Chairside Orthoses Manchester Branch SCP

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Chairside OrthosesManchester Branch SCP

• Gareth Hicks
• Bailey Instruments Limited

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Who am I ?

• Managing Director , Bailey Instruments Ltd
• Podiatrist , qualified 1988
• NHS specialist nail surgery , biomechanics,
  paediatrics
• Private practice specialty in biomechanics
• Podiatrist in multi-disciplinary sports injury
  clinic
• Team podiatrist , Gloucester Rugby Football Club
• Team podiatrist, Gloucester City Football Club
• European Youth Olympics 2004, team podiatrist
• 202 Triathlon magazine events podiatrist 2002

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Why fit an Orthotic ?

• Control of excessive movement
• Slow down , where movement is too rapid
• Cushion excessive impact forces
• Increase any lack of movement
• Re-align structures
• Redistribute pressures

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What type of orthotic ?

• Contact foam construction
• Span plastic/polypropylene

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Why chairside ?

• Chairside quicker prescription
• material science improvements
• life of device is comparable
• Casted is it accurate ?
• Time consuming
• Any better results ?

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Why Chairside ?

• 1. Control - its your prescription
• 2. Speed -making the device should not be
  your prime concern
• 3. Effectiveness
• 4. Value for you and your patient

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Modifications

• Sizing fit the foot not the shoe
• Posting extrinsic .intrinsic, Hemi posts.
• Cut outs 1st met , 1st ray , 5th ray
• Pitching

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Measuring orthotic effect

• Have you controlled excessive movement?
• Forefoot Abduction
• Navicular drop
• Hubscher test , use the Prior scoring system

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Reasons for failure

• If all youve got is a hammer , then the whole
  world is a nail
• Daryl Phillips , Biomechanics Summer School 1996

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Footwear

• Fit of shoe
• Fit with orthotic
• Type of shoe
• Heel height
• Fastening

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Reasons for failure

• Patient choice are they compliant ?
• Calf Stretches good compliance test
• Footwear out with the old.
• Misdiagnosis / misprescription

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Chairside devices ( The unashamed sales pitch)

• Vectorthotic polypropylene shell with posts.
  Minutes to fit. Longevity 2-3 years
• X-line first line device.
• Pedipod paediatric device
• 9 5 for heeled shoes
• Orthotic shells the DIY option

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Conclusion

• Decide your objectives
• Check calf stretch
• Keep patient informed
• Be ready to adjust device
• Review regularly
• Hammer nail

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Thank you for listening..and no hard questions
please!

• Gareth Hicks
• Managing Director
• Bailey Instruments Limited

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Bailey Instruments Limited

• Day and half-day courses
• Practical , hands on elements
• Basic biomechanics Orthotic fitting
• The Diabetic Foot
• Vascular Assessment
• Neurological Assessment
• Instruments decontamination / care