MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES
SCHOOL OF ORTHOPAEDIC TECHNOLOGY
CLASS: 2nd YEAR
TASK:
THERMOPLASTIC KAFO
DATE:
10/03/ 2021
REGISTRATION NUMBER:
SUBJECTIVE ASSESMEMNTS…………………………………………….1
PERSONAL INFORMATIONS ………………………………………1
DIAGNOSIS…………………………………………………………2
CASE HISTORY………………………………………………………3
PAST MEDICAL HISTORY………………………………………………..4
SOCIAL AND FAMILY HISTORY………………………………………5
CHIEF COMPLAIN……………………………………………………..6
HOBBIES…………………………………………………………………….7
SUBJECTIVE
ASSESMENTS……………………………………………………..2
CLINICAL EXAMINATION …………………………………………………8
VISUAL EXAMINATION……………………………………………………..9
PHYSICAL EXAMINATION………………………………………………….10
PALPATION………………………………………………………..10.1
MEASUREMENTS……………………………………………………10,2
RANGE OF MOTION………………………………………………..10.3
MUSCLE SRENGTH………………………………………………..10.4
CLINICAL TESTS ……………………………………………………….10.5
GAIT DEVIATIONS WOTH OUT ORTHOSIS……………………………10.6
GAIT DEVIATION WITH OLD ORTHOSIS…………………………………..10.7
PROBLEMS OF THE OLD ORTHOSIS…………………………………………10.8
PRESCRIPTION ………………………………………………………………10.9
MATERIALS TO BE USED……………………………………………………..10.10
TOOLS TO BE USED………………………………………………………10.11
FABRICATION PLANS………………………………………………………….10.12
ACHIEVEMENTS……………………………………………………………10..13
CHALLENGES/LIMITATIONS ……………………………………10.13
RECOMMENDATION…………………………………………………10.14
1. PERSONAL INFORMATION
Hospital Registration Number:
Names:
Severa Hand Njao
Date of Birth:
09/12/1965
Age:
54
Sex:
Female
Nationality:
Tanzanian
Tribe:
Chaga
Religion:
Christian
Marital Status:
Single
Occupation:
peasant
Residential Address:
KDC Moshi
Contact Cell Number:
0759896367
2. DIAGNOSIS
Post Polio lower limb paralysis of the left side .
3. CASE HISTORY
Severa, when she was three years old, she fall down where she took at maweze distric
hospital in Moshi for further treatnment where she was injected,due injection cause the
injury to the sciatic nerves that cause poliomylitis.due to the case she was reffered at
Kilimanjaro Christian Medical Centre (KCMC) and the doctor realized that she need an orthosis
and the Orthopaedic department of KCMC Hospital provided her first KAFO in 1986 when she
was in S.T.D 4, untill now she has used more than 10 KAFO.
4. PAST MEDICAL/SURGICAL HISTORY
Has no medical complications relevant to her condition.
5. SOCIAL AND FAMILY HISTORY.
She is not married but she is a mother of 3 children’s. 2 of them are married women and
other a son of 11 years old. She is able cookes,washes clothes and farming
6. HOBBIES.
She likes watching TV and reading bible.
7. CLINICAL EXAMINATION
7.1. VISUAL EXAMINATION.
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Head and neck looks normal.
Upper limb are looks normal.
Muscle atrophy at the left foot
Scar at the skin due to old orthosis
External rotation of the left fore foot
Genu varum of the left side.
7.2. PHYSICAL EXAMINATION
(I) PALPATION
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Skin temperature at the left side is cold compering to the right side
Sensation and proprioception are normal.
No edema.
Conformed blood circulation is not normal
(II) MEASUREMENTS.
Measurements taken from the ASIS to the medial malleoli indicates a marked leg length
discrepancy of the right lower limb of 6 cm longer as compared to the left side of the
lower limb.
Left limb =86cm
Right limb =92cm
THIGH
Left side on the thigh 30cm below the greater trochanter = 36cm.
Right side 30cm below the greater trochanter = 44 cm.
Therefore there is marked atrophy of 8 cm.
CALF MUSCLE
Left side =19
Right side=25.
Therefore there is marked atrophy of 6cm
the left foot is short than right foot
(II) RANGES OF MOTION
JOINT
HIP JOINT
KNEE JOINT
ANKLE
MOVEMENT
RIGHT (Degrees)
LEFT (Degrees)
PASSIVE/
ACTIVE
PASSIVE /ACTIVE
FLEXION
0-105 / 0- 40
0-110 \ 0- 15
EXTENSION
0-10 / 0-1
0- 15 / 0-1
ABDUCTION
0-10 / 0- 1
0-28 / 0- 1
ADDUCTION
0-10 / 0- 1
0-15 / 0-1
FLEXION
125/110
12/0
EXTENSION
0
0
DORSIFLEXION
3/0
-25/0
JOINT
muscles power
PLANTALFLEXION 38/30
0/0
INVERSION
30/15
10/0
EVERSION
20/10
10/0
(III)CLINICAL TESTS
TESTS
ON THE RIGHT
ON THE LEFT
THOMAS TEST
Negative
Negative
VALGUS STRESS TEST
Negative
Negative
VARUS STRESS TEST
Negative
Positive
ANTERIOR DRAWERS’ TEST
Negative
Negative
POSTERIOR DRAWERS’ TEST
Negative
Negative
GALLEAZI TEST
GAIT DEVIATIONS WITHOUT AN ORTHOSIS
She walks with hip hiking due to the shortening of the left side hence she use hand to
stabilize the knee during walking due to knee flection contracture.
GAIT DEVIATIONS WITH THE OLD ORTHOSIS
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Lateral trunk bending towards the affected side.
Insufficient time spent from heel strike to foot flat
PROBLEMS WITH THE OLD ORTHOSIS
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No the external rotation stop at the foot.
Not very stable.
Swiss lock inching.
also orthosis is short
ORTHOTIC MANAGEMENT POSSIBILITIES
PRESCRIPTION
Left Knee Ankle Foot Orthosis (KAFO) with mechanical Knee joint and mechanical
ankle joint
Design.
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mechanical drop lock knee joint and mechanical Hansen ankle joint
Side bars
Mild steel upright bars 20mm
Compensation
Vertical compensation 5cm
Posterior thigh shell Molded
Posterior calf shell
opening to allow the room of the correction knee flexion
contracture.
Anterior shell for correction force
Components
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Swiss lock
Hansen joint
Drop lock
Hansen joint
Vertical compensation
side bars
speed riveting
CLIENTS EXPECTATION
Well fitting, light weight Orthosis that will be durable and easy to unlock
MATERIALS USED
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Plaster of Paris (P.O.P.) Bandages
P.O.P. powder
Ladies leggings stockings
Cotton stockinet
Screws and nuts 4mm
Copper rivets 4mm
Leather and Eva foam
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PP plastics
Glue
TOOLS USED
Surform blades (half round, flat and round)
Knife
Tailors’ tape
Folding ruler
Compensation block
Wire mesh
Alignment jig
Tailors’ scissor
P.O.P. Scissor
Indelible pencil
Vanier caliper (big)
cutting niper
14.FABRICATION PLAN
Assessment and Measurements taking
21st January 2021
Client presentation
21st January 2021
Cast taking
21st January 2021
Modification and molding
27th January 2021
Bending of side bars
9th February 2021
First fitting
23th February 2021
Final Finishing
9th march 2021
Gait training/analysis
Delivery
16. ACHIEVEMENTS
patient able to walk with arthosis
well fitting orthosis
propossed desgn is archieved
17.CHALLENGES/LIMITATIONS
challenge in bending iron hence need more practise
spent much time to make an orthosis
18. RECCOMENDATIONS
proper managenment of orthosis
patient should vist our prosthesis and orthosis center for services every 6 months
Signature………m.m.s…………………………………..
Date…………………