FIOR & GENTZ specialises in orthotics for the lower extremity. In this area, one primarily differentiates between orthoses for the paralysed and supportive orthoses. The designation of an orthosis is based on the international classification for standards (ICS), which is developed and maintained by the International Organization for Standardization (ISO). The names indicate which anatomical joints and body parts are covered by the orthosis. For example, an AFO (ankle-foot orthosis) covers the ankle and the foot. In the past, orthoses were called splints, braces, side bars or side bars/bands orthoses. These terms should no longer be used in order to standardise the communication in an interdisciplinary team consisting of patients, physicians, physiotherapists and orthotists.
A custom-made orthosis offers the advantage of being individually adaptable to the patient’s needs. With a unilateral (one-sided) construction, the orthotic joint is placed next to the ankle joint. With a bilateral (double-sided) construction, one orthotic joint is placed on the inside and the other one on the outside next to the ankle joint. Both a unilateral and a bilateral construction can be used at knee level as well. The selection of orthotic joints depends on the clinical picture and the functional deviations of the patient. An optimal orthosis function for the patient is achieved through the adjustability of the functional elements.
The different types of orthoses that are relevant in the area of the lower extremity are summarised below.
AFO is the abbreviation of ankle-foot orthosis. The name is derived from the body parts that are covered by the orthosis: ankle and foot.
An AFO used in cases of paralysis compensates for the functional deviations resulting from the patient’s clinical picture. These include, in particular, a paralysis of the plantar flexors or dorsal flexors. Orthotic joints by FIOR & GENTZ contain adjustable and dynamic functional elements that allow the orthosis function to be adapted to the patient’s needs. If, for example, the plantar flexors are weak, the orthosis compensates for the missing safety when standing and walking. If the dorsal flexors are weak, the functional elements enable the patient, among other things, to walk without stumbling by lifting the forefoot during swing phase.
KAFO is the abbreviation of knee-ankle-foot orthosis. The name is derived from the body parts that are covered by the orthosis: knee, ankle and foot.
A KAFO used in cases of paralysis compensates for the functional deviations resulting from the patient’s clinical picture. These include, in particular, a paralysis of the knee or hip extensors. Orthotic joints by FIOR & GENTZ contain adjustable and dynamic functional elements that allow the orthosis function to be adapted to the patient’s needs. If, for example, the knee extensors are weak, functional elements for stance phase control are integrated into the orthosis.
At knee level, a distinction is made between free moving, locked and automatic system knee joints. The selection of orthotic joints in cases of paralysis depends on the functional deviations of the large muscle groups of the lower extremity.
A knee orthosis only covers the knee. In contrast to a KAFO or an AFO, there is no joint at ankle level. Knee orthoses are used postoperatively to protect and support the knee joint. This can significantly alleviate knee pain. Common indications are injuries to the cruciate ligament, injuries to the capsular ligamentous apparatus and meniscus injuries. The majority of the orthotic joints used for this purpose have gear segments and are classified by FIOR & GENTZ in the category articulated side bars for knee orthoses. The pivot point of the gear segment joints simulates the movement of the anatomical pivot point. Thus, the complex ligamentous apparatus is not unnecessarily loaded.
Terms used in connection with lower leg orthoses can be confusing. They usually describe an AFO with its various properties. However, there are no clear definitions. Here, you will find an overview of the most common designations.
DAFO (dynamic ankle-foot Orthosis)
dynamic lower leg orthosis
FRAFO (floor-reaction AFO)
rigid lower leg orthosis with a ventral shell
HAFO (hinged AFO)
lower leg orthosis with dorsal shell
PLSAFO (posterior-leaf-spring AFO)
lower leg orthosis with leaf spring behind the Achilles tendon
SAFO (solid ankle-foot orthosis)
rigid lower leg orthosis
SMO (supramalleolar orthosis)
orthosis covering the ankle, can have dynamic properties