Why a custom fit OTC AFO is used for this pathology: Western Carolina O&P custom fit OTC type of AFO’s specifically tailored for this common pathology when there is NOT a hind foot instability and/or deformity is involved. Our practitioners start with a comprehensive foot and ankle evaluation of the mechanical and fitting perimeters, and once defined, an appropriate OTC AFO is chosen. The patient is then measured for proper fit. There are many types of custom fit OTC AFO, but all must me custom fit to the patient in insure proper function and comfort. At the device fitting the brace may be modified or adjusted to provide maximum function, toe pick up, and comfort to restore dynamic gait mechanics for safe ambulation. Most all OTC type AFO are of a solid ankle design, although many are considered dynamic because of their structural or material design. This not only helps the patient with increased safe ambulation, but also helps to relieve upper kinetic chain joint forces and improve body alignment. Light weight carbon fiber designed dynamic OTC AFO are a great choice for ultra-low profile and superior dynamic toe pick up. They are easily fit in to normal shoes and easy for the patient to don. Orthotic specific design consideration: OTC AFO’s are designed in either carbon fiber, a semi-flexible or rigid plastic. Because the OTC AFO come in sizes according to patient measurements, they rarely fit an individual properly. There for the OTC AFO must be custom fit to the patient and adjusted to prevent pressure points and skin break down. The custom fitting proses will also insure proper function of the brace. The specific design and materials of an OTC brace can have drastic effects on its function. A properly chosen device based on a comprehensive evaluation will insure that the patient is will have the greatest functional results. A well fit and appropriately functioning OTC AFO will provide proper mechanical foot and ankle control, toe pick up, and support though out the gait cycle. Rx: consideration: On our AFO orthotic specific Rx sheet for physicians, please mark for “OTC AFO DORSI ASSIST” and the specific Dx. Once we have seen and evaluated the patient we will request your face to face progress note and send a CMN for signature and date.