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Lateral Frame Reinforcement

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Lateral Frame Reinforcement

Download as PDF >

< BACK

Lateral Frame Reinforcement

Download as PDF >

Function:

  • Lateral stability
  • Everts frame at midfoot

Clinical Indication:

  • Ankle instability
  • Peroneal tendon dysfunctions
  • Rigid forefoot valgus
  • Lateral pathologies

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About:
The valgus frame reinforcement (lateral frame reinforcement) is semi-rigid to very rigid (45-65 Shore A) EVA material added to the inferior lateral side of an orthotic frame. It begins at the distal rearfoot, extends distally through the midfoot and tapers to the distal edge of the frame, proximal to the lateral metatarsal heads.

Orthotic Lab Codes:
VGFF: VG Lateral Frame Filler

*CLINICAL PEARL
Extrinsic rearfoot posts matching in angulation are recommended, but not required (e.g., for clinically controlling an everted subtalar joint and inverted midfoot, a varus rearfoot post with a valgus frame filler is acceptable. These modifications will create a “twist” or alternating pressures along the foot’s sagittal plane when the orthotic reaction forces interacts with the foot).

Function:

  • Lateral stability
  • Everts frame at midfoot

Clinical Indication:

  • Ankle instability
  • Peroneal tendon dysfunctions
  • Rigid forefoot valgus
  • Lateral pathologies

Hide/show illustrations

About:
The valgus frame reinforcement (lateral frame reinforcement) is semi-rigid to very rigid (45-65 Shore A) EVA material added to the inferior lateral side of an orthotic frame. It begins at the distal rearfoot, extends distally through the midfoot and tapers to the distal edge of the frame, proximal to the lateral metatarsal heads.

*CLINICAL PEARL
Extrinsic rearfoot posts matching in angulation are recommended, but not required (e.g., for clinically controlling an everted subtalar joint and inverted midfoot, a varus rearfoot post with a valgus frame filler is acceptable. These modifications will create a “twist” or alternating pressures along the foot’s sagittal plane when the orthotic reaction forces interacts with the foot).

Orthotic Lab Codes:
VGFF: VG Lateral Frame Filler

Function:

  • Lateral stability
  • Everts frame at midfoot

Clinical Indication:

  • Ankle instability
  • Peroneal tendon dysfunctions
  • Rigid forefoot valgus
  • Lateral pathologies

Hide/show illustrations

About:
The valgus framereinforcement (lateral frame reinforcement) is semi-rigid to very rigid (45-65 Shore A) EVA material added to the inferior lateral side of an orthotic frame. It begins at the distal rearfoot, extends distally through the midfoot and tapers to the distal edge of the frame, proximal to the lateral metatarsal heads.

Orthotic Lab Codes:
VGFF: VG Lateral Frame Filler

*CLINICAL PEARL
Extrinsic rearfoot posts matching in angulation are recommended, but not required (e.g., for clinically controlling an everted subtalar joint and inverted midfoot, a varus rearfoot post with a valgus frame filler is acceptable. These modifications will create a “twist” or alternating pressures along the foot’s sagittal plane when the orthotic reaction forces interacts with the foot).

Denton Modification  (Lateral Frame Reinforcement)

Designed originally by Dr Jane Denton, it provides incredible support to the lateral column.

The Denton Modification is a simple, yet powerful, lateral arch fill. It goes from the extrinsic rearfoot post distally to the end of the plastic under the 4th and 5th metatarsals. It is utilized with any orthotic devices prescribed with varus tilts of some sort, and of course for any patient with any supination tendencies. It is called termed "Lateral Frame Filler". This is a phrase that laboratories may understand better.


 

Back in the day, perhaps 25 years ago, when I was testing the limits of inversion with the Inverted Orthotic Technique, I was always going too far. I was making pronators (with all their problems) into supinators (with a whole new set of problems). Of course, this was not good, so I struggled daily in my office adjusting out this over correction of pronation. Since the varus was intrinsic to the plastic, I had to use other methods like narrowing of the medial width, inskiving the medial heel post, lowering the medial heel cup, or adding temporary padding along the lateral heel cup (a temporary lateral Kirby skive of sorts). Dr. Denton, my partner of 37 years, introduced me to this lateral arch fill, and my problem was largely solved. Today, the Denton Modification can be prescribed for all supinators, or the myriad of patients I call my medial/lateral instability patients. These are patients that technically pronate too much, but have some lateral column instability issues produced (for example) by lateral ankle ligament injuries, weak peroneals, activities requiring them to be excessively on the lateral side of their feet, high degrees of tibial varum or genu varum or subtalar varus. The Denton Modification fills in the space under the lateral column, but does not act as a valgus wedge to pronate. It blocks supination tendencies but does not pronate the subtalar joint.