Catalog excerpts
,,E^*^4^- RICHIE BRACE PRESCRIPTION FORM TACT & PATIENT INFORMATION Patient Name:_ Shoe Type: Shoe Size: Cast enclosed for □ Left □ Right □ B/L Brace MUST MARK MEDIAL AND LATERAL MALLEOLI ON NEGATIVE CAST! □ Also sending cast for standard orthotic - Please enclose separate RX form □ RICHIE BRACE® (standard): Full Flexion Ankle Hinge Pivot. Can include enhancements for Posterior Tibial Tendon Dysfunction (check any or all - See price list for additional charges): Medial Heel Skive □ 4mm □ 6mm Navicular Accommodation □ (please mark negative cast) Adjust Limb Uprights for Tibial Varum □ Yes □ No (see measurements above) FOR SEVERE PTTD, RECOMMENDED MEDIAL ARCH SUSPENDER (SEE RESTRICTED ANKLE PIVOT BELOW) MODIFIED VERSIONS OF STANDARD RICHIE BRACE®: □ RICHIE SOCCER BRACE® - Includes shin guard. □ LITTLE RICHIE BRACE® - Pediatric application for shoe size 4 and under._ □ RICHIE BRACE® RESTRICTED ANKLE PIVOT: Limits ankle motion, yet allows smooth contact phase of gait. Indications: DJD ankle & STJ, tarsal coalition, mild Charcot, lateral ankle instability, peroneal tendinopathy. ENHANCEMENTS (optional): □ MEDIAL ARCH SUSPENDER - Adjustable lifting strap under talo-navicular joint for severe PTTD □ LATERAL ARCH SUSPENDER - Adjustable lifting strap under calcaneal-cuboid joint for peroneal tendinopathy and _severe lateral ankle instability._ □ RICHIE BRACE® DYNAMIC ASSIST: Full flexion pivot with spring hinges for dorsiflexion assist. Patient requirements: 1. Dropfoot 2. Ankle dorsiflexion to at least 90° to leg 3. Stable knee (must have all 3) □ RICHIE BRACE® SOLID AFO: Traditional full leg posterior shell wlbalanced functional orthotic footplate. Indications: Dropfoot with unstable knee, dropfoot with spasticity, Charcot Arthropathy. ALL RICHIE BRACES® HAVE THE FOLLOWING STANDARD FEATURES: ♦ Cover Length - Mets ♦ Orthotic Foot Plate - ♦ Limb Upright Supports - Aligned Perpendicular to Foot Plate ♦ Heel Stabilizer Bar - Included COLOR OPTION- □ BLACK (STANDARD) □ FLESH TONE □ WHITE_ Your prescription is now complete, unless you wish to make any modifications: NOTE: NON-STANDARD BRACE MODIFICATIONS MAY HAVE EXTRA CHARGES - SEE PRICING SHEET Medial Heel Skive For severe pronation control □ Add Medial Arch Flange (please mark on cast) Fascia Band ODIFICATIONS (Optio Extrinsic Long Forefoot Posting Not recommended as this will tilt entire brace to exact degree of posting. SPECIAL INSTRUCTIONS: location(s): (mark Plantar View □ Check here - if you would like a courtesy STS casting sock returned with this order
Open the catalog to page 1All Allied OSI Labs catalogs and technical brochures
-
the TOM-CAT Foot Scanner
2 Pages
-
Product Catalog
20 Pages
-
Doctors Choice Order
1 Pages