Calipers (FOOT ORTHOSIS)

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 Calipers are orthosis fitted to the lower limb. They may be

                        * Foot Orthosis (FO)

                        * Ankle Foot Orthosis (AFO)

                        * Knee Ankle Foot Orthosis (KAFO)

                        * Hip Knee Ankle Foot Orthosis (HKAFO)

Considerations while prescribing Calipers


       Orthosis need to be prescribed, just like drugs. The specification would include the nature and number of joints, the positioning of the straps suspension and accessory attachments to the shoe or boot

       The reason for prescribing it must be explained to the following, before delivering the orthoses.

       The stability of the hip and knee should be good before deciding hoe high the caliper should be. This can only be done after doing a muscle power grading, paying special attention to the hip abductors extensors and knee extensors.

       Alignment is checked whether the ankle joint is over the medial malleoli, the knee joint over the prominence of medial femoral condyle and the hip joint permits a patient to sit upright at 90 degree.

        The caliper should be functional throughout all phases of gait and static and dynamic alignment.

FOOT ORTHOSES (FO)

       The essential difference between a shoe and a boot is that a boot covers the malleoli, while a shoe doesn't. 

       The foot orthoses is nothing but a boot that has components like supports and wedges to manage different foot symptoms and deformities. 

       These modifications are made of various materials like rubber, foam or leather.

Components of the lower part

         * Sole

         * Ball

         * Shank

         * Toe spring

        * Hell

SOLE
       
         It is the part of the shoe in contact with the ground. The inner part of the sole against which the foot rests is the insole.

         Bars straps and wedges, which are common attachments to the orthoses get their leverage and attachments through the sole and exert their forces.

 BALL

        Widest part of the sole that is located in the region of the metatarsal heads.

SHANK

         Is the narrowest part of the sole between the heal and ball. The upright of the AFO attach themselves to a stirrup at the shank region.
      
TOE SPRING

       It is the space between the outer sole and the floor, which helps to produce a rocker effect during toe off phase of the gait cycle.

 HEEL
         
        It is the posterior part of the sole, which corresponds to the heel of the foot. Since it is the portion where most of the body weight is taken it needs to be resilient and thicker so that it can prevent shoe components from "wearing out" and shift weight to the force foot.








Components of upper part

    
          * Quarter

          * Heel counter

          * Vamp

          * Throat

          * Toe box

          * Tongue

          * Stirrup

QUARTER

     This is the posterior portion of the shoe upper. A high quarter is referred as a 'High top' and is used by runners and footballers for greater sensory feedback and to prevent retrocalcaneal pain.

HEEL COUNTER
 
      In sports shoes there is a reinforcement of the quarter posteriorly called a heel counter which provides posterior stability to the shoe and supports the calcaneus.

VAMP
 
    Vamp is the anterior portion of the upper and is often reinforced with a toe box anteriorly. 

    In front is the tongue which protects the upper fore foot behind the lace stays.

    Extra-depth shoes allow more room inside the shoe and supports the calcaneus.

THROAT
    
    This the opening of the shoe located at base of the tongue, through which the foot is inserted.

TOE BOX

    It prevents the toes from suffering trauma when the person kicks as in football. Even normally it is provided in the shoe to avoid stubbing of the toes.

TONGUE

        This is the part of the vamp which extends down in front of the throat.

STIRRUP

   This is a piece on the outer sole in the shank region just in front of the heel offering attachment to the metal uprights.

 Modifications of the Orthopedic Shoe


      The shoe ca be modified according to the deformity, disease process or congenital anatomical configuration of the patient to:

                * Maintain the foot in anatomical position

                * Treat symptoms of pain burning or fatigability

                * Prevent further deformity

                * Afford cosmesis

                * Provide symmetry

                * Provide a better stance and gait



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