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Varus Extrinsic Bar

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< BACK

Varus Extrinsic Bar

Download as PDF >

< BACK

Varus Extrinsic Bar

Download as PDF >

Function:

  • Inverts the forefoot Twists frame into varus

Clinical Indication:

  • Anti-Pronation Reaction & Posts
  • Hyper-mobile 1st ray
  • Overpronation

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About:
A varus extrinsic (bar) post is semi-rigid to very rigid (45-75 Shore A) EVA material added to the inferior distal frame. It begins approximately 2cm proximal to the distal edge on the medial side and terminates at the distal frame. The extrinsic bar also decreases in height as it extends beneath the device to the lateral side of the orthosis. The exact height and amount
of material added is dependent on the desired angulation. A forefoot extrinsic bar post becomes a ‘tip’ post when it has an angulation between 0°-2° because the minimal amount of material used. A tip post doesn’t extend to the lateral side.

Because 2°-6° posts raise the distal medial frame, a “drop off” will be created. If higher varus correction is desired, this modification can be paired with intrinsic forefoot posting.

Note: Bar posts are recommended for frames calibrated to neutral or higher in thickness and not recommended for flexible or EVA frames.

*CLINICAL PEARL
0° varus forefoot posts can also be applied to prevent orthotic frame ‘bite’ or cut in the shoe, which reduces the orthotic effectiveness and shortens shoe life.

Function:

  • Inverts the forefoot Twists frame into varus

Clinical Indication:

  • Anti-Pronation Reaction & Posts
  • Hyper-mobile 1st ray
  • Overpronation

Hide/show illustrations

About:
A varus extrinsic (bar) post is semi-rigid to very rigid (45-75 Shore A) EVA material added to the inferior distal frame. It begins approximately 2cm proximal to the distal edge on the medial side and terminates at the distal frame. The extrinsic bar also decreases in height as it extends beneath the device to the lateral side of the orthosis. The exact height and amount of material added is dependent on the desired angulation. A forefoot extrinsic bar post becomes a ‘tip’ post when it has an angulation between 0°-2° because the minimal amount of material used. A tip post doesn’t extend to the lateral side.

Because 2°-6° posts raise the distal medial frame, a “drop off” will be created. If higher varus correction is desired, this modification can be paired with intrinsic forefoot posting.

Note: Bar posts are recommended for frames calibrated to neutral or higher in thickness and not recommended for flexible or EVA frames.

*CLINICAL PEARL
0° varus forefoot posts can also be applied to prevent orthotic frame ‘bite’ or cut in the shoe, which reduces the orthotic effectiveness and shortens shoe life.

Function:

  • Inverts the forefoot Twists frame into varus

Clinical Indication:

  • Anti-Pronation Reaction & Posts
  • Hyper-mobile 1st ray
  • Overpronation

Hide/show illustrations

About:
The process of balancing a patient’s forefoot to rearfoot begins with drawing a line that bisects the posterior distal achilles tendon along its sagittal plane on the positive foot model. The foot model is then placed on level surface with the calcaneus, 1st and 5th metatarsal heads plantigrade. The angle of the bisecting achilles tendon line is observed. If the bisecting achilles tendon line is everted away from 90 degrees vertical, the 1st metatarsal is elevated within the foot model, sometimes referred to as a forefoot supinatus. Balancing is achieved by adding artificial material to the 1st metatarsal effectively lowering the 1st metatarsal head thus stabilizing and balancing the forefoot, maintaining a vertical achilles bisection line while the three points of the plantar calcaneus, 1st metatarsal and 5th metatarsal are plantigrade.

Artificial material (plaster or digital contour) is smoothed in a tapered fashion from the 1st metatarsal head to proximal base of the metatarsals. If Perpendicular is selected by the clinician, the rearfoot (vertical achilles bisection) will be leveled to perpendicular, and propping and balancing of the forefoot will effectively increase arch height and orthotic reaction forces. At the practitioner’s discretion, this technique can be used to alter the contour of a patient’s arch intrinsically by balancing forefoot to rearfoot at: 2°, 4°, 6° or 8° varus achilles bisection line, thus further propping or artificially plantar flexing the metatarsal head with artificial material. This effectively increases the arch height of the foot model and the congruent orthotic frame.

Because 2°-6° posts raise the distal medial frame, a “drop off” will be created. If higher varus correction is desired, this modification can be paired with intrinsic forefoot posting.

Note: Bar posts are recommended for frames calibrated to neutral or higher in thickness and not recommended for flexible or EVA frames.

*CLINICAL PEARL
0° varus forefoot posts can also be applied to prevent orthotic frame ‘bite’ or cut in the shoe, which reduces the orthotic effectiveness and shortens shoe life.