Hi, my name is Nicholas DeGabriel. I'm from Collier Orthotics and Prosthetics ,and I'm here to show you how to fit a double upright ko for the knee.
This is a very simple brace. Most double uprights are going have very similar landmarks for putting the brace on. This one specifically that we're showing you today is the unloader from Breg. It's called the Duo. It's a very efficient brace. Why don't you follow me today and we'll show you how to put this on.
:30
So this style of unloader knee brace has actually four quick releases on it. You can see all here on the side. The lovely thing about this style of bracing, and on all Breg braces, they are all numbered for you. So there's no guesswork for the patient on how to put them on what order.
:48
All we’ve got to do is pinch the silver pieces at the top of each one of them. And these little guys just rotate right off. Very, very simple. A total of six straps on this specific one, but that can be increased or decreased on the specific patient. For putting these on the leg, we want to do it at about a 45° angle. Most patients aren't going to understand that very well, so I tell people just to put your heel in front of your kneecap, we don't want to be too extended or to flexed with it. Slipping it on the knee, there are a couple landmarks for your height, the location the center of the hinges, these silver pieces right here in the middle should be about the top of the knee cap, as well as back into the knee. We never want to have the brace up here because it's not going be doing what it's supposed to. When it's nice and far back in the correct position. This thing's going to fit like a dream.
1:40
The first strap is the one just below the hinge here. This is actually going to be the most important strap on this brace because not only it's going be the one that makes sure the brace is in the right spot, but it's also the strap that's going to prevent it from falling down. We want to put the top of this pad on the strap, right up to the crease behind the knee, pull it around using the quick release, pop it in here, flip it over and you'll hear a nice little click in place. Once you get the hang of the quick releases, it takes a couple minutes. But once you get that everything is very easy.
2:13
The second strap is at the very bottom. I have a long tab down here, so I'm actually going to take this guy and trim it. This is not something patients will have to do. I will do this all at the fitting appointment. But it's something that they could potentially do if they needed to at home for whatever reason or if they accidentally moved one a little bit, they can just velcro back onto the strap, bring it around, put it right in, flip it over, click it in place. We can always come back then adjust the strap for tightness depending on if the leg swells, they can change circumference size.
2:50
Okay now we're going work on our way back up to number three up here. This one is now above the knee, tighten the strap, pop it in, flip over, click in place. These buckles do buckle independently on both sides so you can actually see potentially that I just undid one side there, not the end of the world. I have put these on patients that play football so they are very, very durable in regards to the quick release as well as the whole brace.
3:31
That fourth and final quick releases all the way up there at the top. Now we have two additional straps here in the front. These are the only straps that don't have quick releases on the brace. They're actually very important because they kind of helped solidify everything on the leg as well as they set the depth of how deep the brace goes into the legs. So a big mistake most patients will make is to have these straps tight when they put the brace on. What that ends up doing though, is making this hinge sit way far up on the knee and the brace no longer fits correctly. It's going end up digging into their shinbone and that's why 90% of my patients come back. But just putting on the brace on with these straps loose will completely fix that.
4:12
The last one, number six, is up here at the top, get that good and snug check everything. Make sure all the buckles are done and then stand up with the brace. Undoubtedly, these front straps come loose though just because the leg will change a little bit when you're standing. We can come back, tighten those down, check all the back straps, make sure everything's in the right spot.
4:40
The biggest thing though with the location of the brace, is this first strap, So just with this one you can see it being right up here in the crease behind the knee. That's what's going to prevent the bridge from falling down based on that circumference being smaller here than it is at the calf. If that's not tight, this whole brace will fall down no matter how tight all the other straps are.
I hope this helped you today have a wonderful day.
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