OTC Orthopaedic Technologist Certified Orthopaedic Appliances and Bracing 5 — Questions and Answers
Question 1: A hinged AFO with a plantarflexion stop is indicated primarily for patients who demonstrate which gait deviation?
- Excessive dorsiflexion during loading response (crouch gait)
- Knee hyperextension secondary to spastic plantarflexion (Correct answer)
- Lateral trunk lean due to hip abductor weakness
- Circumduction gait from hip flexor weakness
Correct answer: Knee hyperextension secondary to spastic plantarflexion
A plantarflexion stop prevents the ankle from dropping into equinus during initial contact, which eliminates the extensor thrust that causes knee hyperextension.
Question 2: Which padding technique is used inside a cast specifically to protect the fibular head from pressure injury?
- Uniform padding throughout
- Donut pad centered over the fibular head (Correct answer)
- Extra layers of Webril over the fibular head
- Heel relief pad only
Correct answer: Donut pad centered over the fibular head
A donut pad (ring pad) distributes pressure away from the prominent fibular head by surrounding it, preventing focal pressure and peroneal nerve injury.
Question 3: The Sarmiento functional fracture brace for humeral shaft fractures relies on which primary mechanism to maintain fracture alignment?
- Rigid fixation of the shoulder and elbow joints
- Soft tissue hydraulic compression and gravity-assisted alignment (Correct answer)
- Electromagnetic bone stimulation
- Traction via skeletal pins
Correct answer: Soft tissue hydraulic compression and gravity-assisted alignment
The Sarmiento humeral brace uses hydrostatic pressure from the surrounding soft tissue envelope combined with gravitational alignment to maintain fracture reduction without immobilizing the joints.
Question 4: When selecting a prefabricated versus custom-fabricated orthosis, which patient factor most strongly justifies the custom option?
- Patient preference for a specific color
- Significant anatomical deformity or limb asymmetry (Correct answer)
- Insurance coverage for only custom devices
- Acute injury requiring immediate immobilization
Correct answer: Significant anatomical deformity or limb asymmetry
Significant anatomical deformity or asymmetry prevents prefabricated orthoses from achieving adequate fit, necessitating custom fabrication to the patient's specific contours.
Question 5: A patient with C5 spinal cord injury requires upper extremity orthotic support. Which orthosis would best enable functional hand use by harnessing wrist extension power?
- Resting hand splint
- Wrist-driven flexor hinge orthosis (tenodesis orthosis) (Correct answer)
- Dynamic MCP extension splint
- Cock-up wrist splint with outrigger
Correct answer: Wrist-driven flexor hinge orthosis (tenodesis orthosis)
A wrist-driven flexor hinge orthosis converts active wrist extension into passive finger pinch through a mechanical linkage, exploiting the preserved C5-C6 wrist extension in these patients.
Question 6: Which observation during cast application indicates that padding has been applied with excessive tension, increasing the risk of compartment syndrome?
- Padding gaps at the popliteal fossa
- Wrinkling and ridging of the cast padding (Correct answer)
- Padding extending beyond the cast edges
- Cast padding applied in overlapping spiral pattern
Correct answer: Wrinkling and ridging of the cast padding
Wrinkling and ridging of cast padding during application indicates it was stretched under tension, which creates circumferential pressure points that can restrict circulation.
Question 7: A Denis-Browne bar is used in the treatment of which pediatric orthopaedic condition?
- Developmental dysplasia of the hip
- Clubfoot (talipes equinovarus) (Correct answer)
- Legg-Calvé-Perthes disease
- Blount disease
Correct answer: Clubfoot (talipes equinovarus)
A Denis-Browne bar connects bilateral shoes at a set angle of external rotation and abduction to maintain clubfoot correction achieved through serial casting.
OTC Orthopaedic Technologist Certified Orthopaedic Appliances and Bracing 5
A hinged AFO with a plantarflexion stop is indicated primarily for patients who demonstrate which gait deviation?