COMMON QUESTIONS & ANSWERS:
- Can I order AFOs from Dr. Jordan?
No. We do not have a central fabrication facility or laboratory. All AFOs are custom fabricated and not customized from pre-designed or pre-made orthotic shells.
2. I hear that Dr. Jordan will be at my child’s surgery to take the plaster impression casts for post operative AFOs. Is this true?
On occasion, if scheduled well in advance, Dr. Jordan does attend some surgeries with Dr. Roy Nuzzo. This may average 1 visit per month. Dr. Jordan’s office is not part of or linked with Dr. Nuzzo’s office. Our schedules are independent.
3. My child has not been evaluated by Dr. Jordan. Can Dr. Nuzzo just send post-operative casts to have Dr. Jordan fabricate and fit the AFOs a few days later?
It is not possible to design AFOs, or any custom fabricated orthoses, without having first examined the child. There must be a functional benefit to the AFO design. Often the left and right AFO, if there is need for bilateral, are different in contour, foot to leg angles and leg to ground angles, trimlines, and plantar posting. This must all come together based on a detailed physical hands-on evaluation and often, discussion with the primary surgeon regarding surgical outcome goals. The specific design is then translated and discussed with the orthotist who then handcrafts each AFO from plaster impression model to its finished state ready for fitting and fine tuning.
4. Others have told me that if I fly in for surgery (SPML), my child can be fit with custom-made AFOs in a day or two?
a) Plaster impression casts are first required to make any custom orthosis. It makes little sense to mold and shape the impression casts over Pre-Operative legs and feet if the the Achilles mechanism or gastrocnemius (calf muscle) are a limiting factor. Soft tissue surgery must First be done.
(b) At the time of surgical correction of the Achilles, plaster impression casts can then be taken to capture a model of the now corrected foot-leg. Someone in the operating room must take the casts and mold it while held in the desired position. In a day or two the cast(s) will be dry enough to send to our office to begin the typical 4-day fabrication process. This timeframe also presumes that your child has already been evaluated in my office for specific functional design of the orthoses; if it is not about function, why use any orthosis.
(c) Now that the impression casts are somehow magically in my office, the positive plaster model is built and the specific thermoplastic is heated in order to vacuform the hot plastic to the corrective model of the leg and foot. The physical properties are such that the extremely hot plastic must then be permitted to cool down so that it retains the shape of the cast. This can take 12-16 hours or so depending on the size of the cast.
(d) Once cold, the plastic can be cut by hand in rough design, from the solid plaster model. The next 4-5 hours will be finer cutting, smoothing and finally adding the straps and SBR plantar posting in three directions to match the child’s current functional needs. At that time [5-10 days depending on your child’s specific needs], the orthoses can be fit, adjusted and modified.
So the quick answer for those children flying in for surgery and orthoses is that it is not reasonable or most often not possible to have surgery on a Thursday and be fit with orthoses on a Tuesday. We are good at what we do but we are not Magical.
5. When orthoses are mailed back to our office for adjustments and strap changes, please place the Suite number (#98) on the package. If sent by U.S. mail they will not deliver it without the suite number.
Also, before mailing, call the office or send and email to make sure that we are not out of the office for the week.