Fidelity Orthopedic, Dayton Ohio

Information for Health Care Professionals

Our Orthotic Products and Services include (but are not limited to) the following:

Orthotic Device	Diagnosis	Indications	Contra-Indications
Hip-Knee-Ankle-Foot Orthoses
HKAFO – single or bilateral
	•Trauma •MS •Spina bifida •Paraplegic •MD	•Hip flexor or extensor weakness – 3 or less along with lower extremity •Variety of hip joints which can be locked or unlocked during stance and sitting •Motivated patient with good support system	•Extremely cumbersome to don/doff •Non compliant •Cosmesis •Heavy
Scottish Rite Hip Abduction Brace
	•Legg-perthes disease •Congenital hip dislocation	•Allows patient to do most activities while in brace •Holds patient’s hips in abduction •Used for pediatric patients	•Non compliant •Patient wears over clothes
Hip Abduction Brace – Custom Fit
	•Post-operative hip surgery •Hip dislocation or subluxation •Congenital hip dislocation	•Keeps hip in best position from further injury •Helps aid in healing process post-op •Holds hip joint in abduction – usually 15º •Hip joint can be fixed, limited or free ROM in sagital plane •Can be removed when advised •Patient can walk with brace on	•Cumbersome to wear and don/doff •Non compliant •Does not usually fit under clothes
Knee-Ankle-Foot Orthoses
Free Knee Joint KAFO Conventional or Thermo-plastic
	•Severe Arthritis •Genu valgum •Genu varum •Non union femoral fracture •CVA •TBA •Polio •Trauma •MS	•Allows for free motion in sagital plane – cannot lock knee joint •Usually is used with varum or valgum knee pad •Low profile knee joint •Good quad and hamstring strength	•Any quad or hamstring weakness •Tendency for knee to buckle or hyperextend •Cosmesis •Weight can be an issue
Drop Lock Knee Joint KAFO Conventional or Thermo-plastic
	•Severe Arthritis •Diabetic neuropathy •Femoral nerve injury •TBA •CVA •Polio •Trauma •MS	•Knee buckles •Quad weakness – 3 or less •Knee joint is manually locked during standing and walking and is unlocked during sitting •Safe, easy and strong lock •Low profile under jeans	•Cannot use hands to lock and unlock while standing, otherwise has to sit straight-legged then unlock •Need to be able to reach knee joints •Cannot have knee flexion contracture •Cosmesis •Weight can be an issue
Bail or Cam Lock Knee Joint KAFO Conventional or Thermo-plastic
	•Severe Arthritis •Paraplegic •TBA •CVA •MS •Polio •Trauma	•Knee buckles •Quad weakness – 3 or less •Knee locks automatically when standing in full knee extension •Can hit bail on a chair to unlock, do not need use of hand	•Cannot have knee flexion contracture •Bail can be accidentally unlocked •More maintenance of KAFO required •Cosmesis – bulky under jeans •Weight can be an issue
Step Lock (Ratchet) Knee Joint KAFO
	•Severe Arthritis •Paraplegic •TBA •CVA •MS •Polio •Trauma	•Knee buckles when standing •Quad weakness – 3 or less •Knee flexion contracture •KAFO locks in intervals as patient stands •Extremely safe for rehab patients •Ratchet makes a click when locking	•Noisy •Cannot use hands to lock and unlock while standing, otherwise has to sit straight-legged then unlock •Need to be able to reach knee joints •More maintenance of KAFO required •Cosmesis •Weight can be an issue
Posterior Offset Knee Joint KAFO
	•Severe Arthritis •Genu recurvatum •TBA •CVA •MS •Polio •Trauma	•Used for hyperextension in knee •Allows free motion in knee – no stiff leg during gait •Can use check strap to prevent further hyperextension	•Knee buckling •Cosmesis •Weight can be an issue
Dial Lock Knee Joint KAFO
	•Severe Arthritis •Knee Flexion Contracture •TBA •CVA •MS •Polio	•Knee buckling •Can be used with drop lock, bail lock or free motion •Dial lock allows the KAFO to lock without needed to be in full extension •Good to use while in therapy to decrease flexion contracture	•Joint is heavier than others •Cosmesis - bulky •Weight can be an issue
Ischial Containment KAFO
	•Severe Arthritis •Non union femoral fracture •TBA •CVA •MS •Polio •Paraplegic •Trauma	•Deweights the leg by transferring the weight onto the ischium •Helps stabilize the hip flexors and extensors •Good for rehabilitation •Can be used with any type of knee joints	•Large and bulky due to Ischial seat •Cosmesis •Weight can be an issue
Ankle-Foot Orthoses
Conventional Solid Ankle AFO
	•Arthritis •Post-Op Fusion •Diabetic •Charcot Joint	•Anytime ankle needs to be locked •Swelling or diabetic •Patient is extremely obese	•Need ROM •Weight of device •Cosmesis •Needs rocker bottom on shoe for smoother toe off
Conventional Free Motion AFO (usually with T-Strap)
	•Severe inversion / eversion •Ankle valgus / varus •Severe post tibial tendonitis •Diabetic	•Allow free DF/PF •Stops M/L motion •Best with custom foot orthosis	•Usually needs solid stirrup so shoe changes are more difficult •Cosmesis
Conventional Dorsi-Assist AFO (Klenzak)
	•Drop foot •Diabetic neuropathy •CVA •Polio	•Allows PF at heel strike with DF at swing phase smoother •More adjustability than plastic AFO	•Knee buckling – no quads •Cosmesis •Weight of device •More maintenance than plastic AFO
Thermoplastic Solid Ankle AFO
	•CVA •CP •MS •Spinabifida •ALS •Trauma •Neuropathy •Arthritis •Post-op fusion •CMT •Drop Foot •Polio •Spasticity	•Dorsiflexor weakness – 3 and lower •Drop foot with M/L instability •Good sensation •No vascular problems •Genu recurvatum <15° •High tone	•Brittle diabetic •Fluctuation swelling •Heat sensitivity •Allergic to plastics •Extremely obese •Severe valgus/varus deformity (ex: Charcot joint)
Thermoplastic Semi-solid AFO
	•CVA •CP •MS •Spinabifida •ALS •Trauma •Neuropathy •Arthritis •Post-op fusion •CMT •Drop Foot •Polio •Spasticity	•Dorsiflexor weakness – 3 and lower •Drop foot with minor M/L instability •Good sensation •No vascular problems •Genu recurvatum <15° •High tone	•Brittle diabetic •Fluctuation swelling •Heat sensitivity •Allergic to plastics •Extremely obese •Severe valgus/varus deformity (ex: Charcot joint)
Thermoplastic Posterior Leaf-spring AFO (Dorsi-assist)
	•CVA •CP •MS •Spinabifida •ALS •Trauma •Neuropathy •Arthritis •Post-op fusion •CMT •Drop Foot •Polio •Spasticity	•Dorsiflexor weakness – 3 and lower •Drop foot without M/L instability •Good sensation •No vascular problems •Genu recurvatum <15° •High tone	•Brittle diabetic •Fluctuation swelling •Heat sensitivity •Allergic to plastics •Extremely obese •Any ML instability
Thermoplastic Articulated AFO
	•CVA •CP •MS •Spinabifida •ALS •Trauma •Neuropathy •Arthritis •Post-op fusion •CMT •Drop Foot •Polio •Spasticity	•Dorsiflexor weakness – 3 and lower •Drop foot with minor M/L instability •Good sensation •No vascular problems •Genu recurvatum <15° •Allows for full range DF •Easier to use stairs, usually with FP stop •Good ROM	•High tone •Sever M/L instability •Allergic to plastic •Bulkier & heavier than other plastic AFO’s •More maintenance due to joints •PF Contractures
Denver T AFO
	•Post Tibial Tendonitis •Rupture •Tear •Valgus/Varus Instability •Mild Foot Drop	•Use for M/L instability •Stops M/L motion •Allows some sagital motion •Dorsi/plantar flexor do not get weak • More stable than UCBL • More cosmetic / low profile that standard AFO	•Severe swelling •Brittle diabetic •Severe sagital instability •Does not control any instability of the knee
Floor Reaction AFO
	•CP •MD •Spinabifia •Polio •Crotch gait •Quad insufficiency	•Crotch gait •Knee buckling •Weak quads •Provides extension moment to knee •Solid or articulated ankle	•Severe knee flexion contractures •Plantarflexion contracture •Larger profile •More difficult to don than regular AFO
Patella Tendon Bearing AFO
	•Non-union fx •Charcot joint •Ankle arthritis •Oesteomyelitis •Avascular nuecrosis •Chronic ulcers on heels	•Unloads the weight off of ankle up to 70% onto calf and knee region •Allows for swelling •Knee in good condition •Allows for various ankle ROM	•Weak knee or soreness in patella tendon •Non compliant •Hot and bulky
Thermoplastic Crow (Neuropathic) Walker
	•Severe Arthritis •Diabetic •C.P. or brain injury when regular AFO’s with ankle strap caused problems •Charcot Joint •AVN, non-union	•Acts like removable total contact cast •Needs total support of ankle •Want no ankle motion •Distribution of pressure over large area •Do not wear shoe on side with brace	•Severe edema •Problems with heat •Bulky •Non-compliant •Cosmesis
Arizona AFO
	•Post Tibial Tendonitis •Rupture •Tear •Valgus/Varus Instability •Mild Foot Drop	•Use for M/L instability •Stops M/L motion •Allows some sagitial motion •More stable than UCBL	•Severe swelling •Brittle diabetic •Severe sagital instability •Does not control any instability of the knee
Toe Off AFO
	•CVA •Polio •MS •Spinabifida •ALS •Trauma •Neuropathy •CMT •Drop Foot	•Drop foot •Good sensation •Ankle instability •No swelling or history of skin irritations •Lightweight •Low profile	•Swelling •Diabetic •History of skin breakdown •Cosmesis – available only in black •Severe spacticity •No sensation in foot and leg
Walk On AFO
	•CVA •Polio •MS •Spinabifida •ALS •Trauma •Neuropathy •CMT •Drop Foot	•Drop foot •Good sensation •Ankle instability •No swelling or history of skin irritations •Lightweight •Low profile	•Swelling •Diabetic •History of skin breakdown •Cosmesis – available only in black •Severe spacticity •No sensation in foot and leg
Dynamic AFO
	•CVA •Polio •MS •Spinabifida •ALS •Trauma •Neuropathy •CMT •Drop Foot	•Drop foot •Good sensation •Ankle instability •No swelling or history of skin irritations •Lightweight •Low profile	•Swelling •Diabetic •History of skin breakdown •Cosmesis – available only in black •Severe spacticity •No sensation in foot and leg
Thermoplastic Supramalleolar (SMO) AFO
	•C.P. (pediatric) •Spinabifida (pediatric) •Post tib tendonitis •Charcot Marie tooth	•M/L instability •Tone •Want limited DF/PF •Mild drop foot •Can be tone reducing	•Severe foot drop •Severe inversion/eversion •Edema
Thermoplastic Dynamic (DAFO) AFO
	•C.P. •Spinabifida •Brain injury •Usually for pediatrics only	•M/L instability •Tone (if high, AFO needs to go to calf height) •Control subtalar joint •Easier to crawl in for pediatric patient	•Severe foot drop •Genu recurvatum •Edema •Want any type of knee control •Bulky in shoes
Dynamic Contracture splint
	•Contractures- tramatic or chronic –Ankle –Knee –Elbow	•Low tension – long stretch •Works with physical therapy •Need good care givers	•High maintenance •Not for non-compliant patients •No caregiver support •Bony lock contractures •Chronic skin breakout
University California Berkley Lab (UCBL) AFO
	•Severe pes planus •Posterior tibial tendonitis •Ankle varus or valgus •Foot fractures •Hallux limitus	•Controls arch more than FO •Provides moderate M/L stability •Fits inside shoes – cosmesis •Less costly than an AFO •Good for short term use while tendon is healing	•Diabetic •Significant fluctuation edema •Severe pronation or supination •Insensate foot •Ridigity •Patient may need larger shoes
Partial Foot Prosthesis Inlay
	•Toe amputations •Trans metatarsal amputation	•Toe or trans met amputation •Provides increased stability during gait •Improves balance •Total contact surface •No slippage in shoe	•Moderate to severe ankle instability (need partial foot AFO) •Incision not healed •Non compliant
Knee Ortheses
Custom-Fit Knee Brace – Post-operative
	•Post-op ligament or meniscus repair •Trauma •Post-fracture treatment •Tibial plateau fracture	•Allows patient to have limited, free or fixed ROM •Patient can take off for bathing •Helps with shorter rehab time	•Non-compliant patients can remove •Cosmesis •Not as rigid as plastic
Custom Knee Brace - Functional
	•ACL •PCL •Meniscus instability, tear, strain •Severe patellar instability	•Helps protect from further injury •Provides good M/L stability •Easy to don/doff •Lightweight •Use for ADL’s, work, sports	•Tendency to migrate •Cosmesis •Diagnoses that also involve hip or ankle, ex: CVA, polio •Severe fluctuating edema
Custom Knee Brace - Osteoarthritis
	•Osteoarthritis •Mild genu valgum or genu varum	•Use for chronic pain in patients •Helps in preventing further damage to knee •Used for patients who are not candidates for knee replacement	•Tendency to migrate •Cosmesis •Extremely obese patients •Severe genu valgum or genu varum (need KAFO)
Spinal Orthoses
Knight-Taylor Thoracic Lumbar Sacral Orthosis (TLSO)
	•Lumbar or thoracic back pain •Arthritis •Lumbar strain or sprain •Post-operative •Herniated disc •Spondylolisis	•Controls limited motion of thoracic and lumbar spine •Rigid posterior section and corset front •Lightweight •Allows air circulation	•Want to stop all motion in back •Only limits motion in lumbar and thoracic regions •Non compliant
Ortholign Lumbar Sacral Orthosis (LSO) or Thoracic Lumbar Sacral Orthosis (TLSO)
	•Low back pain •Arthritis •Lumbar strain or sprain •Post-operative •Herniated disc •Spondylolithesis •Spondylolisis	•Controls motion of thoracic and/or lumbar spine •Rigid anterior and posterior sections •Cooler than thermo LSO/TLSO •Custom fit – less cost •Fits under clothes – lower profile	•Custom fit so cannot use on severely obese patient •Non compliant •More washing care needed
Thermoplastic Anterior Opening Lumbar Sacral Orthosis (LSO) or Thoracic Lumbar Sacral Orthosis (TLSO)
	•Low back pain •Arthritis •Lumbar strain or sprain •Post-operative •Herniated disc •Spondylolithesis •Spondylolisis	•Stops all motion of lumbar and/or thoracic spine •One piece rigid section •Easier to don/doff for non post-operative patients than bivalve	•Heat sensitive •Non compliant •Hard to don post-op •Easy to take off for pediatrics
Thermoplastic Posterior Opening Lumbar Sacral Orthosis (LSO) or Thoracic Lumbar Sacral Orthosis (TLSO)
	•Low back pain •Arthritis •Lumbar strain or sprain •Post-operative •Herniated disc •Spondylolithesis •Spondylolisis	•Stops all motion of lumbar and/or thoracic spine •One piece rigid section •Usually used with pediatrics as it’s harder for patient to doff •Used when posterior scar cannot have pressure on it	•Heat sensitive •Non compliant •Hard to patient to doff
Thermoplastic Bivalve (Clamshell) Lumbar Sacral Orthosis (LSO) or Thoracic Lumbar Sacral Orthosis (TLSO)
	•Low back pain •Arthritis •Lumbar strain or sprain •Post-operative •Herniated disc •Spondylolithesis •Spondylolisis	•Primarily used for post-op as it’s easy to don and doff while in bed •Stops all motion of lumbar and/or thoracic spine •Two piece construction	•Heat sensitive •Non compliant •Hard for patient todon/doff by oneself
Kydex Flexion Lumbar Sacral Orthosis (LSO)
	•Low back pain •Arthritis •Lumbar strain or sprain •Spondylolisis	•Allows flexion, stops extension and lateral flexion •Rigid posterior section and corset front •Lightweight •Allows air circulation	•Want to stop all motion in back •Only limits motion in lumbar region •Non compliant
Soft Body Jacket Lumbar Sacral Orthosis (LSO) or Thoracic Lumbar Sacral Orthosis (TLSO)
	•Congenital scoliosis •Positioning and seating •Low back pain •Arthritis •Lumbar strain or sprain •Post-operative •Mild to moderate herniated disc •Spondylolisis	•Prevent scoliosis from worsening •Easier to tolerate than thermoplastic •Controls most motion in lumbar/thoracic spine •Foam construction with stays which can be placed anywhere •Cooler than thermoplastic •Only anterior or posterior openings	•Not as rigid as thermoplastic so some movement is present •Heat sensitive •Non compliant
Milwaukee Brace
	•High thoracic scoliosis •Double major scoliosis •Fast progressing scoliosis •Idiopathic scoliosis	•Used with young patient with fast growing curves •Used for high thoracic region •First effective scoliosis brace •Extremely good end point control •Compliancy of patient	•Need to wear usually until puberty •Non compliance •Hot •Patient has to wear most of the day •Can see brace under clothes
Boston Scoliosis Brace
	•Low thoracic scoliosis •Thoracolumbar scoliosis •Lumbar idiopathic scoliosis	•Prevent progression of curve •Correct degree of curvature •Moderate curve with low Risser sign •Compliancy of patient •Fits under clothes	•Need to wear usually until puberty •Non compliance •Hot •Patient has to wear most of the day
VertAlign Lumbar Sacral Orthosis (LSO) or Thoracic Lumbar Sacral Orthosis (TLSO)
	•Low back pain •Arthritis •Lumbar strain or sprain •Post-operative •Herniated disc •Spondylolisis •Spondylolithesis	•Primarily used for post-op as it’s easy to don and doff while in bed •Stops all motion of lumbar and/or thoracic spine •Two piece construction •Same day delivery	•Heat sensitive •Non compliant •Modular system
Chairback Lumbar Sacral Orthosis (LSO)
	•Low back pain •Arthritis •Lumbar strain or sprain •Post-operative •Herniated disc •Spondylolisis	•Controls extension and lateral flexion and limited control of flexion •Rigid posterior section and corset front •Lightweight •Allows air circulation	•Only limits motion in lumbar region •Non compliant
Warm and Form Corset
	•Low back pain •Arthritis •Lumbar strain or sprain •Post-operative •Mild to moderate herniated disc	•Control of extension •Limited control of flexion •Lightweight and low profile •Fits under clothes, Velcro™ closure •Plastic insert if formed to patient’s back •Similar to corset with stays	•Want to stop all motion in back •Only limits motion in lumbar region •Not rigid •Non compliant
Upper Extremity Orthoses
Resting Hand / Wrist Orthosis (WHO)
	•Post CVA •Brain injury •MS •Spasticity	•To hold wrist and fingers in a functional position •Used usually at night •Prevent wrist and fingers from contractures •Prevent breakout in palm area from fingernails	•Severe fixed contractures of fingers •Possible skin breakdown due to pressure of straps •Non compliant •No assistance from staff or family
Contracture Hand / Wrist Orthosis (WHO)
	•Contracture of wrist or fingers •Post CVA •Brain injury •MS •Spasticity	•To prevent further contractures •Attempt to correct existing contractures •Ability to adjust the position as contracture decreases •Used usually at night •Prevent breakout in palm area from fingernails	•Patient cannot tolerate pressure •Non compliant •No assistance from staff or family •Contracture too severe for proper fit •Sensitive to skin breakdown
Tenodesis Custom Hand / Wrist Orthosis (WHO)
	•Traumatic brain injury •CVA •Traumatic injury – auto accident, gunshot wound, etc. •Quadriplegic	•Active wrist extensors and good ROM in wrist and fingers •Increases ADL’s for patients after they learn to use it •Possible ability to return to work •Good motivated patient	•No active wrist extensors •Long instruction and rehab sessions needed •Cosmesis •Non compliant
Range of Motion (ROM) Elbow Orthosis
	•Post-operative elbow surgery •Elbow contracture – non fixed •Traumatic injury to elbow •Elbow fracture or severe sprain / strain	•Allows full, limited, or fixed ROM •Can be taken off to wash and monitor healing •Allows for faster therapeutic recovery than a cast •Lightweight	•Not as stable as thermoplastic EO •Non compliant •Patient can remove brace
Custom Flexion-Assist Elbow Orthosis
	•Biceps paralysis	•Good wrist extensors/flexors •Fair or higher shoulder ROM and strength •Highly motivated patient	•Elbow contractures •Non compliant •Cosmesis
Fracture Managment Orthoses
Humeral Fracture Brace with Shoulder Extension
	•Mid-shaft humeral fracture	•Shoulder extension provides more stability and decreased migration •Allows for elbow movement and quicker rehabilitation •Allows for cleaning and monitoring •Provides circumferential pressure to promote bone growth	•Complex fracture •Large lacerations or sores •Non compliant – can be removed
Articulated Elbow Fracture Brace
	•Distal 1/3 humeral fracture •Elbow fracture •Forearm fracture	•Allows for elbow joint to be locked, free or limited ROM •Free shoulder and wrist motion •Allows for cleaning an monitoring •Provides circumferential pressure to promote bone growth	•Complex fracture •Large lacerations or sores •Non compliant – can be removed
Ulnar Fracture Brace
	Ulnar fracture in forearm	•Allows for free elbow and wrist movement •Allows for early return to function and rehabilitation •Allows for cleaning an monitoring •Provides circumferential pressure to promote bone growth	•Complex fracture •Large lacerations or sores •Non compliant – can be removed
Tibial Fracture Brace
	•Diaphyseal fracture of tibia and fibula •Isolated tibial fracture	•Allows for free knee flexion •Cant be attached to a solid or free motion ankle section •PTB section prevents rotation of brace on leg •Allows for cleaning and monitoring •Provides circumferential pressure to promote bone growth	•Complex fracture •Large lacerations or sores •Non compliant – can be removed
Femoral Fracture Brace KAFO
	•Femoral fracture •Tibial plateau fracture	•Can have locked or free knee and ankle motion •Provides stability at knee for femur to allow to heal •Allows for quicker rehabilitation •Allows for cleaning an monitoring •Provides circumferential pressure to promote bone growth	•Complex fracture •Large lacerations or sores •Non compliant – can be removed
Fracture Walker
	•Malleolar fracture •Stress fracture in foot •Post-operative ankle or foot injury	•Holds ankle in fixed or limited ROM •Rocker sole prevents flexion in metatarsals •Can be removed for bathing, sleeping, and follow-up care •Allows for fluctuation edema •Can walk on it	•Not as rigid as cast •Cosmesis •Non compliant – can be removed
Jewitt Brace
	•Compression fracture •Lumbar and thoracic	•Prevents flexion of spine •Controls thoracic spine •Cooler than corset or LSO/TLSO •Does not prevent extension •More comfortable on men	•Cosmesis – bulky and metal •Difficult to don/doff if weakness in hands •Can cut into women’s breasts •Shows under clothing •Non compliant
Cash Brace
	•Compression fracture •Lumbar and thoracic	•Prevents flexion of spine •Controls thoracic spine •Cooler than corset or LSO/TLSO •Does not prevent extension •More comfortable on women •Velcro™ closure	•Comesis – bulky and metal •Cannot be used for person with large stomach •Shows under clothing •Non compliant
Thermoplastic LSO/TLSO
	•Compression fracture •Facet fracture	•Restricts flexion and all other motion •Used for chronic compression fracture in cancer patients	•Hot and bulky •Restricts all spinal motion •Non compliant