instead of a person sitting here, holding this tube or this conduit pipe in the right position, just an inch of the bottom, what you can do is just use a tool like this and then when you are ready to press down, you feel the bottom of the cast and now what I am doing is actually just bring it up an inch. We can walk away, and come back later. It will be all set. I will actually probably fill in a little bit of this gapping and there we go.
I hope this helped you in some way. We will have more information for you soon that shows more about how customs AFOS are made for people.