Lesson Objectives

To understand the UCBL principle

To describe common conditions that can addressed with
a UCBL
To understand the casting technique of UCBL
To understand the fabrication process of UBCL
 University C alifornia
Biomechanics Laboratory
 U CBL
UCBL was designed in attempting to solve a wide range of
malalignment and pressure distribution problems of the
foot, especially those of children with hyper-mobile flat
feet.(Henderson at al 1967)
To stabilize hind foot in a neutral position for flexible foot deformity
Provide correction during weight bearing
Heel cup
Function of UCBL
Design to maintain the rearfoot in neutral position
Provide supports during weight bearing
Apply corrective forces to all three sections of the foot
Design Principles
 Total contact
 To have a medial contour of the orthoses
 To support the medial longitudinal arch
 To control the attitude of the calcaneus in the frontal plane
 Design Principles

O rthosis should
be stable in frontal
plane
 Design Principles

O rthosis should also be

stable in sagittal plane
Design Principles
Appropriate cast rectification to be able to facilitate
adequate gripping of the calcaneous
A good control of adduction or abduction of the fore
foot
Indication and contraindication

Indications Contraindication
Flexible pathology of the Fix deformities
foot Loss of protective
Pes-Plaus sensation
Metatarsus Adduction
Osteoarthrirtis of the
Subtalar and midtarsal
joints
Planterfasciitis
Metatarsalgia
 Common Pathologies
Adult Podiatric
Posterior tibialis Flexible pes planus
dysfunction (stage 1-2) Metatarsal adductus
Healing calcaneal Hypotonia
fracture
Advantages
Corrections of the foot flexible deformity
Shoe changeable
Direct force applied to the foot
C asting technique
Partial weight bearing
Non-weight bearing

Corrective casting position for flexible flat feet

Subtalar neutral
Dorsiflexion the ankle
Adduct forefoot
C asting position
Material and tools
Landmarks

 The medial and lateral malleoli

 The navicular head (tuberosity)
 The base of the 5th metatarsal if is prominent
 1st and 5th metatarsal heads
 Sustentaculum tali groove
C asting
Prepare 2 set of plaster slaps (4 layers of plaster bandage)
From distal to 1st MTH  distal to 5th MTH
Middle of heel  Distal to MTHs
C asting
C asting
Modification
Remarks
Establish trim lines on cast
Anterior trim line
Proximal to metatarsal heads (approximately 5mm)
Medial trim line
Proximal to the navicular and distal to malleolus
Lateral trim line
Distal to malleolus
Posterior trim line
High enough to control the calcaneus
Modification technique using
article written by Marty Carlson.
“An effect Orthotic Design for
Controlling the Unstable Subtalar
Joint”. Orthotics & Prosthetics,
Vol.33 No1. PP 29-49, March
1979.

Modifications to cast are call

intrinsic modification
 Modification
Smooth cast within trim lines
Modify metatarsal pad. Remove up to 8 mm depth
Modification
Modify medial aspect of the midfoot to create support for
the sustentaculumtali maximum depth 8 mm to form a
smooth blend between the S.T. and the calcaneal
tuberosity.
 Modification

Modify the peroneal notch 4-6mm

 Modification

Modify plantar medial surface

of the calcaneus. Remove
up to 6mm medially tapering
to 0mm at the bisection of
the calcaneus
Modification
Slight remove plaster along the 1st
and 5th MTHs to obtain the
correct width

Remove material from the lateral

tissue at the base of the heel about
3mm under measurement to grip
the calcaneus closely
Modification
Add plaster build up to bony prominences, navicular, base
of 5th MT

Smooth the cast and re-draw trim lines

 Fabrication
Prepare cast to vacuum form
Prepare plastic sheet (HPE 4-5mm, PP 3-4mm)
Cut extrinsic post which is the same size as the intrinsic
modification plus extra material to come medial proximal
of the calcaneus
Fabrication
Vacuum form plastic to cast, extrinsic post goes on last.
Use plastic to maintain HF/FF position
W hile plastic is still moldable, create medial flare.
Allow plastic to cool and cut off to the outside of your
trim lines