IDS ::: Orthotics ::: HKAFO's

Hip Knee Ankle Foot Orthoses – HKAFO's are effectively KAFO's (Knee ankle foot orthoses) with extensions to include the pelvic area. They are used in situations where an addition to conditions which would require KAFO's, hip joint stability and/or power is also reduced or absent.

Very rarely they may have no articulation at the hip as normally a hip joint is incorporated into the design. The joint may be designed to be free, allowing flexion and extension within limits, or to be lockable. The latter type can generally be locked at 90 and 0 degree of flexion.

The pelvic area can be included by a belt or strap but a more rigid pelvic section or band is more common. These can be made from plastic or leather and metal.

HKAFO's are rarely used for adults. They are most commonly used as bilateral HKAFO's for children who suffer from neuromuscular disorders such as spina bifida and cerebral palsy. In these situations, the hip and knee joints are almost always locked in stance and ankle joints would rarely be used. Because the hip joints are locked and the pelvic section is relatively rigid, reciprocating gait is normally not possible and progression is made by a swiveling and rocking motion across smooth surfaces with the aid of a walking frame.

This is not always the case however. If the child has some hip flexor power and good trunk control, the pelvic section can be made flexible enough to allow reciprocating gait, even with locked hip joints. This can be possible even in the absence of hip extensor power.

Although HKAFO's would seem to be a lot of ‘hardware’ to use there are benefits to achieving stance. Physiologically it may be good for the abdominal organs. Psychosocially it may be of benefit with regard to increased independence and being ‘on a level’ with peers. Because HKAFO's are difficult to don, doff and use but mainly for biomechanical reasons, their use is often terminated before or around the mid teens.

Bilateral contemporary HKAFOs

Bilateral contemporary HKAFOs

Unusual unilateral contemporary HKAFO

Contemporary bilateral HKAFOs

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