Understanding Your Orthotic Written Exam Results

Select appropriate materials/techniques in order to obtain a patient model/image. Select appropriate materials and components for orthosis based on patient criteria to ensure optimum strength, durability and function. Complete or delegate fabrication of orthosis including positive mold rectification. Assess/align orthosis for accuracy in sagittal, transverse and coronal planes in order to provide maximum function/comfort. Educate patient and/or caregiver about the use and maintenance of the orthosis. Documentation using established record-keeping techniques to verify implementation of treatment plan.

A patient is experiencing recurrent positional posterior dislocation after hip replacement surgery. The PRIMARY goal of a hip abduction orthosis is to block:

1. Hip flexion

2. Hip extension

3. Hip abduction

4. Hip external rotation

When fabricating a thermoplastic articulated AFO, the mechanical ankle joints should be placed at the level of the:

1. Apex of the lateral malleolus

2. Apex of the medial malleolus

3. Distal border of the medial malleolus

4. Distal border of the lateral malleolus

The standard lateral inferior trimline for a single piece anterior opening custom LSO is:

1. 4 cm (1 1/2”) superior to the greater trochanter

2. 2 cm (3/4”) superior to the greater trochanter

3. 2 cm (3/4”) inferior to the greater trochanter

4. At the level of the greater trochanter

While fitting a ground reaction AFO you observe good control of the patient’s knee in the sagittal plane however the patient complains they are having difficulty initiating swing on the side with the orthosis. The MOST appropriate modification to address this would be to:

1. Trim the footplate to end proximal to the metatarsal heads

2. Lower the superior anterior trimlines

3. Reduce the ankle trimlines to bisect the malleoli

4. Add a ¼” heel wedge underneath the AFO

The main functional goal of posterior off-set unlocked knee joints is to:

1. Control genu recurvatum

2. Control genu varus

3. Provide increased stability during stance

4. Prevent the knee from buckling at initial contact

During the casting of an ambulatory child with cerebral palsy for custom bilateral solid ankle AFOs you note that the right side lacks dorsiflexion range of motion (-5°) with the knee extended. The MOST appropriate way to address this is to:

1. Cast in -5° of dorsiflexion and plan to add an external heel wedge

2. Cast in -5° of dorsiflexion and plan to cut the cast and place it in neutral

3. Cast in neutral with the knee maximally flexed

4. Cast in -5° of dorsiflexion and plan to add a rocker sole on the right shoe