AFO VERSUS SMO = AFO FITTED

A referral to the rehab department at KK was given by Dr W when I asked to make a pair for Jonathan in my previous post HERE.

So we were fortunate that a patient didn't turn up for his/her appointment and we could be slotted in to see Orthotist Heidi.

Initial recommendation by Dr W was that we could make an SMO (Supra-Malleolar Orthosis) that looks like this:
Note:  More information on SMO HERE

It is fitted right up to the ankle, which would be good for standing, but the PT who was present said that SMOs break easily if we use it for walking exercises.

Well, we met Heidi.  She made Jonathan stood on his feet.  After seeing his feet turned inwards, she recommended the AFO (Ankle-Foot Orthotic, more information HERE) because the AFO stretches right up to the calf and will give a better support to his ankles.

Before putting the cast, she marked his legs and feet.  I'm actually not quite sure what it was for.  The ink was still evident when we got home.

So started the process of casting to make the AFO.  Below, a guide was put on his shin.

Then Heidi started wrapping his leg with the wet case that actually looks like gauze with white cement.  You had to dip this gauze into water then start to wrap around the leg before it hardens.

 This was before his foot was wrapped.  She needed two plastripes.

Jonathan just couldn't keep still.  Once the calf part is done, she proceeded to cast his foot and it was not easy.  We had to bend his leg at the knee and hold his foot into position so that it will fit correctly.  See he keeps moving his legs and Heidi had to really hold his leg tight while I held on to this knee. Heidi was kicked a few times.

The cast hardened quickly and using a scalpel-lookalike, she cut the cast right through the middle where the plastic guide was first place.

Thus ending the casting process.

We will have to return to Tan Tock Seng Hospital for the fitting soon and then back to KK Rehab Department for follow-up on the use of the AFO.