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Fabricating for Tone Reduction n Tony Wickman R.T.(O,P) n freedom fabrication inc.
What Is Tone? n Tone literally means activation of a muscle. n Spasticity is derived from the Greek word meaning to pull or draw.
Cast Correction: n Cast may require greater than normal correction n Make sure to correct cast at the articulating surfaces
Dorsiflexion Angle n Maximum dorsiflexion deviation should be no more than 20 degrees. n Watch for cavus arch !
Plantarflexion Angle n Plantarflexion angle should be no more than forty degrees. n Watch for plantarflexed metatarsals
Inversion/Eversion Angle n +/- 15 degrees n Cast corrections are difficult
Mold Modification n The model must accurately mimic the patients physiology n You have to have intimate knowledge of skeletal structures!
Maleoli Buildups n Buildups should be more “extreme” than usual n Take into consideration varus valgus tendencies
Medial Maleoli/Navicular n Two apexes n Blend well into surrounding soft tissue
Calcaneal Cuboid Buildup n Include achilles tendon extension n Be sensitive to prominent heels
Heel Buildup n Heel should be rounded n Heel should be symmetrical
S.T. Groove n Anatomy rules n Blend into longitudinal arch
Medial/Lateral Arches n Smooth transition n Connect around to plantar surface of calcaneus
Cuboid/ Lateral Fifth Met Head n Relieve mm n Be careful to maintain radius of plantar lateral surfaces
Metatarsal Relief n Proximal edge relief n Distal edge relief
Padding Techniques n Bony prominences only n Blend edges smoothly n Colored foams
Material Selection n Polypropylene n Polyethylene n Copolymer
Pulling Plastic n Focused stretch n Proper temperature n Maximum vacuum
Trimming Plastic n Establish trim lines n Poly posting is ground first n Trim lines must be smooth
Finishing & Decorating n Colored Velcro n Foams n Ribbon n Transfers
For additional information on this subject: n Tony Wickman at Freedom Fabrication 815-B north main St. Havana Fl n n n or visit our web site at: fabrication.com
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