FabricationRequirements

Thepartialfootprostheticfabricatorwillneedtoknowthatyouwillbemounting thesocketonaBlueRocker.Inaddition,youwillneedtoprovidethefollowing:

1. Arecordofthepatientshistoryincluding: a. Weight:_______andHeight:_______ b. Approximatedateofamputation:___________________________ c. Diagnosis:______________________________________________ d. SizeandTypeofToeOffbeingused:_________________________ 2. Acastoftheresidualfoot.(Crushboxeswillnotshowthecontoursofthedorsal aspectoftheresiduumsoarenotappropriate).Ifpossibleplacethefootand lowerleginthe90/90position,andkeeptherearfoot/STJinneutral. Somepatientsmaynotbeabletoattaintheneutralposition:castthem semiweightbearingandrecordthefixedanglesofheelvarus/valgusand plantarflexion/dorsiflexion.Also,markanyareasofconcernwhereyou wouldlikeextrarelieforprotectionsuchas:boneyprominences,pre ulcerativecallusesorunevenskinfolds. 3. Useangleblockstodeterminetheamountofdorsiflexionavailable.Place successivewedgesunderthefootandmeasuretheheightofdorsiflexion uptothepointthattheheelpadstartsrisingofftheground.Record:

MaxDorsiflexion=______ininches 4. Takeacastofthecontralateralfoot,alsoin90/90,sothefabricatorcan matchlength,widthandsagittalplaneprofileofthatfoot. 5. IndicatesizeoftheBlueRocker(orprovidetheactualproduct)sothe plantarsurfaceoftheprosthesismatchestherockeraspectoftheAFO. 6. Sendtheactualshoe(preferred),oratracingoftheinsoleoftheshoe inwhichthecustomdevicewillbeused.