Written by: Larry Huppin, DPM
3/17/2011 2:10 PM

 Proper casting position is critical when you are prescribing a gauntlet AFO. Today we want to focus on the error we see most often – that is excessive plantarflexion at the ankle in the negative cast. It’s absolutely critical that the cast be taken with the foot at 90 degrees to the leg. In fact, if the foot is plantarflexed to the leg in the cast, then the cast in unusable.

Having the ankle plantarflexed excessively is the casting error we see most often because it is so easy for it to happen. When taking a cast for a gauntlet AFO your patient will be in a sitting position with the thigh parallel to the floor, the leg at 90 degrees to the thigh and the foot at 90 degrees to the leg. If the foot simply slides forward a few millimeters during casting, then the resultant cast will have the foot plantarflexed to the leg. If we receive this cast at the lab we have no choice but to throw it away and ask you to start over. This is inconvenient and costly for your patient, you and us.

To avoid this scenario, follow these instructions:

• Watch this video on proper casting for gauntlet AFOs at the bottom of this page
• During casting, ensure that the foot stays at 90 degrees to the leg
• Critically and carefully evaluate the cast before your patient leaves the office.
• If you are not sure, take a picture of the cast and send it to us. Our medical consultants will evaluate the cast before it leaves your office.

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