RRS Modifications for Blounts Orthosis

THE ROTATION REALIGNMENT SYSTEM CASTING TECHNIQUE SUGGESTED MODIFICATIONS THAT MAY BE USED TO DESIGN A KAFO FOR BLOUNTS PATIENTS

*My course is primarily designed for adult patients with lateral thrust gait. It is also an innovative method, with the following modifications of the design, that should provide the steps to successfully create a KAFO for patients with Blount’s disease.

For best results, follow the negative casting and modifying techniques found in my course, as well as incorporating the following steps below, which will assist you to fabricate an orthosis for a Blounts patient.

If you refer to the drawing, you will notice there are different colored lines which identify different components of the brace.

The thin black lines show the outline of the initial ossification of the bones.

The heavy black lines outline

the patient’s leg
the Velcro straps consisting of the proximal thigh cuff strap
the calf strap which joins the floating calf cuff with the second pull of plastic
the dorsum strap
the drop lock knee joint and uprights
the double adjustable ankle joints

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The red lines outline the first pull of plastic, which is 1/16 polyethylene. The lateral cuff is a floating calf cuff with a Velcro strap.

The blue lines outline the second pull of plastic, which is 3/16 polypropylene, is riveted to the uprights, as opposed to the first pull (in red) that is a floating calf cuff.

*The following information refers to cast modifications and fabrication techniques that are specific the Blounts KAFO:

The thigh cuff should be modified having a medial proximal flare as well as snug pressure on the lateral distal thigh, which should extend down near the knee joint.

The calf cuff should be designed having both the first pull of plastic and the second pull of plastic with an easy on/off modification.

The medial calf cuff should be built up on the positive cast ¾ inch to accommodate the patient’s re-formed bones of the varus deformed leg.

The footplate should be designed with a full foot modification and medial and lateral forefoot extensions.

*As mentioned in the course, the recommended degree of external rotation in the adult foot was six degrees. However, in the pediatric foot with initial ossification of the bones, a lesser amount of rotation is suggested, based upon the practitioner’s judgment and knowledge of the patient’s condition.