TF ESR (Thermoformed Energy Storing & Returning) AFO Logo

  • Access Legacy PDF work order. Legacy form will be accepted until Nov 1st. 

  • Please do not print the Review page.

    Scroll to the bottom, hit Complete and then download the work order. 

  • TF ESR (Thermoformed Energy Storing & Returning) AFO

    Intake Information

  • Please enter a correct Fab PCC#

  •  - -
  •  - -

  • Daily HFN Capacity

  •  - -

  • TF ESR AFO

    Patient Information

  • The Scan Upload is available at the end of the Form. 

    • Please complete and submit the form and print out the Work Order PDF. In the Hanger 3D app, go to Order Forms > Take a Picture and upload the printed PDF along with your scan.

      

  • The Cast Measurement fields are available at the end of the Form. 

  • Due to the scan being modified, the Alignment and Modification options will not be displayed.

    Any Alignment or Modification changes can be called out in the Notes section. 

  • TF ESR AFO

    Configurator
    • Casting: 

    • TWO STAGE CAST IS REQUIRED 

    • Image-1226
    • Image-1224
    • Image-1228

    • ALIGNMENT CASTING BLOCK:

    • Toe Ramp Angle:

      • Low < 10° – household ambulators with limited community ambulation
      • Moderate 12-15° – community ambulator
      • High 15-30° – active community ambulators
    • Measurements: 
    • Patient Measurements
    • Patient Measurements
    • Alignment: 

    • i

      NEUTRAL is the Tibia perpendicular to the floor based on Heel Height. 

    • Final Forefoot Position:

    • Set the Forefoot in   *   ° of      *        

    • Final Hindfoot Position:

    • Set the Hindfoot in   *   ° of      *        

    • Design Criteria: 

    • MANUAL MUSCLE TESTS:

      Strength

    • Image-1243
    • Image-1246
    • Image-1248

    • Observational Gait Analysis:

    • Biomechanical Objectives:

    • Image-1260
    • Image-1261
    • Image-1262

    • Mild Control: provides minimal resistance to tibial advancement in stance.
      MMT: DF ≤ 3, PF ≥ 4, KE ≥ 4

    •  Moderate Control: provides mod. resistance to tibial advancement in stance.
      MMT: DF ≤ 3, PF ≤ 4, KE ≥ 4

    •  Firm Control: provides firm resistance to tibial advancement in stance.
      MMT: DF ≤ 3, PF ≤ 3, KE ≥ 4

    • Modifications/Trimlines: 

    • Standard Mods include:

      • 1/8" (3 mm) buildup at the Malleoli, Navicular and Base of the 5th. 
      • 1/8" (3 mm) reduction at the Medial Longitudinal Arch Apex. 
    • Image-1047
    • Materials/Design: 

    • NOTE: No variation in design at this time.

    • Posting/Wedging:

    • Posting:

    • Image-1118

    • Posting options will not be available if a Heel Wedge is selected.

    • {intrinsicHeel990} Intrinsic Heel Skive was selected.

    • Image-1119
    • Image-1120
    • Image-1121
    • Image-1122
    • Image-1123
    • Image-1138

    • Plastic

    • i

      Finished Plastic Thickness will be within 10% of the requested thickness. 

    • Special Order Transfer Papers can increase device turnaround time.

    • PLEASE SELECT DIFFERENT OPTIONS FOR TRANSFER PAPERS.

    • Image-1082
    • Padding: 

    • Additional Padding

    • Finishing: 
    • Image-1065
    • Image-1069
    • Image-1142

  • TF ESR AFO

    Notes

  • Your order will be sent to CDC after submission along with the Scan. No futher action is needed.

    (No Entry required at the LEO portal)

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • 0/250
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Should be Empty: