Solid (rigid) ankle foot orthoses (AFO) are the most prescribed plastic AFO design. They are indicated when motion needs to be limited or controlled and may be used in the treatment of conditions such as Posterior Tibial Tendon Dysfunction (PTTD), arthritis, Achilles tendonitis, fractures, severe plantar fasciitis etc. They are also indicated where a contracture already exists and the patient does not have any ankle movement present.
They are made with a solid ankle complex which holds the foot and ankle at 90° (neutral plantargrade position). This prevents plantarflexion, toe walking gait as well as ankle valgus and varus movements. They are popular with both physicians and patients alike because they are easy to don.
The goal of the hinged (articulated) AFO is to allow desired motion while preventing any unwanted motion. This is a very popular design for the pediatric population. The brace may allow for full range of plantarflexion/dorsiflexion or may limit plantar flexion at almost any degree with the use of a plantarflexion stop. This dynamic design offers added stability, limits valgus and varus motion and can be modified to correct adduction/abduction issues of the forefoot.
Hinged AFOs are prescribed depending on the patient’s capabilities, disabilities, deficits, daily activities and prognosis. This brace is worn inside of a shoe, which may require a larger size or extra depth shoe. Hinged AFOs provide a more natural gait, allowing the foot and ankle to dorsiflex during daily activities such as standing from sitting, sitting from standing and climbing or descending stairs etc. However, a major disadvantage with hinged AFOs is that they are wider at the ankles and this can be challenging fitting them into regular footwear.
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