There are multiple options in regard to AFO management. Video 1 shows the gait pattern
of a male in his mid 20ʼs following trauma. The gait pattern is very characteristic involving
a foot drop related to a nerve path injury.
The gait typically is slower with a reduced stride length and a high hip hitch to ensure
ground clearance of the foot. There is also a marked degree of lateral transfer (movement sideways).
These compensations create additional demands on surrounding joints and tissues and
have the potential to lead to symptoms in other areas not directly affected by the original
injury.

The role of orthotic management (video 2) in this case was to provide the most efficient
gait pattern possible given the limitations caused through the injuries. The patient was
provided with a bespoke foot drop splint to help with the contact and swing phase of his
gait and also modifications to his own footwear to minimise the effect of the ankle joint
injury.


Video 3 shows a female patient in her 60's who has had significant involvement of her foot
and ankle due to Rheumatoid arthritis. The disease process classically involves the foot
and ankle to varying degrees.
This patient had previous surgery to the right ankle in October 2005 and the objective in
this case was to salvage the left foot and ankle and delay the need for surgical
intervention.



An MRI scan confirmed extensive damage to the left midfoot and also the subtalar joint on
the left side. The scan also identified damage to a number of tendons on the left foot.
given the findings on clinical examination and also the imaging findings the patient was
provided with a bespoke ankle brace (Richie brace www.richiebrace.com ).
Picture left to right show the front, side and rear view of the brace itself.

Video 3 shows the mechanical impact of this type of AFO. The device itself is highly
functional and represents one of the most user friendly devices available. As with all
devices there are issues to consider in regard to footwear and suitability with orthotics and
these are issues that are relevant for all foot and ankle problems that require orthotic input.
The pain scale in this case was reduced by 80% and the patients function improved
dramatically. This type of brace as with many of the AFO devices are more of a medium to
long term strategy in managing foot and ankle problems.

For further reading on Orthotics & Biomechanics. feel free to download this PDF
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