Dynamic Ankle-Foot Orthosis (DAFO)  and Supramalleolar Orthosis (SMO)

The dynamic ankle-foot orthosis (DAFO) is made of lightweight, custom-molded plastic. The shell has an intimate fit, which wraps around the entire foot and ankle. DAFOs come in various styles, such as solid ankle, articulated, posterior leaf spring (PLS), and supramalleolar (SMO). All are designed to provide support and help maintain proper positioning of the ankle and foot. 

 Posterior leaf spring (PLS) dynamic ankle-foot orthosis (DAFO)

 Supramalleolar orthosis (SMO)

1. Sit with the child’s hip and knee bent and the foot resting on the floor. Smooth any wrinkles in the sock. Open the top/front of the brace wide (Figure 1). Using your thumbs, scoop the foot into the brace. 
2. Work the heel into the back of the brace. Pull the brace up and down slightly while pushing the top of the foot back. 
3. If the brace has an instep pad, lift one side of the top/front opening and insert one side of the instep pad under the brace shell. Lift the other side of the top/front opening and insert the remaining part of the instep pad under the brace shell (Figure 2). 
4. Massage the instep pad and the top of the brace. This will settle the pad down onto the foot and resettle the foot back into the brace. 
5. Fasten the ankle (instep) strap. Make sure the heel is all the way down in the brace. Fasten the forefoot and/or calf straps to secure the brace (Figure 3).