How Prosthetics & Orthotics Are Made

[Music] everybody here at new life brace and live we do orthotics and prosthetics for all of our patients this is my dear QAF pose which is an essential foot orthosis this is an adult with pivot joints on them and you just show you guys kind of like the processes for this for this pediatric anthro right here we're going to take a piece of 5/32 plastic polypropylene cut it to fit and we'll take you here and put it in our oven and lay trusses for 10 to 15 minutes to pull it out transfer it now when our patients come in they have a variety of designs able to pick from just whatever they decide we have tornado blue actual Caucasian and Hispanic just anything that you know actually blend with skin tones we have butterflies and we're gonna come back and show you guys how we transfer that and get everything pull up here in a second okay all right Rick's gonna show you how we transfer this and then we're going to get ready to pull it and then here he goes I'll pick it up bring it over to the AFO and you have to be extremely precise with this just so you don't have wrinkles anywhere because any wrinkle and a glove mark any little imperfection we have to completely read it and then what he'll do from this point is he'll get down and cut off all the excess plastic because once that cool is gonna get extremely hard and difficult to mess with and cut off and just like that so he's pulled it right now after this we're gonna let it cool we'll take it into the plaster room we'll cut it off and we'll show you guys how we trim and buff it okay so we are going into our plaster room now and for this process our practitioner Jesse when he sees a patient he will diagnose their needs and trying to figure out a plan to get them you know back healthy and back on track so what he'll do then is after he makes his diagnosis he will cast the patient with casting tape after that he'll will cut it off once it sets bring it back to us and once that's done it's in our hands now we'll staple it up flash to the front to where no actual plaster is able to leak out and then where we fill up a bucket pour all of them and we let them set the reason all these pipes are in here is just because whenever we actually take the cast off and we have the actual plaster mold we put it into a vise such as those over there and we're able to modify them bring them down and alter them the way they need to be done to fit the patient so which works gonna do right now is he's going to mix up plaster and vermiculite the plaster is what gives you that that hardness that form that we need and the vermiculite is this he's putting in there right now and what that does is help us smooth up the cast it makes it a little bit easier to work with a little bit easier to modify so we're not chipping away at basically a rock hmm I don't know what about yeah so then you wait about 10 15 minutes for these are set and you're able to strip them off and you'll get it down to something that looks like this this one's already been modified and had a toe plate put on it so whenever the top whenever we get one out I'll show you this is actually this next step is you add a toe plate to it so we can get the correct form of the plastic whenever we pull it over our a fo and we don't have a crazy-looking misformed leg to deal with basically we have the patient model here it's a positive model so the cast of the impression is a negative model to catch the shape of the patient's limb and that can be manipulated by hand so if patients have a deformity with their foot pointing down or inwards you know with foot drop or if they have an inversion deformity with Aquinas we can actually manipulate that shape with our hands while we're taking the mold and we can see what the patient can tolerate and what their end range of motion is while we're taking the mold and then after that during this phase of model rectification we can further offload areas that are painful or very prominent and those are those areas that are marked like the lateral malleolus the basement fifth metatarsal and we also not only do a positive release but we can also do a negative relief where we compress the areas of soft tissue like this part of the heel called the sustantivo of taillight groove this part of the body can tolerate a lot of support and pressure to hold that heel in alignment so that when we're talking about our gables we'll doing a little bit of the initial contact that heel doesn't roll off into valgus and we can control that heel and keep it underneath the patient to prevent any kind of pain or deformity that there happen so this is the process where we try and get a shape that would best represent what the plastic that's being pulled will fit over the patient and do for us about mechanically whenever the patients walk you to accomplish our goal and then after that like we went to we'd go to the plastic room get it ready and after we transfer the paper pull the plastic let it cool down this is the next step it comes to where we get the entire as you can see the entire leg is in plastic we put trim lines on it so we know where to cut and with their specific trim lines for each patient note they're not always gonna be the same and after we take this we'll cut this off pull the front off and you pop the back of it you pop the back of the actual afo off and then from that point we sand it up we buff it up and then it's ready for pads and straps so what the first step we're going to do is after we plug in is since we have all this excess plastic up you the easiest way to just manipulate it is just go straight ahead and cut all this off because these are out of our trim lines are not gonna need this anyways so I'll demonstrate that real cool [Music] so then once you put cut the front of the cast off looks pop-up and then from that point we need to get the actual AFO off so you're gonna have to lightly work it so we can need to be careful so that we don't have our entire he'll fall off or our toe plate completely break and collapse and boom then we got to rip our liners out and and then this is the step and then now after this we just have to follow these trim lines trim it up buff it sand it Pat it up and we're ready to go to our patient so you can see like I said earlier with trim lines this is a more solid trim line no real differentiating you know nothing like that as you can see here we have a lateral stablish trim line out here it comes up brings it out and that's a three point pressure system one here one here and another pressure right here just to completely hold that patient you know lock that patient in and keep them from falling swinging or you know injuring themselves anymore and it's just gonna correct any you know imperfections that have in their leg to get to something like this we have to go through a few modification steps what you'll initially do is once you come in here we need to get our afo down to the exact trim lines that you see on here so we can fit the patient's needs we'll use a belt sander to get it in our big areas as much as we can this is extremely fast and it rips a lot of plastic plastic up very quick so it's easy way to get through a lot of the big stuff once we get through that stage we'll come over here and we'll go to this it's a sanding cone and this is a Troutman so what you can easily remove the sanding cones and any of the cones just like this and boom pop a new one on so we'll go I'll use an actual sanding cone we use something a little bit more fine like this on the outsides and the inside so we can knock the edge down and get a smooth round surface for our patients once we do that well switch out the cones and we'll go to this this is a buffing cone it goes here just like this and what it does is once you have a nice pair once you have the plastic down you got all the big chunks off it takes it and makes it just as smooth as the rest of the cast so everything is smooth there's no sharp edges no one's getting poked you know we're gonna make sure patients have the perfect fit every time and that's basically it and then once you do that we go do pads and everything else [Music]

Channel: Antonio J. Webb, M.D.

Views: 4,029

Rating: 4.9798994 out of 5

Keywords: surgeon pay, surgeon salary, orthopedic surgery, ortho, residency life, life as a resident surgeon, MCAT, prosthetic, how prosthetics are made, how orthotics are made, what is a prosthetic, what is an orthotic, career as an orthotist, how is a prosthetic made, how artificial limbs are made

Id: fy5cmfbVeCE

Length: 11min 5sec (665 seconds)

Published: Mon Jun 08 2020