Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Malleolar Irritation with AFOs

Discussion in 'General Issues and Discussion Forum' started by admin, Jan 19, 2007.

  1. admin

    admin Administrator Staff Member

    Members do not see these Ads. Sign Up.
    The latest newsletter from ProLab:
    Preventing Malleolar Irritation with AFOs
  2. LCBL

    LCBL Active Member

    I am not aware of the extent of training that Pod's get in AFO's and their casting/use/.... etc.

    However, this advice in this newsletter is dangerous. Poly AFO's are contrindicated for fluctuating oedema.

    If you cast in the AM then the fit in the PM is constrictive leading to pressure on the leg.

    If you cast in the PM then the AFO in the AM is loose leading to fiction/pressure sores as the leg 'moves' in the AFO.

    These are not problems you want in a patient with fluctuating oedema.
  3. Scorpio622

    Scorpio622 Active Member

    After reading your post, the question I ask is how many non-Pods get training in treating fluctuating oedema???

    I disagree with your statement that fluct oedema is a "contraindication". It is a precaution. This must be taken on a case-by-case basis. The mere fact that the oedema "fluctuates" suggests that it most likely can be managed with compression therapy.

    There are many advantages to a MAFO compared to a double upright AFO- better hindfoot control, less heavy, less O2 consumption, concealable, less expensive, can be used with a variety of shoes, less stigma, better compliance, etc. Patients HATE double uprights.

    Why not TREAT the oedema and order the MAFO in patients with low risk limbs. It will serve as a barometer and reinforcement for the oedema treatment. I do this quite often and have much success.

  4. LCBL

    LCBL Active Member

    Heah Nick

    I agree. Treat the oedema first and when its stabilised then use the AFO (???MAFO....not one ive come across before).

    My point is that the advice here is that the two can be done together.....which is misleading.

    Also, are they recommending that the cast is taken with the compression hoisery on? There are too many variables for this newsletter to be correct.


    PS There are loads of professions that treat oedema....apart from pod's.
  5. pretschko

    pretschko Member

    As an Orthotist Prosthetist (Foot and Ankle Centre) I can assure everyone that there are many many many types of AFO's. When the AFO is custom made, adequate relief in the positive cast can be inbuilt so that the malleoli can not abrade.
    The prescription principles always relate to what (mechanically) the AFO needs to achieve - treat the oedema as oedema.
    My lab does some ex fab work for remote podiatrists - I think it worthwhile that in circumstances such as an absence of a P&O that a professional with mechanical device fitting experience helps out.
    Regards Paul R

Share This Page