Hanger PDR

PROSTHETICS & ORTHOTICS
PHYSICIANS DESK REFErENCE
HANGER PROSThETICS & ORThOTICS
INtrOduCtION
The Hanger Difference

The strength that comes from 150 years of providing prosthetic and orthotic services combined with a commitment to superior care and innovative technology is what sets Hanger apart. Understanding a patients needs and experiences is deeply rooted in Hangers way of doing business. In 1861, James Edward Hanger became the rst amputee of the Civil War. When a satisfactory solution to help him walk again was not available, he fashioned an articial leg for himselfa device constructed of barrel staves and a hinge at the knee. Hangers ingenuity and desire to help other wounded veterans became the foundation for the company that today provides individualized prosthetic and orthotic care for hundreds of thousands of patients at more than 600 facilities nationwide. The specialized care programs offered by Hanger are designed around the needs of the patient and are able to meet the challenges of the most complex cases. Staffed by some of the worlds leading prosthetic and orthotic practitioners, each program delivers the best and most comprehensive plan for care.
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INtrOduCtION
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The Hanger Difference

Upper Extremity Prosthetics Program: Hangers Upper Extremity Prosthetics Program is the largest and most reputable in the world. Compared to the average independent prosthetic clinic, which only sees one or two cases a year, Hanger sees hundreds of upper extremity cases each year. Because of this, Hanger is able to bring world-class expertise and experience to a very specialized eld. Lower Extremity Prosthetics Program: Hangers Lower Extremity Prosthetics Program provides patients with the most advanced and clinically appropriate technology to help them meet their goals and regain independence. Hanger practitioners are especially skillful dealing with patients who have complex amputations or tting needs. Orthotics Program: The specialties of Hangers Orthotics Program span from complex bracing systems to splints and foot orthotics, to cranial helmets and mastectomy services. These specialized programs, combined with our cutting edge technologies, such as the ComfortFlex Socket System, Insignia and the WalkAide System, have propelled Hanger to the forefront of the industry.
Hometown Care. Nationwide Resources.

What could be better for a patient than the personalized service and attention of a local practice combined with the resources of the nations leading orthotic and prosthetic company in the world? This is what Hanger offers every patient. Each Hanger practice is locally operated under the direction of a board-certied practice manager ensuring individualized care and attention. Practitioners work closely with patients, physicians and the entire rehabilitation team to develop the best plan of treatment and support. The added benet of a national network of internationally-renowned professionals available for consultation provides an unparalleled level of clinical expertise. Hanger believes continuing education and training is critical to providing excellent service. Every Hanger practitioner is required to participate in annual training programs on subjects ranging from the latest technological advancements to compliance issues. As a result, Hanger practitioners are some of the most highly-trained in the industry. And if a patient should move or travel, Hangers extensive network of care centersnearly 600 nationwideoffers quality continuum of care throughout their lives.
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INtrOduCtION
INtrOduCtION
Innovative Technology
Hanger was founded on clinical innovation and since its beginning has been a leader in introducing state-of-the-art prosthetic and orthotic components to patients. Hanger continues to develop innovative technology only available through Hanger practitioners. The patented ComfortFlex Socket System sets a new standard in socket technology. The Comfort Flex gives the user maximum comfort by incorporating the unique shape of the residual limb with channels and grooves that support the underlying anatomy. The result is a socket that provides maximum comfort and promotes muscle growth and better circulation for the residual limb. Hangers latest innovation, the WalkAide, gives unprecedented mobility to people who have had a stroke or suffer from multiple sclerosis, spinal cord injuries, traumatic brain injuries or cerebral palsy. This FDA cleared device uses functional electrical stimulation to produce a safer and more natural gait.
Innovative Technology
Insignia, Hangers exclusive 3D laser imaging system, easily and comfortably creates a precisely t, customized prosthesis or orthosis. This alternative to plaster molding ensures a more accurate t, creates permanent patient records and assists in documentation for medical or insurance needs. The Insignia logo throughout this guide indicates products made using the Insignia system.
This prosthetic and orthotic product guide is intended to be used only as a reference. While comprehensive in scope, every product currently on the market could not be included. Additionally, because technology is constantly evolving, the products shown are subject to change. It is the responsibility of the prescribing physician to select the correct device which will meet the needs of a patient. Consultation with a board-certied prosthetist or orthotist helps ensure that the most appropriate product is prescribed.
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ORTHOTICS
9 Spinal Orthoses 21 Lower Extremity Orthoses 59 Pediatric Orthoses 73 Upper Extremity Orthoses 83 Mastectomy
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SpINAL ORTHOSES
10 Soft Cervical Collar 10 Philadelphia Cervical Collar 11 Rigid Two Piece/Bivalve Cervical Collar 11 Miami JTO Cervical Orthosis 12 Minerva Cervical Orthosis 12 SOMI Cervical Thoracic Orthosis 13 CTLSO (Cervico-Thoraco-Lumbo-Sacral-Orthosis) 13 Cervical Halo 14 Spinomed 14 Thoracolumbar Corset/Support 15 Hyper-Extension Orthosis 15 CASH (Cruciform Anterior Spinal Hyper-Extension) Orthosis 16 Wrap AroundBoston Style TLSO 16 Custom TLSO (Thoraco-Lumbo-Sacral Orthosis) Body Jacket 17 Custom Soft TLSO (Thoraco-Lumbo-Sacral Orthosis) 17 Custom LSO (Lumbo-Sacral Orthosis) Body Jacket 18 Chairback Orthosis 18 LSO (Lumbo-Sacral Orthosis) Pull Cord Design 19 Lumbosacral Corset 19 Elastic Lumbosacral Binder 20 SI (Sacroiliac) Orthosis
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Soft Cervical Collar

DX: Mild cervical sprain, strain, whiplash, muscular weakness Soft foam collar offers support and some limitations of exion, extension, lateral bending Hook and loop Velcro closures
Rigid Two Piece/Bivalve Cervical Collar

DX: Post-operative Removable inner lining can stabilization, stable be washed and/or replaced Available in varying heights cervical fractures, degenerative pathologies, and neck circumferences AKA: Miami J, Aspen arthritis Restricts exion, extension, lateral bending X-ray, CT, and MRI compatible components Rigid plastic two piece frame with bivalve opening, Velcro closures and removable inner lining
Philadelphia Cervical Collar

DX: Post-operative stabilization, stable cervical fractures, degenerative pathologies Restricts exion, extension, lateral bending Latex free, non toxic, hypoallergenic Plastizote two piece bivalve design with hook and loop Velcro closures Water resistant, can be used in the shower, bathing and aqua therapy Available in varying heights and circumferences
Miami JTO Cervical Orthosis

DX: Cervical and high thoracic injuries, stable fractures, post-operative stabilization, degenerative pathologies, arthritis Restricts exion, extension, lateral bending X-ray, CT, and MRI compatible components Rigid Miami J collar combined with thoracic extension for additional control and stabilization Rigid plastic two piece frame with bivalve opening, Velcro closures and removable inner lining Removable inner lining can be washed and/or replaced Available in varying heights and neck circumferences
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ORThOTICS
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Minerva Cervical Orthosis

DX: Low cervical and high thoracic fracture or injury management, stable fractures, post-operative stabilization, arthritis, degenerative pathologies Two piece design restricts exion, extension, lateral bending Mandibular and occipital extensions modied to accommodate varying anatomical alignment Available in pediatric and adult sizes small thru large
CTLSO (Cervico-Thoraco-Lumbo-Sacral-Orthosis)
DX: Low cervical and thoracic fracture or injury management, stable fractures, post-operative stabilization, arthritis, degenerative pathologies Rigid plastic exterior shell with soft aliplast lining, closed cell foam does not absorb moisture, water resistant Bivalve design with mandibular and occipital extension modied to accommodate varying anatomical alignment Custom-made to patient model
SOMI (Sub-Occipital Mandibular Immobilization) Cervical Thoracic Orthosis

DX: Low cervical and high thoracic fracture or injury management, stable fractures, post-operative stabilization, arthritis, degenerative pathologies Mandibular and occipital extensions modied to accommodate varying anatomical alignment Anterior design allows supine donning Available in pediatric and adult sizes small thru large
Cervical Halo
DX: Unstable cervical Available in pediatric and adult sizes x-small thru fractures, post-operative stabilization xx-large Two piece thoracic vest with lambs wool liner, rigid super structures, buckle closures, and CPR break for emergent issues, traction bar optional MRI compatible Sterilized ring, skull pin, and application kit
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ORThOTICS
ORThOTICS
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Spinomed
DX: Thoracic and lumbar compression fractures, hyper-kyphosis, chronic back pain, osteoarthritis Low prole design aids to decrease pain and increase patient mobility Velcro closures for ease of donning/dofng
Hyper-Extension Orthosis
DX: Thoracic and lumbar compression fractures, post-operative stabilization, osteoporosis Restricts exion and lateral bending Rigid metal frame design with three point biomechanical stabilization, adjustable horizontal and vertical bars Available in pediatric and adult sizes x-small thru x-large AKA: Jewett, 3-point hyper-extension orthosis
Thoracolumbar Corset/Support
DX: Thoracic and lumbar Available in sizes x-small thru xx-large or sized to hip chronic back pain, osteoarthritis and waist circumference Available in cotton and measurements nylon designs, Velcro or hook and eye anterior closures, optional removable moldable metal stays Padded adjustable shoulder straps
CASH (Cruciform Anterior Spinal Hyper-Extension) Orthosis

DX: Thoracic and lumbar compression fractures, post-operative stabilization, osteoporosis Restricts exion Rigid cross-shaped metal design with three point biomechanical stabilization, adjustable horizontal and vertical bars Optional articulated sternal and pubic pads Available in pediatric and adult sizes x-small thru x-large
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ORThOTICS
ORThOTICS
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Wrap AroundBoston Style TLSO (Thoraco-Lumbo-Sacral Orthosis)

DX: Spondylolisthesis, Rigid posterior stays lysis, losis, post-operative available for additional stabilization, disc stabilization herniation Available in off-the-shelf stock sizes or custom-made Restricts exion, extension, and lateral bending to patient model Wrap around plastic design with anterior Velcro closures provides maximum abdominal compression for biomechanical control
Custom Soft TLSO (Thoraco-Lumbo-Sacral Orthosis) Body Jacket

DX: Thoracic and lumbar fracture management, post-operative stabilization, spinal stenosis, degenerative pathologies Semi-rigid foam exterior with soft aliplast lining, and rigid internal or external frame closed cell foam does not absorb moisture, water resistant Restricts exion, extension, and lateral bending Available with bivalve or one piece design Custom-made to patient model AKA: Soft body jacket, turtle shell brace
Custom TLSO (Thoraco-Lumbo-Sacral Orthosis) Body Jacket

DX: Thoracic and lumbar fracture management, post-operative stabilization, spinal stenosis, degenerative pathologies Restricts exion, extension, and lateral bending Rigid plastic exterior shell with soft aliplast lining, closed cell foam does not absorb moisture, water resistant Available with bivalve or one piece design Available in off-the-shelf stock sizes or custom-made to patient model AKA: Body jacket, turtle shell brace
Custom LSO (Lumbo-Sacral Orthosis) Body Jacket

DX: Lumbar fracture management, postoperative stabilization, spinal stenosis, degenerative pathologies Restricts exion, extension, and lateral bending Rigid plastic exterior shell with soft aliplast lining, closed cell foam does not absorb moisture, water resistant Available with bivalve or one piece design Available in off-the-shelf stock sizes or custom-made to patient model AKA: Body jacket, turtle shell brace
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Chairback Orthosis
DX: Low back pain, lumbar stenosis, post-operative stabilization, lumbar strains/sprains, disc herniations Rigid anterior and posterior frame design with abdominal compression panel Pulley system available Lightweight, breathable design Available in sizes x-small thru x-large
Lumbosacral Corset
DX: Low back pain, lumbar stenosis, post-operative stabilization, lumbar strains/sprains Washable cotton construction with removable moldable metal stays Velcro, hook and eye, anterior closure options Available in mens and womens styles, sized to waist and hip circumference
LSO (Lumbo-Sacral Orthosis) Pull Cord Design

DX: Low back pain, lumbar Available in mens and womens sizes x-small thru stenosis, post-operative stabilization, lumbar xx-large strains/sprains AKA: California Compressor, Pull cord design for optimal Cybertech, DonJoy BOA, abdominal compression Aspen LSO, Aspen Quick Draw and ease of donning Two and three piece designs, available with rigid abdominal and posterior panels
Elastic Lumbosacral Binder

DX: Low back pain, lumbar stenosis, post-operative stabilization, lumbar strains/sprains Flexible elastic binder with optional moldable rigid posterior panel Single or double pull Velcro anterior closure options Available in xx-small thru xx-large sizes
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ORThOTICS
LOWER EXTREMITY ORTHOSES

FOOT ORTHOSES 24 Accommodative Foot Orthosis 24 Medicare Accommodative Foot Orthosis 25 Functional Foot Orthosis 25 UCBL Foot Orthosis SHOES AND CAST BOOTS 26 Healing Shoe 26 Surgical Cast Shoe/Boot 26 Pressure Relief Shoe/Boot 27 Answer 2 Shoes 27 Extra Depth Shoes 27 Custom Shoes ANKLE FOOT ORTHOSES (AFO) 28 Fracture Walking Boot 28 Mid-Calf Fracture Boot 28 Pressure Relief AFO 29 Lace-Up Ankle Orthosis 29 Lace-Up Ankle Orthosis with Stays 29 Air Stirrup Ankle Orthosis 30 Articulated Ankle Orthosis 30 Plantar Fasciitis Night Splint 31 Off-the-Shelf Posterior Leaf Spring AFO 31 Carbon Fiber Dynamic AFO 32 Custom Articulated Ankle Orthosis 32 Molded Leather Ankle Gauntlet 33 Double Upright Metal AFO (Ankle Foot Orthosis) continued
SI (Sacroiliac) Orthosis
Sacroiliac dysfunction Wrap around Velcro closure belt design Latex free Available in sizes 30 thru 60 AKA: SI Belt
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33 Neuropathic Walking Boot (CRO) 34 Custom Posterior Leaf Spring AFO 34 Custom Semi-Solid AFO 35 Custom Solid Ankle AFO 35 Custom Articulated AFO fRACTURE ORTHOSES 36 Patellar Tendon Bearing Orthosis (PTBO) 36 Tibial Fracture Orthosis 37 Femoral Fracture Orthosis CONTRACTURE ORTHOSES 37 Ankle Foot Contracture Orthosis 38 Knee Ankle Foot Contracture Orthosis 38 Knee Contracture Orthosis KNEE ORTHOSES 39 Knee Immobilizer 39 Post-Op Knee Orthosis 40 Post-Op Knee Orthosis 40 Bledsoe Post-Op Knee Orthosis 40 Elastic Knee Sleeve 41 Neoprene Patellar Stabilizing Knee Sleeve 41 Lateral J Buttress Knee Orthosis 41 Hinged Patellar Stabilizing Knee Orthosis 42 Hanger Select Knee Orthosis 42 Breg X2K OTS 42 Hinged Neoprene Knee Orthosis 43 Hinged Neoprene Knee Orthosis

43 Townsend Premier 43 CTiInnovation Sports 44 Breg X2K 44 DonJoy Deance OSTEOARTHRITIS (OA) KNEE ORTHOSES 45 Generation II 45 V-Vas Anatomical Concepts 46 DonJoy OA Everyday 46 DonJoy OAdjuster 47 DonJoy Deance OA 47 Breg X2K Counterforce KNEE ANKLE fOOT ORTHOSES (KAFO) 48 Knee Ankle Foot Orthosis (KAFO) 49 Laminated Knee Ankle Foot Orthosis (KAFO) 50 Stance Phase Locking (SPL) KAFOFillauer 51 Stance Control Knee Orthotic Joint (SCKOJ) KAFOHorton 52 E-Knee Stance Control KAFO Becker 53 FreeWalk Stance Control KAFO OttoBock 54 UTX Stance Control KAFO Becker HIP ORTHOSES 55 Hip Abduction Orthosis HIP KNEE ANKLE fOOT ORTHOSES 56 Hip Knee Ankle Foot Orthosis (HKAFO) RECIPROCATING GAIT ORTHOSES 57 Reciprocal Gait Orthosis (RGO)
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LOWER EXTREMITY ORThOSES
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Accommodative Foot Orthosis

DX: Diabetes, vascular and sensory insufciencies Multi density semi-rigid orthosis Custom-made to patient model NON-Medicare patients
Functional Foot Orthosis

DX: Biomechanical Fabricated in non, semi insufciencies, plantar and full weight bearing fasciitis, hyper pronation/ positions to achieve supination, neuromas, neutral or functional alignment (subtalar neutral metatarsalgia, Multi-density semi-rigid alignment) or rigid orthosis inclusive Custom-made to patient model of plastic (polypropylene variations) and carbon ber designs
Medicare Accommodative Foot Orthosis

DX: Diabetes, vascular and sensory insufciencies Multi-density semi-rigid orthosis Custom-made to patient model Medicare compliant
UCBL Foot Orthosis

DX: Hyper-prontation, posterior tibial tendon dysfunction, tibial tendonitis Semi-rigid orthosis encompassing medial and lateral borders of the calcaneous, may include navicular, fabricated from plastic (polypropylene designs) Fabricated in non or semi weight bearing positions to achieve neutral or functional alignment (subtalar neutral alignment) Custom-made to patient model
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SHOES ANd CASt bOOtS
LOWER EXTREMITY ORThOTICS
SHOES ANd CASt bOOtS
Healing Shoe
DX: Stable fractures, ulcers, post-operative management Provides immobilization of the forefoot, metatarsals, and toes Available in sizes small (size 4) thru x-large (size 14) Wedged sole with non-skid shock absorbing surface and nylon mesh upper AKA: Fracture boot, off loading or pressure relieving shoe
Answer 2 Shoes
DX: accommodative shoes for orthotic designs i.e. UCB, AFO, KAFO and custom foot orthoses Contemporary styled shoes with removable multi-layer inserts Wide, extra depth toe box for increased comfort and reduction of shear/pressure forces Available in pediatric and adult sizes
Surgical Cast Shoe/Boot

DX: Stable fracture, soft tissue injury, post operative management Provides immobilization of the forefoot, metatarsals, and toes Non-skid sole with nylon mesh upper Available in sizes x-small thru large AKA: Darco shoe
Extra Depth Shoes

DX: Diabetes, vascular and sensory insufciencies, biomechanical instabilities, also used in conjunction with accommodative/functional foot orthoses, orthotic designs i.e. UCB, AFO, KAFO. Available with lace and Velcro closures, plastizote foam lining Available in sizes 6.5 thru 16 AKA: Diabetic shoes
Pressure Relief Shoe/Boot

DX: Plantar surface ulcers, skin breakdown and/or irritation Removable shock absorbing segments, removable toe piece, soft mesh upper Velcro closure Available in sizes small (size 6) thru x-large (size 14) AKA: Puzzle shoe
Custom Shoes
DX: Acquired and congenital foot deformity, charcot, amputations Available in multiple styles, colors, lace and Velcro closures Made from semi-weight bearing cast or Insignia 3D scan of the patients feet
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ANKlE FOOt OrtHOSES (AFO)
Fracture Walking Boot

DX: Stable fracture, soft tissue injury (grade 2 or 3 sprain) post-operative management Provides ankle and foot immobilization Plastic or aluminum uprights, solid or controlled range of motion ankle joint, pneumatic or static options Available in pediatric and adult sizes small thru large AKA: Walker boot, CAM walker
Lace-Up Ankle Orthosis

DX: Medial and lateral ankle instability Bilateral semi-rigid inserts provide additional medial and lateral support. Available in womens sizes: 6 thru 12, mens: 7 thru 13 Lace up design allows for increased stability and ease of donning AKA Swede O
Mid-Calf Fracture Boot

DX: Stable fracture, soft tissue injury (grade 2 or 3 sprain) post operative management Provides ankle and foot immobilization Plastic or aluminum uprights, solid or controlled range of motion ankle joint Available in pediatric and adult sizes small thru large AKA: Short walking boot
Lace-Up Ankle Orthosis with Stays

DX: Medial and lateral ankle instability Bilateral low prole molded ankle stays combined with adjustable nylon gure 8 straps provide additional stability and support Available in womens sizes: 6 thru 12, mens: 7 thru 13 AKA: Figure 8 ankle orthosis
Pressure Relief AFO

DX: Heel ulcerations, plantar Soft sheep skin liner can be fasciitis, Achilles tendonitis laundered and replaced Provides ankle immobilization Available in sizes small and resists plantar exion thru large Large area of relief for hind AKA: PRAFO foot and calcaneous
Air Stirrup Ankle Orthosis

DX: Medial and lateral ankle instability, ankle sprains/ strains Anatomical medial and lateral pre-inated air struts provide stability and patient comfort Graduated compression available Available in pediatric and adult sizing AKA: Aircast ankle splint
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Articulated Ankle Orthosis

DX: Medial and lateral Available in x-small to ankle instability x-large sizes Articulated ankle orthosis AKA: Velocity ankle brace, with light low prole design Arch Loc, Sure Step allows for adequate range of motion and maintains medial/lateral stability Fits easily into most athletic and extra depth shoes
Off-the-shelf Posterior Leaf Spring AFO

DX: Drop foot, CVA, MS, peroneal palsy Thermoplastic custom t posterior leaf spring AFO Provides dorsi exion assist during swing phase of gait for stability and safety Available in size small thru x-large
Plantar Fasciitis Night Splint

DX: Plantar faxciitis, tight gastroc-soles complex, Achilles tendon injuries Rigid posterior frame with a soft foam lining and bilateral adjustable straps allows for variable plantar/ dorsi exion settings Available in sizes small thru large
Carbon Fiber Dynamic AFO

DX: Drop foot, CVA, CMT, Available in womens size: 5 thru 14 and mens size MS, peroneal palsy Carbon ber dynamic AFO 4 thru 14 available with medial AKA: Toe-Off, Walk-on AFO, or lateral strut provides Dynamic AFO stability and energy return for weakened or damaged muscular structures Off-the-shelf design custom t to the patient ts easily into most lace up or Velcro shoe styles
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Custom Articulated Ankle Orthosis

DX: Posterior tibial tendonitis and deformities, pes planus, hyper pronation, ankle and/or foot injuries, medial/lateral ankle instabilities Custom-made ankle orthosis with UCBL style foot bed, articulated ankle joint, with padded uprights Available with custom and custom t uprights Available with various ankle joints to include adjustable range of motion, free range of motions, dorsi/plantar exion stops and dorsi exion assist Custom-made to patient model AKA: Custom Richie brace, Custom Sure Step
Double Upright Metal AFO

DX: Foot drop, diabetes, Ankle joint variations charcot foot deformities, include: solid ankle, edema and/or volumetric, variable range of motion, anatomical changes, and dorsi and plantar exion assists and stops plantar ulcers Custom-made double metal Custom-made to uprights can be fabricated patient model from aluminum, stainless steel, or titanium Molded leather calf strap can be attached with Velcro or buckle closures
Molded Leather Ankle Gauntlet

DX: Posterior tibial tendonitis and deformities, pes planus, hyper pronation, ankle and/or foot injuries, medial/lateral ankle instabilities Custom-made molded leather ankle gauntlet with molded polypropylene inner shell Available with lace and/or Velcro closures Available with various leather colors and thickness and various style inner AFO plastic shells Custom-made to patient model AKA: Arizona style leather gauntlet
Neuropathic Walking Boot (CRO)

DX: Charcot foot, diabetes, chronic wound care and/ or ulcerations, arthritis, degenerative joint disease Total contact custom-made bivalved plastic ankle foot orthosis with rigid anterior lined panel Available with molded foam inner boot that can be modied for ongoing anatomical changes Custom-made to patient model AKA: CRO Walker
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Custom Posterior Leaf Spring AFO

DX: Drop foot, CVA, CMT, MS, peroneal palsy, spinal cord injury, lower extremity weakness and/or instability Custom-made plastic ankle foot orthosis aids in dorsi exion during the swing phase of gait for increased toe clearance and safety Custom-made to patient model
Custom Solid Ankle AFO

DX: Medial/lateral instabilities, plantar exion and dorsi exion muscular weakness and imbalance, valgus/vaurs instabilities, mild knee instability, arthritis, CVA, CMT, MS, spinal cord injury, plantar exion tightness, and hypertonicity Custom-made plastic ankle foot orthosis with trim lines anterior to the malleoli to provide maximum medial/ lateral and plantar/dorsi exion stability Available with various foot plate congurations, additional medial and lateral support anges, and with/without soft interface Custom-made to patient model
Custom Semi-Solid AFO

DX: Drop foot, CVA, CMT, Custom-made plastic ankle MS, peroneal palsy, spinal foot orthosis with trim lines cord injury, lower extremity just posterior to the medial weakness and/or instability, and lateral malleolus adds mild medial/lateral additional strength and instability, mild plantar stability for the patient exion weakness during the gait cycle Custom-made to patient model
Custom Articulated AFO

DX: Medial/lateral instabilities, plantar exion and dorsi exion muscular weakness and imbalance, valgus/vaurs instabilities, mild knee instability, arthritis, CVA, CMT, MS, spinal cord injury, plantar exion tightness, and hypertonicity Plantar exion and dorsi exion stops available Custom-made plastic ankle foot orthosis with bilateral ankle joints allowing for variable range of motion, xed range of motion, free range of motion Custom-made to patient model
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FrACturE/CONtrACturE OrtHOSES
Patellar Tendon Bearing Orthosis (PTBO)

DX: Tibia and bula fractures, non-union, malunion, chronic wound care and/or ulcers Custom-made patellar tendon bearing orthosis provides circumferential compression and aids in the reduction of axial loading Padding on posterior and anterior shells optional Available with various style ankle joints for xed, variable, and free range of motion Custom-made to patient model
Femoral Fracture Orthosis

DX: Femoral fractures Removable design allows Available with quadrilateral for inspection of the skin brims, narrow M/L brims to and/or wound care aid in weight distribution Custom-made to patient model and maintaining rotational control Available with various style knee and ankle joints for xed, variable, and free range of motion
Tibial Fracture Orthosis

DX: Tibia and bular Available with various style ankle joints for xed, fractures, non-unions, mal-unions variable, and free range Bivalved design for total of motion contact and circumferential Custom-made to compression, aids in patient model the reduction of axial loading and maintaining anatomical alignment of the injured site Padding on posterior and anterior shells optional
Ankle Foot Contracture Orthosis

DX: Joint contracture and/or Dynamic components minimize skin breakdown tightness Incorporates a custom tone and irritation secondary to reducing foot plate, static neuropathy and vascular and dynamic controls for disease conservative management AKA: Contracture AFO of spasticity Improves muscle length, exibility, balance and correction of postural deformities
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CONtrACturE OrtHOSES
KNEE OrtHOSES
Knee Ankle Foot Contracture Orthosis

DX: Joint contracture and/or Improves muscle length, tightness exibility, balance and Incorporates a custom tone correction of postural reducing foot plate, static deformities Dynamic components and dynamic controls for conservative management minimize skin breakdown of spasticity and irritation secondary to neuropathy and vascular Provides stretch and control across knee and ankle disease AKA: Contracture KAFO complex
Knee Immobilizer
DX: Knee instability Contoured posterior, medial and lateral aluminum stays Comfortable wide elastic strapping, trimmable foam Easy applications Available sizes 14, 17, 20, 24, 27
Knee Contracture Orthosis

Machine washable, DX: Joint contracture and/or breathable liners for tightness Provides low load, increased patient comfort prolonged stretch across AKA: Dynasplint, the knee Contracture KO Flexion and extension assist in one unit Rigid lightweight, aluminum frame, easy application and reapplication by the patient without change in tension setting
Post-Op Knee Orthosis

DX: Post operative knee stability Incremental range of motion control Buckles for ease and consistency of donning/ dofng Reduced foam coverage for increased comfort and cooler t AKA: ROM knee orthosis, post-op knee orthosis
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Post-Op Knee Orthosis

DX: Post-operative knee Custom t and trimmed to stability patient Telescoping medial and AKA: ROM knee orthosis, lateral bars post-op knee orthosis Variable range of motion, free motion, or locked positioning full knee extension
Neoprene Patellar Stabilizing Knee Sleeve

DX: Patello-femoral dysfunction, mild osteoarthritis Medial and lateral spiral stays Tubular buttress for additional support Proximal and distal straps for support and suspension Available in sizes small thru xx-large AKA: Neoprene knee sleeve with knee buttress
Bledsoe Post-Op Knee Orthosis

DX: Post-operative knee stability Polycentric knee with range of motion 0 120 degrees Rigid medial and lateral stays, molded posterior supports Available sizes 20, 22, 24, 26, 28, 30 AKA: ROM knee orthosis, post-op knee orthosis
Lateral J Buttress Knee Orthosis

DX: Lateral tracking patellar disorder/dislocations Medial and lateral spiral stays Tubular buttress for patellar stabilization and tracking Proximal and distal straps for support and suspension Available in sizes x-small thru xx-large
Elastic Knee Sleeve

D X: Patello-femoral dysfunction, mild osteoarthritis L ightweight knit orthosis Silicone insert optional Osteoarthritis version optional Available in sizes small thru xx-large AKA: Genutrain, Genumedi
Hinged Patellar Stabilizing Knee Orthosis

DX: Patello-femoral dysfunction, mild medial/ lateral instability Lateral buttress for patellar stabilization Medial and lateral hinges Proximal and distal straps for support and suspension Available in sizes x-small thru xx-large AKA: PTO
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Hanger Select Knee Orthosis

DX: Moderate to severe ACL, MCL, and LCL instabilities Aluminum lightweight rigid frame Polycentric hinges with contoured condyle shells Custom t Available in sizes small thru x-large
Hinged Neoprene Knee Orthosis

DX: Mild medial/lateral instability Lightweight, neoprene alternative material Wrap around styles optional Available in x-small thru xx-large
Breg X2K OTS

DX: Moderate to severe ACL, MCL, and LCL instabilities Aluminum lightweight rigid frame Polycentric hinges with contoured condyle shells Available in mens and womens sizes: small thru x-large
Townsend Premier
DX: Moderate to severe ACL, PCL, MCL, LCL, ligament instability Low prole lightweight composite frame 3 polycentric hinge style options available 4 shell length options Custom-made to patient model
Hinged Neoprene Knee Orthosis

DX: Moderate to severe ACL, MCL, and LCL instabilities Polycentric hinges with contoured condyle shells Available in sizes x-small thru xx-large
CTiInnovation Sports
DX: Moderate to severe ACL, Custom-made to PCL, MCL, LCL, ligament patient model instability Low prole lightweight composite frame Motocross, equestrian options available
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OStEOArtHrItIS (OA) KNEE OrtHOSES
Breg X2K
DX: Moderate to severe ACL, PCL, MCL, LCL, ligament instability Lightweight low prole aluminum frame design Custom t to patients leg Custom-made to patient model
Generation II
DX: Unicompartmental knee osteoarthritis Wide carbon frame for increased surface area and patient comfort Dynamic corrective strap, conforming shell material, and polycentric adjustable dynamic joint Custom-made to patient model
DonJoy Deance
DX: Moderate to severe ACL, PCL, MCL, LCL, ligament instability Lightweight carbon composite frame ACL/PCL option with 4-point dynamic strap/ leverage system Custom-made to patient model
V-Vas Anatomical Concepts

DX: Unicompartmental knee osteoarthritis Long axis, adjustable off loading double upright joint Auto-aligning, low prole, polycentric knee joint Custom-made to patient model
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DonJoy OA Everyday
DX: Unicompartmental knee Swiveling, quick release osteoarthritis buckles allow for easy 3 point loading system donning/dofng reduces degenerative knee joint compression Telescoping condyle pad allows for patient adjustments according to activity level Lightweight aluminum frame
DonJoy Deance OA
DX: Unicompartmental knee osteoarthritis Carbon ber frame with telescoping hinge Custom-made to patient model
DonJoy OAdjuster
DX: Unicompartmental knee osteoarthritis Lock and off-Load Technology reduces degenerative knee joint compression Lightweight aluminum frame OA-Key enables patient controlled load and alignment adjustment
Breg X2K Counterforce

DX: Unicompartmental knee osteoarthritis Aluminum frame with telescoping hinge Custom-made to patient model
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KNEE ANKlE FOOt OrtHOSES
Knee Ankle Foot Orthosis (KAFO)

DX: Muscular imbalance and/or weakness, knee instability, genu recurvatuum, genu valgum/ varum, polio, post-polio, spinal cord injury, MS, CVA, spina bida, cerebral palsy, Guillain Barre Syndrome, trauma, total knee replacement Provides stability and/ or assists functionality of the knee, ankle and foot complex Can be fabricated from plastic, carbon composites, hybrid variations, leather and metal Provides rigid support to the anatomical structures and reduces torsion of the orthosis and components Various style knee joints available for free, variable range of motion, or locked range of motion Various style ankle joints incorporated per patient presentation/diagnosis Knee Joint Options Free knee Drop lock Stance control Off set knee Extension assist Electronic control Variable range of motion Fixed range of motion Ankle Joint Options Solid Semi-solid Articulated Posterior leaf spring Free motion Double action Variable range of motion Plantar and dorsi exion assists and stops
Laminated Knee Ankle Foot Orthosis (KAFO)

DX: Muscular imbalance and/or weakness, knee instability, genu recurvatuum, genu valgum/ varum, polio, post-polio, spinal cord injury, MS, CVA, spina bida, cerebral palsy, Guillain Barre Syndrome, trauma, total knee replacement Provides stability and/ or assists functionality of the knee ankle and foot complex Fabricated from laminate carbon ber and berglass congurations Provides rigid support to the anatomical structures and reduces torsion of the orthosis and components Various style knee joints available for free, variable range of motion, or locked range of motion Various style ankle joints incorporated per patient presentation/diagnosis Knee Joint Options Free knee Drop lock Stance control Off set knee Extension assist Electronic control Variable range of motion Fixed range of motion Ankle Joint Options Solid Semi-solid Articulated Posterior leaf spring Free motion Double action Variable range of motion Plantar and dorsi exion assists and stops
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StANCE PHASE KNEE ANKlE FOOt OrtHOSIS (KAFO)
Stance Phase Locking (SPL) KAFOFillauer

DX: Muscular imbalance and/or weakness, knee instability, quadriceps weakness, genu recurvatuum, genu valgum/ varum, polio, post-polio, spinal cord injury, MS, CVA, spina bida, trauma, total knee replacement Provides locking knee control during stance phase of gait while allowing free knee exion during the swing phase of gait Does not require any ankle joint or foot plate activation, can be used as a knee orthosis Provides stability and/ or assists functionality of the knee ankle and foot complex Fabricated from plastic, laminate carbon ber, berglass, hybrid congurations, metal and leather Provides rigid support to the anatomical structures and reduces torsion of the orthosis and components Various style ankle joints incorporated per patient presentation Ankle Joints Solid Semi-solid Articulated Posterior leaf spring Free motion Double Action Variable Range of motion Plantar and dorsi exion assists and stops
Stance Control Knee Orthotic Joint (SCKOJ) KAFOHorton

DX: Muscular imbalance and/or weakness, knee instability, quadriceps weakness, genu recurvatuum, genu valgum/ varum, polio, post-polio, spinal cord injury, MS, CVA, spina bida, trauma, total knee replacement Provides locking knee control during stance phase of gait while allowing free knee exion during the swing phase of gait Locks in any degree of knee exion providing maximum stability from sit to stand Requires ankle joint/foot plate activation Provides stability and/ or assists functionality of the knee, ankle and foot complex Fabricated from plastic, laminate carbon ber, berglass, hybrid congurations, metal and leather Provides rigid support to the anatomical structures and reduces torsion of the orthosis and components Various style ankle joints incorporated per patient presentation Ankle Joints Solid Articulated Double Action Variable Range of motion Plantar and dorsi exion assists and stops
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E-Knee Stance Control KAFO Becker

DX: Muscular imbalance and/or weakness, knee instability, quadriceps weakness, genu recurvatuum, genu valgum/ varum, polio, post-polio, spinal cord injury, MS, CVA, spina bida, trauma, total knee replacement Provides locking knee control during stance phase of gait while allowing free knee exion during the swing phase of gait Electronic lock allows for stability in any degree of knee exion providing maximum stability from sit to stand Requires foot plate activation Provides stability and/ or assists functionality of the knee, ankle and foot complex Fabricated from plastic, laminate carbon ber, berglass, hybrid congurations, metal and leather Provides rigid support to the anatomical structures and reduces torsion of the orthosis and components Various style ankle joints incorporated per patient presentation Ankle Joints Solid Articulated Double Action Variable Range of motion Plantar and dorsi exion assists and stops
FreeWalk Stance Control KAFO OttoBock

DX: Muscular imbalance and/or weakness, knee instability, quadriceps weakness, spinal cord injury, MS, CVA, spina bida, trauma, total knee replacement Provides locking knee control during stance phase of gait while allowing free knee exion during the swing phase of gait Requires 10 degrees of passive ankle dorsi-exion to disengage knee joint lock Provides stability and/ or assists functionality of the knee ankle and foot complex Fabricated from tubular metal congurations with unique strapping design Lightweight design, straps and bands can be moved from anterior to posterior upon request
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HIp OrtHOSES
Hip Abduction Orthosis

DX: Hip dislocations, subluxations, postoperative management, surgical revisions Rigid pelvic section, adjustable for various hip and waist development measurements Available in low prole or high prole pelvic designs per patient presentation/ diagnosis Easy Velcro/snap closures for ease of donning/dofng Hip joint options include variable, static, and free range of motion for abduction, adductions, exion, and extension. AKA: Newport Hip Orthosis
UTX Stance Control KAFOBecker

DX: Muscular imbalance and/or weakness, knee instability, quadriceps weakness, spinal cord injury, MS, CVA, spina bida, trauma, total knee replacement Provides locking knee control during stance phase of gait while allowing free knee exion during the swing phase of gait Requires 5 degrees of passive ankle dorsi-exion to disengage knee joint lock Provides stability and/ or assists functionality of the knee, ankle and foot complex Fabricated from tubular metal congurations with unique strapping design Lightweight design, straps and bands can be moved from anterior to posterior upon request
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HIp KNEE ANKlE FOOt OrtHOSES
rECIprOCAtINg gAIt OrtHOSES
Hip Knee Ankle Foot Orthosis (HKAFO)

DX: Muscular imbalance and/or weakness, paralysis (spinal cord injury, spina bida, myelomeningocele), cerebral palsy, muscular dystrophy, MS Provides maximum stability at the hip, knee, foot and ankle complex Can be fabricated from plastic, carbon composites, hybrid variations, leather and metal Various styles of hip, knee, and ankle joints per patient presentation and diagnosis Hip Joint Options Free Variable range of motion Flexion Extension Abduction Adduction Fixed/locked Off-set Knee Joint Options Free Knee Drop lock Stance control Off-set knee Extension assist Electronic control Variable range of motion Fixed range of motion Ankle Joint Options Solid Semi-solid Articulated Double action Variable range of motion P lantar and dorsi exion assists and stops
Reciprocal Gait Orthosis (RGO)

DX: Muscular imbalance and/or weakness, paralysis (spinal cord injury, spina bida, myelomeningocele) Allows for reciprocal ambulation, hands free standing balance and support, and dynamic hip stretching Pelvic components include: isocentric (rocker bar design), cable driven designs, plastic and/ or metal Pelvic section can be fabricated from various colors, body jacket style available Internal or external AFO designs Various styles of hip, knee, and ankle joints per patient presentation Growth extensions available for pediatric patients Hip joint options include: locked, pre-selected, abduction hinge, and quick disconnect
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PEDIATRIC ORTHOSES
60 Dennis Brown Bar/Straight Last 60 Foot Orthoses 61 UCBL 61 Answer 2 Shoes 62 Fracture Walking Boot 62 Supramalleolar Orthosis (SMO) custom-made 63 Dynamic Ankle Foot Orthosis custom-made 63 Semi-Solid Ankle Foot Orthosis (AFO) custom-made 64 Solid Ankle AFO custom-made 64 Articulated AFO custom-made 65 2 Stage AFO custom-made 65 Pavlik Harness 66 Tubingen Hip Abduction Orthosis 66 Hip Abduction Orthosis 67 Hip Abduction Orthosis 67 SWASH 68 Knee Ankle Foot Orthosis (KAFO) custom-made 69 Hip Knee Ankle Orthosis (HKAFO) custom-made 70 Reciprocal Gait Orthosis (RGO) 70 Boston Style Scoliosis Orthosis 71 Nocturnal Scoliosis TLSO 71 Milwaukee CTLSO Scoliosis Orthosis 72 Soft Scoliosis Orthosis 72 Hanger Cranial Orthosis
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ORThOTICS
pEdIAtrIC OrtHOSES
Dennis Brown Bar/Straight Last

DX: Club foot/feet, tibial torsion and congenital deformity Provides correction for rotational, torsional, and angular deformities of the lower extremity Available in various width bars and shoes sizes
UCBL
DX: Hyperpronation, posterior tibial tendon dysfunction, calcaneal inversion/eversion, accessory navicular and collapse of mid tarsal joint Semi-rigid orthosis encompassing the medial and lateral borders of the calcaneous, may include navicular, fabricated from plastic (polypropylene designs) Fabricated in non or semi-weight bearing positions to achieve neutral or functional alignment (subtalar neutral alignment) Custom-made to patient model
Foot Orthoses
DX: Biomechanical insufciencies, hyperpronation/supination, calcaneal inversion/ eversion Multi-density semi-rigid orthosis, rigid orthosis inclusive of plastic (polypropylene variations) and carbon ber composite materials Fabricated in non, semi and full weight bearing positions to achieve neutral or functional alignment (subtalar neutral) Custom-made to patient model
Answer 2 Shoes
DX: Accommodative shoes for orthotic designs i.e. UCBL, AFO, KAFO and custom foot orthoses Wide low Blucher opening allows for ease of donning/dofng, accommodates orthotic designs without excessive shoe modications Triple layer removable inserts provide ease of tting and accommodations for orthotic applications Wide, extra depth toe box allows for increased comfort and reduction of shear/pressure forces
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ORThOTICS
pEdIAtrIC OrtHOSES
Fracture Walking Boot

DX: Stable fracture, soft tissue injury (grade 2 or 3 sprain) post-operative management Provides ankle and foot immobilization Plastic or aluminum uprights, solid or controlled range of motion ankle joint Pediatric sizes available AKA: Walker boot, CAM walker
Dynamic Ankle Foot Orthosis custom-made

DX: Neurological or neuromuscular imbalance, cerebral palsy, spina bida, ligament laxity, calcaneal inversion/eversion, severe pes planus or hyper pronation/supination Assists in controlling medial and lateral ankle instability, mild control of knee instability Tone reducing foot plate options available Provides rear and fore foot control for optimal positioning during gait cycle Aids in controlling hyper pronation/supination of the foot ankle complex Custom-made to patient model AKA: Scoot3, DAFO
Supramalleolar Orthosis (SMO) custom-made

DX: Neurological or neuromuscular imbalance, cerebral palsy, spina bida, muscular dystrophy, ligament laxity, calcaneal inversion/eversion, severe pes planus or hyper pronation/supination Assists in controlling medial and lateral ankle instability Provides rear and fore foot control for optimal positioning during the gait cycle Aids in controlling hyper pronation/supination of the foot ankle complex Custom-made to patient model
Semi-Solid Ankle Foot Orthosis (AFO) custom-made

DX: Drop foot, neurological or neuromuscular imbalance, cerebral palsy, spina bida, muscular dystrophy, ligament laxity, mild medial lateral instability, mild plantar exion weakness Custom-made to patient model Custom-made plastic ankle foot orthosis with trim lines just posterior to the medial and lateral malleolus adds additional strength and stability for the patient during the gait cycle
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ORThOTICS
pEdIAtrIC OrtHOSES
Solid Ankle AFO custom-made

Medial/lateral instabilities, Custom-made plastic ankle neurological or foot orthosis with trim lines anterior to the malleoli neuromuscular imbalance, cerebral palsy, spina provide maximum medial/ lateral and plantar/dorsi bida, muscular dystrophy, exion stability ligament laxity, medial lateral instability, dorsi and Custom-made to patient model plantar exion weakness Available with various foot plate conguration, additional medial and lateral support anges, and with/without soft interface
2 Stage AFO custom-made

Medial/lateral instabilities, neurological or neuromuscular imbalance, cerebral palsy, spina bida, muscular dystrophy, ligament laxity, medial lateral instability, dorsi and plantar exion weakness Custom-made plastic ankle foot orthosis with trim lines anterior to the malleoli provide maximum medial/lateral and plantar/dorsi exion stability Available with various foot plate congurations, additional medial and lateral support anges, and with/ without soft interface Removable exible inner boot with rigid outer shell Ideal for patients with plantar exion contractures and hypertonicity Custom-made to patient model AKA: Scoot3, DAFO
Articulated AFO custom-made

DX: Medial/lateral Custom-made plastic ankle foot orthosis with bilateral instabilities, neurological or neuromuscular imbalance, ankle joints allowing for cerebral palsy, spina variable range of motion, bida, muscular dystrophy, xed range of motion, free ligament laxity, medial range of motion lateral instability, dorsi and Custom-made to plantar exion weakness patient model Plantar exion and dorsi exion stops available
Pavlik Harness
DX: Congenital hip dysplasia, developmental hip dysplasia Strapping design allows for variable hip exion and abduction position Soft interface to avoid skin breakdown or abrasions Can be laundered Available in sizes 09 months of age
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ORThOTICS
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Tubingen Hip Abduction Orthosis

DX: Congenital hip dysplasia, developmental hip dysplasia Soft interface to avoid skin breakdown or abrasions Moderate abduction with hip exion greater than 90 degrees Spreader bar adjustable to achieve desired abduction position Available in size 1 12 months of age AKA: Otto Bock hip abduction orthosis

DX: Post-operative stabilization of the hip secondary to soft tissue release and osteotomies, hip subluxation and dislocation Rigid pelvic section, adjustable for various hip and waist development measurements Available in low-prole or high-prole designs Easy Velcro/snap closure for ease of donning/dofng Hip joint options include variable, static, and free range of motion for abduction, adduction, exion, and extension Available in sizes x-small thru x-large

DX: Congenital hip dysplasia, developmental hip dysplasia Polypropylene or polyethylene shell with aliplast soft foam lining 90 degree hip exion and approximately 160 degree abduction (can be altered according to patient presentation and prescription request) Closed cell foam allow for ease of cleaning and does not absorb uids Available in sizes 0 18 months or 8lbs 30lbs
SWASH
DX: Pre/post-operative management of the pediatric hip, cerebral palsy, spinal cord injury, hypertonicity, traumatic brain injury, CVA Bilateral thigh cuffs and pelvic band aid in proper positioning of the hip, reducing subluxation and/ or dislocation Aids in sitting balance, hands-free activities of daily living (ADLs), and in the prevention of scissoring gait patterns
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ORThOTICS
ORThOTICS
pEdIAtrIC OrtHOSES
Knee Ankle Foot Orthosis (KAFO) custom-made

DX: Muscular imbalance and/or weakness, knee instability, genu recurvatuum, genu valgum/ varum, spinal cord injury, MS, CVA, spina bida, cerebral palsy, Guillain Bane Syndrome, trauma, total knee replacement Provides stability and/ or assists functionality of the knee ankle and foot complex Can be fabricated from plastic, carbon composites, hybrid variations, leather and metal Provides rigid support to the anatomical structures and reduces torsion of the orthosis and components Various style knee joints available for free, variable range of motion, or locked range of motion Various style ankle joints incorporated per patient presentation Knee Joint Options Free knee Drop lock Stance control Off-set knee Extension assist Electronic control Variable range of motion Fixed range of motion Ankle Joint Options Solid Semi-solid Articulated Posterior leaf spring Free motion Double action Variable range of motion Plantar and dorsi exion assists and stops
Hip Knee Ankle Orthosis (HKAFO) custom-made

DX: Muscular imbalance and/or weakness, paralysis (spinal cord injury, spina bida, myelomeningocele), cerebral palsy, muscular dystrophy, MS Provides maximum stability at the hip, knee, foot and ankle complex Can be fabricated from plastic, carbon composites, hybrid variations, leather and metal Various style hip, knee, and ankle joints per patient presentation Hip Joint Options Free Variable range of motion Flexion Extension Abduction Adduction Fixed/locked Off-set Knee Joint Options Free Knee Drop lock Stance control Off-set knee Extension assist Electronic control Variable range of motion Fixed range of motion Ankle Joint Options Solid Semi-solid Articulated Double action Variable range of motion Plantar and dorsi exion assists and stops
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ORThOTICS
ORThOTICS
pEdIAtrIC OrtHOSES
Reciprocal Gait Orthosis (RGO)

Muscular imbalance and/or weakness, paralysis (spinal cord injury, spina bida, myelomeningocele) Allows for reciprocal ambulation, hands-free standing balance and support, and dynamic hip stretching Pelvic components include: isocentric (rocker bar design), cable driven designs, plastic and/or metal Pelvic section can be fabricated from various colors, body jacket style available Internal or external AFO designs Various style hip, knee, and ankle joints per patient presentation Growth extensions available for pediatric patients Hip joint options include: locked, pre-selected, abduction hinge, and quick disconnect
Nocturnal Scoliosis TLSO (Thoraco-Lumbo-Sacral Orthosis)

DX: Idiopathic scoliosis, kyphosis Rigid plastic shell with soft aliplast lining, counter force re-directional pads, posterior Velcro closures for maximum abdominal compression and biomechanical control Nighttime/nocturnal overcorrection orthosis Custom-made to patient model AKA: CBB (Charleston Bending Brace), Providence Brace
Boston Style Scoliosis Orthosis

DX: Idiopathic scoliosis, kyphosis Rigid plastic shell with soft aliplast lining, counter force re-directional pads, posterior Velcro closures for maximum abdominal compression and biomechanical control Available in stock sizes or custom-made to patient model AKA: Boston Brace, low prole scoliosis brace
Milwaukee CTLSO (Cervico-Thoraco-Lumbo-Sacral Orthosis) Scoliosis Orthosis

DX: Idiopathic scoliosis, cervical and high thoracic involvement, kyphosis management Rigid plastic shell with soft aliplast lining, counter force re-directional pads, posterior Velcro closures for maximum abdominal compression and biomechanical control Metal super structure with neck ring Custom-made to patient model
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ORThOTICS
UppER EXTREMITY ORTHOSES

74 Cock-Up Wrist Splint
Soft Scoliosis Orthosis

Neuropathic scoliosis, lordosis, or kyphosis, neurological disorders with poor trunk stability, postoperative stabilization Semi-rigid foam exterior with soft aliplast lining, and rigid internal or external frame, closed cell foam does not absorb moisture, water resistant Custom-made to patient model AKA: Soft Boston Brace
74 Wrist Hand Orthosis (WHO) 74 Thumb Spica Splint 75 Resting Wrist Hand Splint 75 Tennis Elbow Strap 75 Heelbo Elbow Pad 76 Genumedi Elbow Sleeve 76 Elbow ROM (Range of Motion) Orthosis 77 Clavicle Strap 77 Arm Sling 78 Elastic Shoulder Immobilizer 78 Abduction Sling 79 Gunslinger Orthosis 79 Wrist Hand Fracture Orthosis
Hanger Cranial Orthosis

DX: Deformational Cranial remolding is not achieved by placing severe plagiocephaly, brachycephaly, scaphocephaly, post-operative pressures on the skull. The orthotic management cranial band applies a Follow up care to ensure constant, static pressure over appropriate modications are the areas of the skull that are most prominent. Opposite of made as baby develops Custom-made to this, the band has open areas patient model where the attened section of Cranial orthoses are worn the skull can grow for 23 hours a day for approximately 3-6 months
80 Ulnar/Radial Fracture Orthosis 80 Elbow Wrist Hand Fracture Orthosis 81 Humeral Fracture Orthosis 81 Wrist Hand Contracture Orthosis 82 Elbow Contracture Orthosis
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uppEr ExtrEmItY OrtHOSES
ORThOTICS
ORThOTICS
Cock-Up Wrist Splint

DX: Carpal tunnel syndrome, Available in variable lengths, tendonitis, wrist sprain/strain sizes x-small thru x-large One piece design with anterior Velcro closures Rigid moldable stay to reduce unwanted wrist exion and extension
Resting Wrist Hand Splint

DX: Paralysis, contracture management, spasticity, post-operative management Maintains wrist, hand and ngers in functional position Moldable plastic shell, soft interface available Available in off-the-shelf or custom-made to patient model
Wrist Hand Orthosis (WHO)

Carpal tunnel syndrome, One piece design with anterior tendonitis, wrist sprain/strain, Velcro closures post-fracture management Material options include Rigid moldable dorsal canvas, neoprene, and plastic and volar stays to prevent congurations unwanted wrist exion and Available in variable lengths, extension sizes x-small thru x-large
Tennis Elbow Strap

DX: Medial or lateral epicondlyitis Wrap around splint with Velcro closure and directional padding Universal sizing
Thumb Spica Splint

One piece design with Velcro DX: Carpal tunnel syndrome, tendonitis, wrist sprain/strain, closures, moldable stays post-fracture management Material options include Once piece semi-rigid design canvas, neoprene, and plastic congurations incorporates the thumb Available in variable lengths, for increased stability and sizes x-small thru x-large reduced range of motion
Heelbo Elbow Pad

DX: Ulnar neuropathy Elastic elbow sleeve with foam padding to prevent excessive pressure over bony prominences Available in sizes x-small thru x-large
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ORThOTICS
ORThOTICS
Genumedi Elbow Sleeve

DX: Medial or lateral epicondylitis, tendonitis, ulnar neuropathy Elastic elbow sleeve with contoured silicone inserts Provides compression and edema control Available in sizes x-small thru x-large
Clavicle Strap
DX: Clavicle fracture Foam padded shoulder straps provide increased shoulder retraction and appropriate positioning 3 way buckle or Velcro closure AKA: Figure 8 strap
Elbow ROM (Range of Motion) Orthosis

DX: Elbow dislocations, post-operative management, contracture management, fracture management Variable range of motion elbow joint for controlled elbow exion and extension, with optional wrist hand extension if immobilization is necessary Rigid exterior shell with soft washable removable inner lining Shoulder harness with adjustable straps for increased comfort and suspension Integrated straps for additional circumferential compression Available in sizes x-small thru x-large
Arm Sling
DX: Immobilization for mild sprains/strains, fracture management, shoulder injuries, post-operative management Durable canvas material with adjustable Velcro straps Available in sizes small thru x-large
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ORThOTICS
ORThOTICS
Elastic Shoulder Immobilizer

DX: Rotator cuff repairs, shoulder capsule injury, glenohumeral dislocation and/or subluxation, soft tissue injury and/or repair Elastic and neoprene waist band options with Velcro closures for ease of donning/dofng Available in female and male sizing
Gunslinger Orthosis
DX: Rotator cuff repairs, shoulder reconstruction, gelonhumeral dislocation and/or soft tissue injury or repair Upper extremity frame design with adjustable shoulder abduction, internal/external rotation, and wrist and hand extension Removable inner lining can be replaced or laundered
Abduction Sling
DX: Rotator cuff repairs, Abduction pad can be shoulder capsule injury, moved to accommodate glenohumeral dislocation anatomical needs and/or subluxation, soft and biomechanical tissue injury and/or repair requirements Maintains the upper extremity in neutral position to aid in healing soft tissue injuries and/or repairs
Wrist Hand Fracture Orthosis

DX: Wrist and hand fractures, post-operative or post-cast stabilization Plastic one piece design with Velcro closures Provides immobilization of the wrist and hand Soft interface and fracture socks optional Available in off-the-shelf, custom-made to patient model
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ORThOTICS
ORThOTICS
Ulnar/Radial Fracture Orthosis

DX: Mid ulnar or radial fractures, post-operative or post-cast stabilization Plastic semi-rigid design with Velcro closures Allows total contact with circumferential compression for increased stability and control of ulnar/radial segments Soft interface and fracture socks optional Available in off-the-shelf sizes or custom-made to patient model AKA: Sarmiento fracture brace
Humeral Fracture Orthosis

DX: Mid humeral fractures, post-operative or post-cast stabilization Plastic semi-rigid design with Velcro closures Allows total contact with circumferential compression for increased stability and control of humeral fractures or injuries Shoulder cap, soft interface, and fracture socks optional Available in off-the-shelf sizes or custom-made to patient model AKA: Sarmiento fracture orthosis
Elbow Wrist Hand Fracture Orthosis

DX: Distal humeral fractures, proximal radial and/or ulnar fractures, post-operative or post-cast stabilization Plastic semi-rigid design with unilateral or bilateral elbow joints with locked, free or variable range of motion options Shoulder cap, soft interface, fracture socks, and ventilation optional Available in off-the-shelf sizes or custom-made to patient model
Wrist Hand Contracture Orthosis

DX: Wrist and hand contracture management Positional orthosis with dynamic wrist joint to aid in contracture and spasticity management, soft tissue release Can be used during rest and activities of daily living AKA: Dynasplint, Ultraex, Dynamic exion/extension
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ORThOTICS
MASTECTOMY
84 Mastectomy Forms 84 Custom Mastectomy Prosthesis 85 Mastectomy Bras/Undergarments
Elbow Contracture Orthosis

DX: Elbow Contracture Available in off-the-shelf management sizes or custom-made to Positional orthosis with patient model dynamic elbow joint to aid AKA: Dynasplint, Ultraex, Dynamic exion/extension contracture and spasticity management, soft tissue release Variable range of motion elbow joints can be unilateral or bilateral Can be used during rest and activities of daily living
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MAStECtOmY
ORThOTICS
ORThOTICS
MAStECtOmY
Mastectomy Forms
DX: Mastectomy procedures Mastectomy forms are available in different weights, sizes, shapes, and styles according to patient model and preference Breast forms can also be matched to patients bra or specialized undergarments can be ordered Hanger Prosthetics and orthotics carries all of the top mastectomy product lines
Mastectomy Bras/Undergarments
Hanger Prosthetics and orthotics carries all of the top mastectomy product lines Inclusive of the latest styles, colors, camisoles, immediate post-operative garments, leisure bras, and regular support bras Bras available for each stage of the recovery process
Custom Mastectomy Prosthesis

DX: Mastectomy procedures Custom breast prosthesis fabricated by duplicating chest wall and utilizing patients anatomy to select size, shape, color, weight according to patient model and preference Custom-made to patient model
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PROSTHETICS
89 INTRODUCTION TO PROSTHETICS LOWER EXTREMITY PROSTHETICS 93 Hanger Lower Extremity Prosthetics Program 94 Lower Extremity Functional Classications 96 Hanger ComfortFlex Socket System 96 Types of Prosthetic Feet 97 Types of Prosthetic Knees 97 Immediate Post-Operative Care (IPOCare) Amputation Levels 98 Partial Foot 99 Symes 100 Transtibial or Below Knee (BK) 101 Transfemoral of Above Knee (AK) 102 Hip Disarticulation/Hemipelvectomy 103 Lower Extremity Prosthetics Prescriptions UPPER EXTREMITY PROSTHETICS 105 Hanger Upper Extremity Prosthetics Program Upper Extremity Prosthetic Options 106 Oppositional (Passive) 106 Cable Operated (Body-Powered) 107 External Powered 107 Hybrid System 108 Activity Specic continued
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PROSThETICS
PROSTHETICS
UPPER EXTREMITY PROSTHETICS CONT. Terminal Devices 108 Passive Hand 109 Mechanical Hand 109 Mechanical Hook 110 Electric Hand 110 Electric Hook Amputation Levels 111 Partial Hand 111 Wrist Disarticulation (WD) 112 Transradial (BE) 112 Elbow Disarticulation (ED) 113 Transhumeral (AE) 113 Shoulder Disarticulation (SD)
PrOStHEtICS INtrOduCtION
Introduction to Prosthetics
A Certied Prosthetist (CP) or Certied Prosthetist/Orthotist (CPO) provides clinical care to patients with amputated or congenitally absent limbs. They design, fabricate and t prosthetic devices (articial limbs). These devices replicate the function and appearance of a limb so that patients can resume activities of daily living and work. Signicant developments in the last twenty years have dramatically advanced the eld of prosthetics. Improvements in material science have provided stronger and more durable lightweight materials (titanium, composites) that enable users to function and ambulate with greater ease and less stress. Soft materials that absorb axial loading and shear forces are commonly used to enhance the t and feel of the prosthesis. New designs in feet, knees, hands, arms, sockets and interface liners have brought us closer to the goal of completely restoring lost function and appearance. The future of prosthetics lies in microprocessors integrated into prostheses to assist with specic functions and computers to improve diagnosis and design. The prosthetics profession is moving toward evidence-based practice with clinical protocols based on scientic research. Advanced technology does not guarantee optimal rehabilitation outcomes. The prosthetists role is to provide each patient with an appropriate prosthesis and to deliver ongoing care to insure optimal t and function. Every patient has different functional and lifestyle requirements that must be met for that person to regain functional independence. The prosthetist incorporates expertise in anatomy, socket design, materials, components, gait analysis, and biomechanics in their evaluation of the
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PROSThETICS
PROSThETICS
patient to design the most appropriate prosthestic system for each patient. Patients have the best chance for a successful rehabilitation when prosthetists work closely with doctors, therapists, social workers, and other professionals, as well as the patients family and insurance company. Post-operative Protocols: The physician will generally determine which prosthetic treatment protocol is utilized following surgery. These commonly include: 1. Rigid Dressing (RD): used to prevent knee exion contracture, manage edema and protect the surgical site. A second RD is usually applied 7-10 days following surgery as part of this protocol. 2. Removable Rigid Dressing (RRD): used for the same purpose as the RD, with the added benet of being able to remove the dressing and monitor the surgical site as needed. Prosthetic socks of increasing thickness are used to ensure continued t as the edema in the residual limb decreases. The Kiwi, a Hanger innovation for lower extremity amputations, provides all of the advantages of a traditional RRD with additional benets provided by its unique design that includes a transparent silicone liner covered by an adjustable and removable rigid cast. The removable custom outer shell allows visual inspection of the residual limb through the transparent liner while providing continuous support and compression to the limb.
3. Immediate Post-Op Prosthesis (IPOP): a combination of an RRD with the addition of a pylon and foot or hand system. The IPOP allows the patient to ambulate with controlled partial weight-bearing shortly after surgery. Applied early and correctly, an IPOP provides protection, volume management and early function, while preparing the residual limb for prosthetic wear and/or ambulation. This protocol is more common in a hospital or rehab facility because it requires that the patient be closely monitored by a physical therapist and rehab nurse. 4. Compression Therapy: is the use of a compressive wrap or sock shrinker to control edema when none of the previous treatment protocols are appropriate. Compression therapy is often utilized as part of the previous treatment protocols. Preparatory Prosthesis: Following the successful use of any of the above listed postoperative processes, the physician will order the tting of a preparatory prosthesis. The preparatory prosthesis is designed to allow the patient to begin rehabilitation before the residual limb has completely stabilized in size. Its design allows the prosthetist to continuously adjust the prosthesis to mirror the progress achieved by the amputee as the patient regains strength and condence. A preparatory prosthesis can be used as soon as six weeks post-surgically and throughout rehabilitation until the residual limb edema has stabilized. Should large reduction in limb volume occur, the modular design allows the socket segment to be replaced and ret to ensure optimal t of the prosthesis.
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PROSThETICS
LOwEr ExtrEmItY PrOStHEtICS
PROSThETICS
Hanger Lower Extremity Prosthetics Program

Denitive Prosthesis: The design and tting of this prosthesis is a reection of all the rehabilitation processes that have previously occurred. The prosthetist considers the strength, motivation, functional requirements, and daily needs of the user when recommending the design, components and materials utilized for each prosthesis. The goal of the denitive prosthesis is to allow the patient to fulll the requirements and functions unique to his or her daily activities. All denitive prostheses are custom-made utilizing a mold of the remaining residual limb. The mold may be generated either from a plaster cast impression or through the use of Insignia, Hangers computer imaging system. After the mold is created, a series of diagnostic test sockets are t to ensure optimum comfort and function. Test sockets are often set up for trial as part of the dynamic alignment process. Once the alignment and proper t of the prosthesis are determined, the denitive prosthesis is fabricated and delivered to the patient for use. Cosmetic enhancements (shaped foam covers and latex skins) are usually delayed until all follow up adjustments have been made. Regular long-term follow up is essential to ensure optimal prosthetic rehabilitation for the patient. The Hanger Lower Extremity Program is comprised of practitioners certied and specically trained in all aspects of lower extremity prosthetics. Because of Hangers network of internationallyrenowned specialists, a team of experts is readily available to work on particularly complex cases, such as hip-disarticulation and hemi-pelvectomy amputations, bi-lateral amputees, and those who face unique challenges with their residual limb. Hangers lower extremity specialists utilize a full spectrum of state-of-the-art prosthetic components such as microprocessor knees and feet. Hangers ComfortFlex Socket System provides a socket design that gives more exibility to the patient and promotes a healthier residual limb. To assure that each patient receives the most appropriate prosthetic system, Hanger has developed a unique Patient Assessment Validation Test (PAVET). This analysis evaluates a patients particular circumstances in terms of lifestyle, health, capabilities and goals and assists clinicians in delivering the best care to every patient.
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PROSThETICS
PROSThETICS
Lower Extremity Functional Classications

Prosthetic components and design elements are selected based on the patients functional level (or K Levels 0 to 4). Functional level is determined by the reasonable expectations of the prosthetist and the ordering physician. Considering factors include, but are not limited to: The patients past history (including prior prosthetic use, if applicable) The patients current and potential abilities and condition including the status of the residual limb and the nature of other medical problems The patients desire to ambulate Clinical assessments of a patients functional level should be based on these classication levels: Level 0: Does not have the ability or potential to ambulate or transfer safely without assistance and a prosthesis does not enhance quality of life or mobility Level 1: Has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at xed cadence. Typical of the limited and unlimited household ambulatory Level 2: Has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. Typical of the limited community ambulatory Level 3: Has the ability or potential for ambulation with variable cadence. Typical of the community ambulatory who has the ability to traverse most environmental barriers and may have vocational, therapeutic or exercise activity that demands prosthetic utilization beyond simple locomotion Level 4: Has the ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high impact, stress or energy levels. Typical of the prosthetic demands of the child, active adult or athlete Note: Bilateral amputees often cannot be strictly bound by functional level classications.
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PROSThETICS
PROSThETICS
PrOprIEtArY TECHNOlOgY
Hanger ComfortFlex Socket System

Built-in relief for concentrated pressure points Totally exible brim and back An aggressive, more intimate t of the pelvic bone Improved side-to-side control Increased front-to-back stability Reduced socket rotation on the residual limb Command and alignment of the thigh bone Anatomically correct channels & grooves Ability to increase muscle tone in residual limb This type of prosthesis can be cosmetically nished with a natural or custom appearance
Types of Prosthetic Knees

Manual locking Stance/weight activated locking Polycentric Pneumatic Hydraulic Combination of the above Microprocessor
Types of Prosthetic Feet

Solid Ankle Cushion Heel (SACH) Flexible keel Single axis Multi axial Dynamic response Energy storing Combination of above
Immediate Post-Operative Care (IPOCare)

An important part of IPOCare is the removable rigid protective device. Applied just after the patient has undergone amputation, it provides protection to the healing residual limb by reducing the risk of post-surgical infection or edema. It also plays an important role in protecting the residual limb from accidental trauma and aids in the prevention of knee exion contractures. All are critical factors in facilitating prosthetic rehabilitation.
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AMPUTATION LEVELS
AmputAtION LEvElS AmputAtION LEvElS
PROSThETICS
PROSThETICS
Partial Foot
This type of amputation can have a dramatic effect on gait due to the loss of lever arm (toes and metatarsals) Depending on the length of the remaining foot, a variety of prosthetics may be used from a toe ller to a tibial height prosthesis May require the addition of a carbon or steel plate to the plantar surface of the orthotic to stiffen the shoe
Symes
This amputation level, which is an ankle disarticulation, requires a prosthetics socket which usually extends to the knee due to increased forces on the residual limb Utilizes an expandable wall or removable window to allow entry and suspension of the bulbous distal end A low prole foot is used to match the height of the opposite side
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PROSThETICS
PROSThETICS
AmputAtION LEvElS
AmputAtION LEvElS
Transtibial or Below Knee (BK)

Foot componentry ranges The below knee unit uses from stable, for the less several different style active patient to dynamic socket congurations with for active and athletic the attachment of a foot individuals. Single axis, and/or ankle component solid ankle cushion heel Options are numerous and (SACH), exible keel, must be determined by a multiaxial, energy-storing complete evaluation and vertical shock feet Considerations on selection are just some of the many include diagnosis and past options medical history, the shape and length of the residual limb, activity level, surgical issues, and goals of the patient Socket and suspension options are numerous and include, sleeve, suction with expulsion valve, suction with pin and locking mechanism or Vacuum Assisted Suction Suspension (VASS) or supracondylar for short limbs
Transfemoral of Above Knee (AK)

The above knee prosthetic Feet options are numerous system consists of a socket, as in transtibial (BK) and knee joint and foot/ankle include energy storing, complex multiaxial, exible heel, Options are numerous for solid ankle cushion heel componentry and must be (SACH) and single axis feet determined by a complete evaluation Considerations for componentry selection relies on past medical history, length of residual limb, activity level, surgical issues and goals of the patient Socket congurations range from the innovative Hanger ComfortFlex Socket System to ischial containment and quadrilateral shaped designs Knee options range from microprocessor-controlled such as the C-Leg to hydraulic swing and stance phase control, to safety knees with extension assist and manual locking for stability control
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PROSThETICS
PROSThETICS
AmputAtION LEvElS
Hip Disarticulation/Hemipelvectomy
Socket is designed around a total contact shell that uses the opposite side for suspension and stabilization The hip joint provides the connection between the proximal assembly and the knee joint Knee joint options are limited to stabilityenhanced designs This type of prosthesis can be cosmetically nished with a natural or custom appearance Choices in feet are similar to the more distal levels
Lower Extremity Prosthetics Prescriptions

The prescription and design of a prosthesis is based on the patients level of amputation, functional level (K0 to K4) classication, and stage of healing (preparatory or denitive). Multiple descriptors are used to specify all the required elements of an appropriate prosthesis specic to each amputee. The most important part of any prosthesis is a comfortable socket. Usually Associated Prescription Terms Test Socket(s)Used to diagnosis socket t before nal fabrication Total ContactTechnique for preparing the socket to prevent skin problems Alignable SystemAllows for alignment adjustments and the interchange of comments Ultra-Light MaterialIncreases material strength without adding weight Acrylic SocketAllows socket to be adjusted after tting Flexible Inner Socket, External FramePermits muscle movement and fenestration Suction SocketProvides enhanced suspension Gel Socket Inserts (locking or non-locking)Provides comfort, skin protection, suspension Locking Mechanism or Suspension SleeveProvides suspension continued
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PROSThETICS
PROSThETICS
UppEr ExtrEmItY PrOStHEtICS
Hanger Upper Extremity Prosthetics Program

FootBased on patients potential functional level and expected activities KneeBased on patients potential functional level and expected activities Custom Shaped CoverCosmesis and protection of internal components Flexible Outer Surface Cover (skin)Provides moisture protection ShealthsUsed by patient to make ne adjustments to socket t SocksUsed by patient to make adjustment to socket t ShrinkersEdema control and limb shaping Specialty Prescription Terms Microprocessor controlImproves stability and function Replacement SocketRequired for changes in the size or shape of residual limb. Elevated Vacuum SystemOptimal suspension socket t and reduced perspiration Axial Rotation UnitAllows lower limb to rotate at the knee for sitting and dressing RepairsRegular follow-up necessary to ensure optimal function The Hanger Upper Extremity Program is a unique program that utilizes the knowledge of internationally-respected experts who specialize in upper extremity prosthetics, especially hard-to-t patients. These experts incorporate cutting-edge technology, including myoelectric components, to best address the functional requirements of each Upper Extremity patient. Hangers highly-skilled practitioners assist clinicians in designing and implementing individualized and unique prosthetic care programs for every patient.
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uppEr ExtrEmItY PrOStHEtICS

UPPER EXTREMITY PROSTHETIC OPTIONS
UppEr ExtrEmItY PrOStHEtIC OptIONS
PROSThETICS
PROSThETICS
Oppositional (Passive)
Devices meant to oppose the sound hand/or remaining digits of a partial hand Made for specic tasks or for high denition cosmetics Does not provide active prehension
External-Powered
Uses a battery to operate a terminal device Most often controlled by EMG signals in residual limb & electrodes to control the device (Myoelectric) If a minimum amount of EMG can not be achieved, sophisticated switches are used in place of the electrodes Not recommended around certain environments or for rough activities May require more maintenance than other systems depending on use A moderate amount of occupational therapy is required Increased grip forces compared to other types of devices
Cable Operated (Body-Powered)

Uses a cable and harness for control of a terminal device and suspension of the prosthesis Can be made very heavy duty for rough environments A minimum amount of range of motion and strength are required for use Easily maintained A minimum amount of occupational therapy is required
Hybrid System
Used in higher levels of deciency or amputation, it combines the technology of the above systems. Most often seen is the cable operated elbow and the external powered terminal device Heavier duty & lighter weight than a pure electric system Requires harness & cable to operate body-powered components May require harness for suspension Often times easier to operate the external powered versus the cable operated components because lower amounts of body motion and energy are required
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PROSThETICS
PROSThETICS
TErmINAl DEvICES
Activity Specic
A specialty terminal device or a device designed for a specic activity which can attach to an existing device Wide variety of tools and adaptations available depending on vocational and avocational needs
Mechanical Hand
Used on cable operated devices Available as Voluntary Opening (VO) or Voluntary Closing (VC) Moderate durability Meant to provide the appearance of a hand for cable operated devices Moderate function allows the interchanging with other types of terminal devices for improved function and durability Provides better cosmetics than other types of cable operated terminal devices
TERMINAL DEVICES
TErmINAl DEvICES TErmINAl DEvICES
Passive Hand
Meant to provide the appearance of a sound hand Does not provide prehension, but can provide opposition against the sound side or the body Can be covered with a high denition glove for maximum cosmetics
Mechanical Hook
Used on cable operated devices Available as Voluntary Opening (VO) or Voluntary Closing (VC) Highest durability of prosthetic terminal devices Many different shapes and sizes are available to assist with different types of vocational and avocational needs Poor cosmetics can limit acceptance
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PROSThETICS
PROSThETICS
AMPUTATION LEVELS
TErmINAl DEvICES AmputAtION LEvElS
Electric Hand
Used on external powered devices Although heavier than mechanical hands, provides grip forces of over 20 lbs with minimal effort Provides user with a very natural appearance and the operation of a natural hand Easily interchanged with the electric hook for heavier duty tasks
Partial Hand
Cosmetic restorations are very life like and well accepted Wide variety of oppositional devices for bimanual activities Advancements with body-powered and external-powered devices provide enhanced grasping patterns
TErmINAl DEvICES
AmputAtION LEvElS
Electric Hook
Used on external powered devices Provides very high grip force, some hooks have over 40 lbs of force with minimal effort Moderate durability Some specic electric hooks are environmentally resistant around water and dirt Provides the user with a comfort that a grasped object will not be dropped
Wrist Disarticulation (WD)

Various types of socket designs are used including a window or expandable interface Length of limb dictates types of components used to prevent limb length discrepancy Body-powered, external powered (including myoelectric), oppositional and activity specic devices all are very functional for this level
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PROSThETICS
PROSThETICS
AmputAtION LEvElS
AmputAtION LEvElS
Transradial (BE)
Various socket designs used based on length of residual limb and control system Suspension mechanism includes self suspending sockets, suction sockets or the use of a harness. Body-powered, external powered (including myoelectric), oppositional and activity specic devices all are very functional for this level
Transhumeral (AE)
Incorporates either a passive, cable operated, or external powered elbow to assist with positioning of the terminal device Requires more body motion for control of cable operated devices than the transradial level, therefore some patients may require an external powered terminal device for optimum function. A Hybrid device, a passive or cable operated elbow combined with an external powered terminal device, provides a lightweight device with high function. Most often suspension is achieved by the use of a harness system, although suction and gel liners can be used as an auxiliary suspension.
AmputAtION LEvElS
AmputAtION LEvElS
Elbow Disarticulation (ED)

Through the elbow amputation provides a longer lever arm for axial loading and control of the prosthesis Length of limb can limit use of certain components and create a limb length discrepancy with non-affected side and hinder cosmetic restoration. Outside hinges are typically used that often increase the width and overall circumference at the elbow Components reduce cosmetic restoration and limits wearing certain types of clothing Suspension may be obtained by self suspending socket, allowing high level of range of motion and control of the prosthesis
Shoulder Disarticulation (SD)

With the addition of a shoulder joint, this level incorporates all the components of a transhumeral level. Body-powered, external powered (including myoelectric), oppositional and activity specic devices can be t under certain patient characteristics External powered controls or a hybrid of controls often provide better functional results at these high amputation levels Experience and expertise in tting and attaining appropriate function are key elements for positive results Suspension is achieved by a harness system
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INDICATION CROSS REFERENCE

116 Ankle 116 Arm 116 Elbow 117 Foot 117 Hand 117 Hip 118 Knee 118 Leg 119 Neck 119 Shoulder 119 Spine/Back 120 Wrist
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INdICAtION CrOSS rEFErENCE
Ankle
Contracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28, 36, 62 Instability. . . . . . . . . . . . . . . . . . . . . . . . . 25, 2935, 6065 Sprain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2830, 62 Symmes Amputation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Tendonitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2830, 62 Weakness. . . . . . . . . . . . . . . . . . . . . . . . . 25, 2935, 6065
Foot
AmputationPartial Foot . . . . . . . . . . . . . . . . . . . . . . . . 98 Bunion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2526 Cellulitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2427, 33 Charcot. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 27, 33 Foot Drop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31, 33, 35 Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28, 36 Heel Spur. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Pes Cavus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25, 27 Pes Planus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25, 27 Plantar Fasciitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Arm
Amputation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Elbow
Amputation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Contracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6162 Dislocation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76, 80 Epicondylitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7576 Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76, 7981 Neuropathy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7476 Tightness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80, 82 Strain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7576 Tendonitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7576 Ulnar neuropathy. . . . . . . . . . . . . . . . . . . . . . . . . . . . 7576 Hyperextension. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76, 80
Hand
Amputation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Osteoarthrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7475 Sprain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Hip
AmputationHip Disarticulation. . . . . . . . . . . . . . . . . . 102 Contracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56, 69 Degenerative Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Dislocation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Dysplasia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55, 6567 Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5556 Post-Op . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
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Knee
AmputationBelow Knee . . . . . . . . . . . . . . . . . . . . . . . 100 Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . 4041, 43, 4547 Chondromalacia. . . . . . . . . . . . . . . . . . . . . . . . . . 4041, 43 Contracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Dislocation. . . . . . . . . . . . . . . . . . . . . . . . . . . 3940, 4849 Instability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3944 Ligament Tear/Strain. . . . . . . . . . . . . . . . . . . . . . . . . 3944 Osgood Schlatters. . . . . . . . . . . . . . . . . . . . . . . . 4041, 43 Osteoarthritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4547 Patellofemoral . . . . . . . . . . . . . . . . . . . . . . . . . . . 4041, 43 Post-Op . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3940 Hyperextension. . . . . . . . . . . . . . . . . . . . . . . . 4244, 4852 Tendonitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4041, 43
Neck
Pain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1011 Strain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1011 Torticollis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1112
Shoulder
Acromio Sprain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Amputation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Clavicular Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Disolcation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . pg 7879 Rotator Cuff Strain. . . . . . . . . . . . . . . . . . . . . . . . . . . 7879 Tendonitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7879
Leg
AmputationAbove Knee . . . . . . . . . . . . . . . . . . . . . . . 101 Femur Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Fibular Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3637 Tibial Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3637 Paralysis. . . . . . . . . . . . . . . . . . . . . . . . . . 31, 33, 35, 4854 Paraplegia. . . . . . . . . . . . . . . . . . . . . . . . 31, 33, 35, 4854 Ulcers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 2627, 33 Neuropathy. . . . . . . . . . . . . . . . . . . . . . . . 31, 33, 35, 4854
Spine/Back
Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . 1012, 14, 1819 Burst Fracture . . . . . . . . . . . . . . . . . . . . . . . . 11, 13, 1617 Cervical Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1013 Compression Fracture. . . . . . . . . . . . . . . . . . . 1012, 1516 Degenerative Disc Disease. . . . . . . . . . . . 1012, 14, 1819 Herniated Disc. . . . . . . . . . . . . . . . . . . . . . . . 1012, 1516 Kyphosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1117, 7071 Laminectomy . . . . . . . . . . . . . . . . . . . . . . . . . 1012, 1516 Lumbar Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1519 Osteoporosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1415
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Spine/Back continued
Pain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1820 Sciatica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Scoliosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7074 SI Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Spondylolisthesis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Spondylosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Sprain/Strain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1819 Stenosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1419 Thoracic Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1217 Spina Bida. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Wrist
Amputation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Carpal tunnel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 De Quervains. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Radial fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74, 79 Sprain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Tendonitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
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PROSTHETICS & ORTHOTICS

PHYSICIANS DESK REFErENCE

HANGER PROSThETICS & ORThOTICS

The Hanger Difference

HANGER PROSThETICS & ORThOTICS

HANGER PROSThETICS & ORThOTICS

The Hanger Difference

Hometown Care. Nationwide Resources.

HANGER PROSThETICS & ORThOTICS

HANGER PROSThETICS & ORThOTICS

Soft Cervical Collar

Rigid Two Piece/Bivalve Cervical Collar

Philadelphia Cervical Collar

Miami JTO Cervical Orthosis

Minerva Cervical Orthosis

SOMI (Sub-Occipital Mandibular Immobilization) Cervical Thoracic Orthosis

CASH (Cruciform Anterior Spinal Hyper-Extension) Orthosis

Wrap AroundBoston Style TLSO (Thoraco-Lumbo-Sacral Orthosis)

Custom Soft TLSO (Thoraco-Lumbo-Sacral Orthosis) Body Jacket

Custom TLSO (Thoraco-Lumbo-Sacral Orthosis) Body Jacket

Custom LSO (Lumbo-Sacral Orthosis) Body Jacket

LSO (Lumbo-Sacral Orthosis) Pull Cord Design

Elastic Lumbosacral Binder

LOWER EXTREMITY ORTHOSES

LOWER EXTREMITY ORTHOSES

LOWER EXTREMITY ORTHOSES

LOWER EXTREMITY ORThOSES

LOWER EXTREMITY ORThOSES

Accommodative Foot Orthosis

Functional Foot Orthosis

Medicare Accommodative Foot Orthosis

UCBL Foot Orthosis

SHOES ANd CASt bOOtS

LOWER EXTREMITY ORThOTICS

LOWER EXTREMITY ORThOSES

SHOES ANd CASt bOOtS

Surgical Cast Shoe/Boot

Extra Depth Shoes

Pressure Relief Shoe/Boot

ANKlE FOOt OrtHOSES (AFO)

LOWER EXTREMITY ORThOSES

LOWER EXTREMITY ORThOSES

ANKlE FOOt OrtHOSES (AFO)

Fracture Walking Boot

Lace-Up Ankle Orthosis

Mid-Calf Fracture Boot

Lace-Up Ankle Orthosis with Stays

Pressure Relief AFO

Air Stirrup Ankle Orthosis

ANKlE FOOt OrtHOSES (AFO)

LOWER EXTREMITY ORThOSES

LOWER EXTREMITY ORThOSES

ANKlE FOOt OrtHOSES (AFO)

Articulated Ankle Orthosis

Off-the-shelf Posterior Leaf Spring AFO

Plantar Fasciitis Night Splint

Carbon Fiber Dynamic AFO

ANKlE FOOt OrtHOSES (AFO)

LOWER EXTREMITY ORThOSES