26 August, 2010

A day out for casting of splints

On Tuesday 24th August we bundled up into the van and took Chan Chea, along with her mother and cousin, to 'Cambodia Trust', in Phnom Penh, for casting of ankle foot orthoses (AFOs), spending the entire day there! Step by step in Cambodia :)
Below you can see Chan Chea's feet when serial casts were removed.

We are able to correct her foot into a better position in sitting, with her knees bent, than we are when her knees are straight. This shows there is tightness and contracture in the muscles that cross her knee as well as her foot. By casting her into as best position as possible when sitting, and then practicing standing and having her legs out straight, we hope this will continue to stretch the muscles and tissues, but it is still highly likely surgery will be required to obtain a more functional position. By making splints for Chan Chea, she will be in a much more comfortable, will be able to remove the splints for washing, and they are much lighter. They will hold her foot in the best position we could get with casting, but will not progress the stretch, as we did with serial casting. Wearing the splints will enable her to continue to work on strength and balance, and then we can come back to further correcting her foot position.
These pictures show the process of casting for the AFOs with the PO (prosthetist/orthotist).

You can see the corrected position of the foot - you can see that the heel still turns inwards a bit.

This is the best angle that was able to be achieved - this will mean that the heel of the splint will need to be built up, so as to provide a 90 degree angle to the ground so that Chan Chea can practice standing and walking.

The right foot is a bit harder to correct than the left.
We will return to Cambodia Trust (CT) next week for fitting of the AFOs. In the meantime, Chan Chea's feet have been placed in casts once again until splints are available.

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