Ankle Foot Orthoses (AFO) – Richie Brace and Arizona Gauntlet

Ankle Foot Orthoses, or AFOs, are devices used to support the lower limb. They usually cover the sole of the foot and extend to the ankle. The size of the brace is tailored to the patient and varies according to the needs of the patient. Some cover the entire ankle to just below the knee, while others barely extend past the ankle. They are usually prescribed for patients to help reduce pain when walking or while recovering from injury. An AFO can also be used to aid walking in people with neurological disorders, such as Charcot-Marie-Tooth syndrome or cerebral palsy. Diabetics who have lost sensation in their feet can also benefit from using an AFO to prevent injury.

One condition that is frequently treated with the use of an AFO is posterior tibial tendon disorder (PTTD), also known as adult acquired flatfoot. The posterior tibial tendon runs from the calf around the inside and behind the ankle and attaches below the midfoot on the side of the arch Chattanooga podiatry. The action of this muscle / tendon when working properly is to provide stable arch support. An important function of the posterior tibial tendon is to turn the foot inward while walking, thus creating a stable foot capable of propelling the body forward. When there is a decrease in muscle strength in the posterior tibial tendon, the foot no longer functions as it should. With prolonged overuse, the posterior tibial tendon can lose its ability to create a stiff arch, causing the foot to flatten. If this progressive condition is left unsupported, the tendon can rupture and may need surgery.

Richie’s brace is an AFO, commonly used to treat mild to moderate stages of PTTD. The brace consists of a custom foot orthosis and two hinged upright braces on either side of the ankle. The orthosis supports the arch of the foot, rebalances the muscular strength of the foot, and controls the position of the bones and joints of the foot and ankle. When used for PTTD, its purpose is to prevent the posterior tibial tendon from working too hard to maintain the arch of the foot, thus reducing the possibility of damage to the tendon. This low profile style device can generally be worn with many commonly available shoes. Most of the time, it may be necessary to wear a shoe that is one size larger than what is normally worn for comfort.

Another commonly used AFO is the Arizona Gauntlet AFO. This style of device is also worn with shoes and immobilizes ankle movement. It is effective in the treatment of degenerative diseases of the joints or arthritis of the ankle and foot. Arthritis can occur due to a previous traumatic injury, such as an ankle fracture or sprain, or it can occur as an aging process. As these conditions progress, it becomes increasingly painful to move the foot and ankle. Wearing the Arizona splint restricts movement and can eliminate pain when walking. The brace is two-layer with a firm, durable exterior and a soft leather interior. It is equipped with laces, which is convenient for those who need to make minor adjustments to the size of the brace if the foot and ankle swell. This type of brace may also require patients to wear a larger or deeper shoe to accommodate the foot and brace. The Arizona glove can also be used for PTTD.

If an AFO is the correct form of treatment for your condition, your doctor will recommend the appropriate type of corset for you. The next step in the process of doing your AFO is that a cast or fiberglass cast will be taken of your foot and ankle. This model will then be sent to the orthopedic lab to manufacture the custom device for your foot and ankle. When the lab returns the finished device to the doctor’s office, the AFO will be checked to make sure it fits properly. After a short period of adaptation, the brace should be comfortable and should be worn as directed by your doctor.

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