COF Pediatric Orthotics 5

Question 1

A toddler presents with tibial torsion causing in-toeing gait. When is orthotic intervention with a Denis Browne bar typically indicated?

Accepted Answer

It is rarely indicated; most cases resolve spontaneously by age 8

Answer

Internal tibial torsion usually resolves spontaneously during normal growth, and orthotic devices like the Denis Browne bar are no longer routinely recommended.

Question 2

Which material property is most critical when selecting thermoplastic for a pediatric AFO that must flex during push-off?

Accepted Answer

Flexibility and fatigue resistance

Answer

A dynamic pediatric AFO requires a material that flexes under load and resists fatigue cracking to maintain function over repeated cycles of use.

Question 3

When fabricating a TLSO for an infant with congenital scoliosis, what casting position is recommended to achieve optimal correction?

Accepted Answer

Derotation and side-bending away from the convexity

Answer

Casting in derotation and side-bending toward the concavity (away from the convexity) maximizes three-dimensional spinal correction during brace fabrication.

Question 4

A child with Down syndrome presents with hypermobility and pes planus causing fatigue and pain. The first-line orthotic choice is typically:

Accepted Answer

Custom supramalleolar orthosis (SMO)

Answer

A custom SMO provides medial-lateral stability at the subtalar joint while accommodating the hypermobility common in Down syndrome, improving alignment and reducing fatigue.

Question 5

For a child fitted with a Resting Hand Splint following spastic hemiplegia, what wrist and finger position should be maintained?

Accepted Answer

Wrist 20–30° extension, fingers and thumb in functional alignment

Answer

A resting hand splint for spasticity positions the wrist in 20–30° extension with fingers and thumb in gentle abduction to prevent contracture while allowing some functional posture.

(COF) Certified Orthotic Fitter Practice Test

(COF) Certified Orthotic Fitter Practice Test

COF Pediatric Orthotics 5