Determining Stirrup Placement

1. Determining Stirrup Placement For an AFO Without Tibial Torsion

2. LATERAL MEDIAL Left AFO Determining Stirrup Placement Without Tibial Torsion • For this demonstration a Left AFO is being fabricated • Draw a line across the width of the paper 3” from the bottom (baseline)

3. Toe-Out Toe-In LATERAL MEDIAL Left AFO Determining Stirrup Placement Without Tibial Torsion • Locate the toe-in / toe-out measurement on the orthometry form • If placing on a (L) shoe establish a toe-in/toe-out line on the right side of the baseline. Reverse this if placing on a (R) shoe. Extend the line below the baseline

4. LATERAL MEDIAL Left AFO Determining Stirrup Placement Without Tibial Torsion • Find the mid-point between the top lace section and the back of the heel on the medial side • Drop this mark perpendicularly and mark the sole at that point 1/2 1/2

5. Toe-Out Toe-In LATERAL MEDIAL lateral sole edge mark medial sole edge mark Left AFO Determining Stirrup Placement Without Tibial Torsion • Place the shoe on the diagram so that: • the medial border is on the toe-in/toe-out line • the mark on the medial sole edge is on the baseline • Mark the lateral sole edge where the baseline intersects

6. LATERAL MEDIAL Left AFO Determining Stirrup Placement Without Tibial Torsion • Remove the shoe from the diagram and turn it over so that the sole faces you • Transfer the marks on the sides of the sole to the bottom of the sole • Connect the marks with a light straight line

7. LATERAL MEDIAL 3/8” Left AFO Determining Stirrup Placement Without Tibial Torsion • Measure back 3/8” and draw a second heavier line • The back edge of the stirrup will be lined up on this line

8. LATERAL MEDIAL Left AFO Determining Stirrup Placement Without Tibial Torsion • Place the stirrup on the shoe so that the posterior edge of the stirrup is on the positioning line • Trace the outline of the stirrup on the sole • Determine where the holes in the tongue are to be drilled, mark and center punch them

9. 1/8”-3/16” Determining Stirrup Placement Without Tibial Torsion • Bend the tongue of the stirrup to conform to the curve of the sole leaving a clearance of 3/16" to 1/8" at the anterior most point

10. 1/8”-3/16” Determining Stirrup Placement Without Tibial Torsion • Bend the tongue of the stirrup to conform to the curve of the sole leaving a clearance of 3/16" to 1/8" at the anterior most point. This is done to insure that the stirrup upright will be vertical after the heel is reattached • Drill all holes in the stirrup using an appropriately-sized drill for a #8 rivet

11. Determining Stirrup Placement Without Tibial Torsion • Bend the tongue of the stirrup to conform to the curve of the sole leaving a clearance of 3/16" to 1/8" at the anterior most point • Drill all holes in the stirrup using an appropriately-sized drill for a #8 rivet • Countersink all holes on bottom of the stirrup

12. Determining Stirrup Placement Without Tibial Torsion • Place the stirrup back on the shoe and mark the locations of the holes on the sole • Drill one 3/16” hole in the sole and place a rivet through this hole from the inside out to position the stirrup • Drill the remaining holes using the stirrup as a guide placing a rivet through each hole after drilling

13. Determining Stirrup Placement Without Tibial Torsion • You are now ready to rivet the stirrup to the shoe