Written by: Larry Huppin, DPM
3/25/2010 1:19 PM

Over the past several weeks we have discussed five critical rules for casting for functional orthoses.  Following these rules will assist you in providing optimum clinical outcomes to your patients.

All five rules are listed below with links to the blog entries that discuss each rule in detail

• Casting Rule #1: Non-weightbearing casting is the best method to ensure that the first ray will be plantarflexed.
  
  
• Casting Rule #2: Orthoses made from casts with a dorsiflexed first ray are more likely to lead to jamming of the first MPJ. Those made with a plantarflexed first ray enhance first MPJ dorsiflexion
  
  
• Casting Rule #3: To produce an orthosis that decreases strain on the plantar fascia, cast out any soft tissue varus to enhance forefoot valgus in the negative cast.
  
  
• Casting Rule #4: To allow frontal plane correction of the orthosis (balancing the forefoot-to-rearfoot) the posterior heel must be captured in the negative cast.
  
  
• Casting Rule #5: The negative cast must capture a perfect representation of the plantar aspect of the foot while the foot is held non-weightbearing in subtalar neutral position
  

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