Orthotics - Knee Ankle Foot Orthosis (KAFO) for Children

What is this leaflet about and who is it for?

This leaflet is produced for the parents and carers of children who have been provided with a knee ankle foot Orthosis (KAFO) by the Orthotics service. It will explain how you should care for the Orthosis and other important information about the Orthotics service.

We hope you find this information useful. If you require further information or are unable to attend an appointment, please telephone the Orthotics department where the appointment has been made for you as soon as possible:

Bury, Rochdale or Oldham: 0161 778 2670
Email: nca.orthotics@nca.nhs.uk

Salford: 0161 206 4912
Email: salford.orthotics@nca.nhs.uk

For further information about our service, please visit:

www.northerncarealliance.nhs.uk/our-services/orthotics

Our sites are open for collection and dropping off devices:

Bury: Tuesdays only
Rochdale: Thursdays only
Oldham: Mondays only
Salford: Monday - Friday

What does the KAFO do?

Your child has been supplied with a KAFO, which is designed to control the knee and ankle joints when deformity and/or instability are present. The Orthotist has designed this device specifically for your child.

What is my child’s entitlement?

You child is entitled to one KAFO (or one pair if both legs are affected). Due to growth in children a spare KAFO/pair of KAFOs would not normally be provided unless there was a particular clinical need. However, they will be given a second item/pair after inspection of the original orthosis, by the Orthotist for the following reasons:

• Your child outgrows the KAFO(s)
• Your child’s original KAFO is beyond repair
• Your child’s original KAFO is deemed to be clinically ineffective
• Your child is unable to function without it

Theft, loss or damage of the KAFO

If your child’s KAFO is stolen you will need to obtain a crime number from the police before we are able to order you a replacement. If your child’s KAFO is lost or damaged (either accidentally or maliciously) you will be asked to pay for its replacement. The average cost of replacement of a KAFO is £350.

How should my child wear the KAFO?

• Ensure all straps on the top (thigh) and bottom (AFO) sections are unfastened. Where the KAFO has a knee apron, ensure that the two straps on the inner side are unfastened and that the apron is folded back
• With the child laid on their back on a suitable flat surface raise the leg and slide the KAFO underneath. Place the thigh into the thigh section and the foot and ankle into the bottom section
• Bend the KAFO/leg to 90 degrees and fasten the bottom section straps first
• Fasten the straps on the thigh section ensuring the tongue is placed underneath the thigh cuff at its free edge and has no creases
• Straighten the KAFO/leg, reposition the knee apron over the knee and fasten the two straps, ensuring that they loop around the side member as on the opposite side
• If the joints have a locking mechanism, straighten the KAFO until the joints lock to ensure correct operation
• Place the foot section of the KAFO into a suitable item of footwear and fasten straps/laces to ensure safe location of the foot section within the footwear

If your child’s KAFO has spurs at the bottom rather than a plastic ankle/foot section then:

• Place the item of footwear with the tube receptors for the spurs onto the foot and fasten straps/laces
• Apply the KAFO as above but instead of placing the foot into the ankle/foot section, place the KAFO spurs into the tube receptors in the heel of the footwear
• Fasten the heel retaining strap, which retains the spurs, in the tube receptors
• Fasten all other straps in accordance with the KAFO instructions above

How should I care for my child’s KAFO?

• Joints should be cleaned regularly using an old toothbrush or similar, never immerse the KAFO in water
• Dry the KAFO with a towel, away from direct sources of heat and cold
• Apply a small amount of Petroleum Jelly (Vaseline or chemists own brand) to the joints once a month
• You are responsible for looking after your child’s KAFO and returning it for maintenance and repair, never attempt to repair/ adjust the KAFO yourself
• If the KAFO has spurs which fit into the tube receptor in the heel of the shoe, the spurs should have a small amount of petroleum jelly (such as Vaseline or chemists own brand) applied once a month to keep the spur lubricated in the tube

What problems should I be aware of?

If you notice any of the following, please contact the Orthotics department as soon as possible on the telephone number at the top of this leaflet.

• Skin redness that doesn’t fade after 15-20 minutes
• Sores or blisters on the skin
• Pain, irritation or rubbing
• Any damage to the KAFO

What should I do about my child’s footwear?

If your child’s KAFO has metal spurs we will need to adapt their footwear with caliper sockets, and possibly leather straps. Please see separate leaflet on footwear adaptations.

Further appointments

Following supply of your child's KAFO you will be told about the follow up procedure and a review appointment will be arranged at the discretion of the Orthotist.

However if you feel your child’s condition has worsened, not improved or they are experiencing problems with their KAFO, you can ask to see the Orthotist for a review by telephoning the Orthotic department where they had their original appointment.