fabrication of lower extremity orthoses in lamination technique … · 2015. 3. 8. · fabrication...

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T e c h n i c a l I n f o r m a t i o n 5 . 9 . 1

Fabrication of Lower Extremity Orthoses in Lamination Technique

using the UL Joint System

2

Lower Extremity Orthoses with UL Joint System

Table of Contents ____________________________________________________

1 Introduction ...............................................................................................................................3

2 General Information on Lamination Technique ........................................................................4

3 Tools and Materials for Orthotic Fabrication ............................................................................4

4 Components ..............................................................................................................................5

4.1 Ankle Joint Components ...................................................................................................................................5

4.2 Knee Joint and Accessories ..............................................................................................................................5

5 Fabrication of the Lower Extremity Orthosis ............................................................................6

5.1 Joint Components Selection .............................................................................................................................6

5.2 Preparing the Plaster Model ............................................................................................................................7

5.3 Reinforcing the Band ......................................................................................................................................12

5.4 Reinforcement of the Model ............................................................................................................................13

5.5 Removal from the Model and Trial Fitting of the Orthosis ................................................................................19

5.6 Finishing the Orthosis .....................................................................................................................................23

6 Order Form for the UL Joint System ......................................................................................27

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1 Introduction _______________________________________________________

The fabrication of orthoses for the lower extremity with joint bar on one side only represents an alterna-tive to the kind of orthotic fitting used up to now. In some fields of application, bilateral joint bars with corresponding pairs of joints usually used in lower extremity orthoses can be replaced by a Unilateral (UL) Joint System. The UL joint system is positioned on the lateral side of the leg and is designed such that medial bars are not needed. The UL joint system can be used for ankle, knee and hip joints. A connection plug connects the knee and ankle joint to a unilateral bar. The UL bars serve to stabilize the orthotic construction and match the joints’ strength. They bear torsion stress as well as bending forces and vertical loads and must in their full length remain in the orthosis. If you want to use them in combination with the 17H100 Otto Bock

RGO Hip Joint System, connectors are available for connecting the system.The special construction and modular design of the UL joints combine different functions as well as easy handling of the components. Different joint inserts, for example, are used to limit the range of movement of the UL ankle joint. The multifunctional design of the UL knee joint allows to change the function as needed. Detailed functional descriptions of the UL ankle joint and UL knee joint are contained in the 647G201 and 647G200 Instructions for Use.

To verify the fit, we recommend fabricating a test or-thosis (see figure) with 616T83=1250×1025×6 Ther-molyn Clear.

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2 General Information on Lamination Technique _________________________

This technical information booklet describes the fab-rication in lamination technique of an individual lower extremity orthosis with unilateral joint design. In an or-thotic example fitting, the processing and integration of the UL joint system, size 2, is described. For the fabrication of lower extremity orthoses in lamination technique, extra longe PVA bags of 1.30 m length are available. During the lamination process, the joints are replaced by dummies made of lamination resin repelling plastic. This facilitates later removal of the orthosis from the model. In order to achieve the required rigidity and also flex-ibility for the support surfaces (bands), special uni-directional (UD) carbon fiber materials and carbon stockinettes are used. Partial layers of carbon fiber cloth are used to reinforce the orthosis in the clo-sure system zones and the forefoot. The lamination technique is particularly suitable for the application of special construction principles (3-point system) to make the UL joint system comply with biomechanical requirements and for enabling the patient to benefit from the advantages of the dynamic characteristics of the entire orthosis. The special embedding of the UL system bar in the laminate without additional re-

inforcement material allows for a dynamic force dis-tribution in the entire orthosis, preventing peak forces to act upon the joints.

Note: The thickness of reinforcement used here (carbon fiber and stockinette) represents a recommendation. The number of layers of the reinforcement can vary in depen-dence of load, body weight, forefoot lever load, etc.

Attention!The use of the UL system bar and tibial bar as system lamination bar, i.e. short-ened bars of approx. 100 mm length, is not provided for as it would compromise the function and stability of the orthosis and thus threaten the patient’s safety. The UL system bar remains on the orthosis with maximal length.

3 Tools and Materials for Orthotic Fabrication ___________________________

Knee Pivot Gauge 743A8Foot Casting Aid 743A9Orthotic Alignment Aid 746A6Pivot Point Adjustm. Aid 743A7Orthotic Joint Alignment Fixture

743R6

Thermolyn Clear 616T83=1250×1025×6PVA Bag 99B81=130×19×5

99B81=130×22×599B81=130×26×5

Carbon-Fiberglass Webbing

616B2 (unidirectional)

Carbon Fiber Cloth 616G12 (bidirectional)C-Orthocryl Lamination Resin

617H55

Plastaband 636K8=20×2×10Fabric for Lamination "Blue Star"

623S5=15

Pigment Paste, white 617Z4Terry Cloth Padding Fabric

623P3

Space-Tex 623F62Micro Hook Strip 623Z4=50-6Padding Tape 623P5=*PE Adhesive Tape 627B4

5


4 Components ______________________________________________________

4.1 Ankle Joint Components1) 30U120 Ankle Joint (stainless steel) 2) 17LA* Joint Insert (plastic)3) 17LA2 Tibial Bar

(aluminum alloy)4) 4B136 Bushing (plastic)5) 4A101 Axis 6) 507S96 Lock Washer 7) 30Y78 Holding Pin 8) 170Z10=4 O-ring9) 30Y79 Joint Dummy 10) 30Y77 Holding Bolt11) 17LF1=1 Foot Stirrup 17LF1=2 (aluminum alloy) 17LF1=3 12) 17LF2=L/R1 Foot Stirrup, Two-part 17LF2=L/R2 (aluminum alloy) 17LF2=L/R3

4.2 Knee Joint and Accessories1) 30X82 Knee Joint Upper Part

(stainless steel) 2) 30U121 Knee Joint Lower Part

(stainless steel)3) 30Y87 2 Bushings (plastic)4) 170Z93 2 Bearing Washers

for knee joint5) 17Y93 Bearing Nut, hardened 6) 501S32 Truss Head Screw7) 4A101 Axis8) 507S96 Lock Washer9) 30Y88 Knee Lever10) 513D83 Compression Spring11) 17Y* Wedge Lock12) 507S96 2 Lock Washers13) 4A101* Axis14) 4A101* Axis15) 30Y90 Joint Dummy for

UL Knee Joint (not illustrated)

16) 30Y89 Shoulder Screw (not illustrated)

17) 17LS1* UL System Bar (not illustrated)

18) 636W28 Special Adhesive (not illustrated)

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3 4 5

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The UL Joint System can be used for different fields of application, such as: cerebral palsy, condition after poliomyelitis, frontal and sagittal ankle/knee axis devi-ations, spina bifida, traumatic paraplegia; or general nerve lesions: paralysis or weakness of foot lifting and/or foot lowering muscles, paralysis or weakness of knee extensors.The UL ankle joint can be used for ankle-foot ortho-ses (AFOs) and the UL knee joint, maybe in combi-nation with the UL ankle joint, can be used for knee-ankle-foot orthoses (KAFOs). For hip-knee-ankle-foot orthoses (HKAFOs), e.g. using the 17H100 RGO Hip Joint System, a connection to the UL Joint System can be provided by the 17LH100 Connectors.A classification helps to select the joint components, taking into account the body weight and lower leg length.When used as bilateral fitting, a body weight of up to 160 kg is allowed.Classification matrix

Size Body weight Lower leg lengthkg lbs MTP to floor cm inch

Size 1 up to 100 220 up to 55 22Size 2 up to 75 165 up to 45 18Size 3 up to 45 100 up to 35 14

Alignment Instructions

Attention!For sagittal alignment (evaluation with the L.A.S.A.R. Posture, article no. 743L100) the following applies: With all three joint sizes the load line must not be more than 3 cm behind the compromise pivot point according to Nietert (60/40) or mechani-cal pivot point, as otherwise the function and stability of the orthosis and thus the patient’s safety (see graphic illustration below) would be compromised.The frontal axis deviation (valgus, varus deviation) in the knee joint must not be more than maximally 10°. If need be, a medial support joint (e.g. 17B205=*) must be used as otherwise the function and stability of the orthosis and thus the patient’s safety would be put at risk.Do not heat the UL system bar (alumi-num) beyond 150 °C, because this would jeopardize the stability of the UL system bar and thus the safety of the patient.

5 Fabrication of the Lower Extremity Orthosis ___________________________

5.1 Joint Components Selection

60 % / 40 %(anterior) (posterior)

compromise pivot point according to Nietert

15 mm /0,6 inch

Recommended (physiological) course of the load line in the orthosis (measurement with the L.A.S.A.R. Posture)

30 mm / 1,2 inch

Maximal posterior course of the load line in the orthosis (measurement with the L.A.S.A.R. Posture)

60 % / 40 %(anterior) (posterior)

compromise pivot point

according to Nietert

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5.2 Preparing the Plaster Model This section decribes how to use the joint dum-mies and process the UL bars. Further information is contained in the respective Instructions for Use: 647G200 for UL Knee Joint and 647G201 for UL Ankle Joint.

Note:To achieve secure embedding of the foot and a plaster cast with correct align-ment, use the 743A9 Foot Casting Aid (see Fig.). For positioning of the align-ment axes for later joint position we rec-ommend using suitable orthotic alignment tools such as the 743A6 Orthotic Align-ment Aid.Before shaping the bars, any padding mate-rial should be taken into consideration. De-pending on the padding material used later, spacer material is applied to the model. This can be 617S3 Pedilin, for example, or sev-eral layers of stockinette. If any compression of the spacer material shall be avoided we recommend glueing 620P3 Rubber Cork onto the model. In the area of the alignment adapter, the spacer material must be re-moved.

Determine the position of the alignment axes in the plaster negative, fix them with plaster bandages and prepare the model for casting the positive.We recommend using the 746A6 Orthotic Alignment Aid for positioning the axes.On the medial side, the square channels resulting later in the plaster positive can be closed if need be (see Fig.).

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In the ankle joint zone or knee joint connection plug zone, the bar must not be shaped or damaged by bending irons, since otherwise the notch effect could cause breakage of the bar. For this reason, mark the position in the joint dummy before shaping the tibial bar.

Do the same with the UL system bar of the knee joint.

Grind away the separation edge of the ankle joint dummy on the side facing the model. Grind away sharp edges on the joint dummies to prevent tearing of the PVA bag. The joint dummies are lamination resin repellent and don’t need to be isolated.

Mount the knee joint dummy to the 743Y56=4 Align-ment Adapter using the provided shoulder screw. Fix the tibial bar in the ankle joint dummy using a cor-responding M5/M6 screw or the provided holding pin. The joint dummies are useable for both, left and right sides.

When using stockinette as spacer material (as in our fitting example), apply 636N9 Contact Adhesive to the surface above the adapter, let the adhesive dry and cut free the stockinette above the adapter using scissors.

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Fix the tibial bar in the ankle joint dummy on the plas-ter model.

Mark the length and trim the tibial bar. For fitting the tibial bar between the ankle joint and knee joint, first leave the bar somewhat longer than the exact mea-sure, since the bar length can still change due to shaping.

Different Otto Bock bending irons are available for shaping. For the UL bar, size 1, the 711S5=7×9 Bending Iron can be used. When shaping the foot stirrup, make sure that the bending radius is not less than 15 mm to avoid the risk of breaking. Depending on the thickness of the reinforcement ma-terial, a distance of 2 mm between the plaster model and foot stirrup must be provided for.

Grind away any grooves and burrs caused by shap-ing, since otherwise the notch effect could cause breakage of the bar. For fine surface processing we recommend using the 649Z10 Polishing Sanding Drum.

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For secure fixation of the UL bar during the lamination process, the bar is secured in the joint dummy’s con-nection plug with a screw. After shaping, insert the bar into the joint dummy and lightly countersink with a 4 mm drill bit to mark the correct position of the bore hole. Then drill with 3.3 mm and cut a M4 thread.

When shaping the split foot stirrup make sure that the upper end is fully inserted into the ankle joint dummy.

Fix the ankle joint dummy using the holding bolt or a M5 or M6 screw.

Secure the shaped UL bars in the knee joint dummy using a M4 screw to prevent them from slipping out. This ensures that the UL bar will keep its position in the dummy during the lamination process.

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Readily shaped UL bar. For the reinforcement, a dis-tance of approx. 1 mm between the plaster model and UL bar must be observed. In the area of the bands below the UL bar, a distance of approx. 2 mm must be observed to allow good soaking of the car-bon stockinette.

Bands made out of carbon fiber reinforced PVC Profile Material (17Y106) are used to reinforce the support surfaces. Use a hot-air gun to heat the PVC profile material. Cold forming is also possible to some extent.

The PVC profile material reaches up to the bar. View of the shaped profile material for the subcondylar support surface.

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5.3 Reinforcing the BandTo counteract the loads in the area of the support sur-faces, the bands are reinforced with 616G15 Carbon Fiber Stockinette. The number of layers varies from 1 to 3. Leave the stockinette approx. 30 – 40 mm / 1,2 – 1,6 inch longer in the connection area for later connection of the band to the UL bar. We recommend using always 2 layers of carbon stockinette in the connection area (= 30 – 40 mm / 1,2 – 1,6 inch before and 50 mm / 2 inch above the band), in order to achieve sufficient stability in this area (see sketch).

17Y106 PVC Profile Material

Second layer of 616G15 Carbon Stockinette

First layer of 616G15 Carbon Stockinette

30 – 40 mm / 1,2 – 1,6 inch 50 mm / 2 inch

Lead the carbon fiber stockinette over the PVC pro-file material and make sure that the fibers are taut. Wrapping around a normal sewing thread (waxed pack-thread should not be used) helps to bring the carbon fiber stockinette closer to the core material.

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Isolate the plaster model with a PVA bag (e.g. 99B81=130×19×5) and apply a piece of 627B4 PE Adhesive Tape to the surfaces above the alignment adapter to protect them from tearing.

5.4 Reinforcement of the Model

Pull one layer of Perlon stockinette tightly over the model.

Apply a small amount of 636N9 Otto Bock Contact Adhesive to the stockinette above the alignment adapter. After drying, cut in the stockinette.

Attach 616F10=6 Double-Faced Adhesive Tape to the unidirectional (UD) 616B2 Carbon Webbing. Use as little adhesive tape as possible. If the adhesive tape is not used properly, it can prevent soaking of the carbon fibers. During lamination, always make sure that the material gets well soaked by the lami-nation resin.

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To reinforce the foot part, apply 1 longitudinal layer and 1 transversal layer of UD carbon webbing. The entire surface of the foot part up to the roll-over edge must be covered with UD carbon webbing. Laterally, a minimum of 20 mm / 0,8 inch between the carbon fiber material and the lower edge of the ankle joint dummy should remain free.

Apply 1 circular layer of UD carbon webbing in the areas of the support surfaces.

Apply 1 layer of UD carbon webbing in the medial area of the support surface above and below the knee joint.

To reinforce the hook and loop closure attachment zones, 2 pieces of 616G12 Carbon Fiber Cloth can be applied.

The shaped UL bars have already been fixed in the knee joint dummy to prevent them from slipping out. Seal the bore holes on the rear side of the knee joint dummy with 636K8 Plastaband. This will make it easier to get the UL bars out of the dummy after lamination and curing.

20 mm /0,8 inch

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Apply a bit of Plastaband above the alignment adapt-ers around the thread and then prick the PVA bag.

Mount the prepared bar assembly to the model but do not yet completely screw in the screws.

Fix the reinforced bands to the model. Split the stock-inette in the connection area and lay one part below and the other part over the UL bar.

Finally cover with a piece of UD carbon webbing.

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Medial view of the tibial band.

Snugly tighten the screws of the joint dummies and seal the screws with Plastaband.

Fill any hollow spaces with 617V12 Perlon Fleece (Dacron) to avoid air inclusions in the laminate.

UL joint bar system with dummies on the plaster model.

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UL foot part with ankle joint dummy.

Pull one layer of Perlon stockinette over the model. As an alternative, Nylglas stockinette can be used.

For the long-sole foot part of the orthosis we rec-ommend using a cut piece of 2 layers of 616G12 Carbon Fiber Cloth with 45° fiber orientation (see sketch).

Wal

king

dir

ectio

n

18


Again, apply 1 longitudinal layer and 1 transversal layer of UD carbon webbing of corresponding width to the foot part. Again, make sure that on the lateral side, a minimum of 20 mm / 0,8 inch between the carbon fiber material and the lower edge of the ankle joint dummy remains free.

Apply 1 layer of UD carbon webbing longitudinally in the medial area of the support surfaces.

Medial and lateral view.

Pull over 1 layer of Perlon stockinette. As final layer, either design fabric (e.g. 623S5=15 Fabric for Lami-nation “Blue Star”) or another layer of Perlon Stocki-nette can be used.

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Verify the position of the bands, pull over a PVA bag, apply vacuum to the model and make sure that the PVA bag is tight. Apply talcum to the PVA bag.

To prevent that the carbon fiber material shines through, a small amount of white color (617Z4) is added to the 617H55 C-Orthocryl® lamination resin mixture. Use only lamination resins from Otto Bock, since they are specially designed to match the carbon fiber material. To avoid overheating during curing, an amount of 1.5 % of hardener should be added.

Evenly and slowly distribute the lamination resin on the model and make sure that the material is properly soaked.

5.5 Removal from the Model and Trial Fitting of the OrthosisBefore removing the orthosis from the model, mark the brim course of the orthosis and cut the joint dum-mies free.

20


Remove the screws from the knee joint and ankle joint dummy.

Separate the thigh part from the tibial part.

Carefully cut along the separation edge using an os-cillating saw. The tibial bar and foot stirrup must not be damaged.

Separate the foot part from the tibial part.

21


Remove the rests of the dummy from the bar. Heating is not required.

Grind the orthosis.

Attention!The UL bar must not be damaged by grinding, since this would compromise the function and stability of the orthosis and thus threaten the patient’s safety.

For trial fitting, connect the knee joint to the orthosis with two M4 screws. Glueing of the components will only be made when finishing the orthosis.

To mount the ankle joint, select the corresponding joint insert and slide it onto the tibial bar until the bore holes are congruent.

Attach the ankle joint, insert the joint axis, and slide on the lock washer. For better handling we recom-mend attaching the lock washer laterally on the joint.

22


For the foot lever function, insert the holding pin into the ankle joint and secure with Loctite 241 (636K13). Slide the O-ring over the tibial bar and mount the ankle joint. Finally, stretch the O-Ring over the hold-ing pin.

Stick self-adhesive 623Z8 Hook Strip onto the ortho-sis for trial fitting and close the orthotic shells with hook and loop straps. Glue together the foot part and ankle joint using 636W28 Otto Bock Special Adhesive. Glueing can also be made at a later point in time. For trial fitting, the lower part and upper part of the knee joint can be fixed to the orthosis with a 501T19 Countersunk Head Screw. Any occurring play is due to the tolerance between the joint’s con-nection plug and bar. These small tolerances are re-quired in order to have a little space for the adhesive.

The UL knee joint can optionally be equipped with a toggle switch that temporarily unlocks the knee joint (e.g. for bicycling). Insert the button and toggle switch into the front hole of the UL knee joint and then press in the grooved pin. Further information is contained in the 647G103 Mounting Instructions.

23


When handing over the orthosis, the joint bar com-ponents must be glued in place with 636W28 Otto Bock Special Adhesive. The previously used screws may be removed because they have no holding func-tion.

5.6 Finishing the Orthosis

Glueing the knee joint

Glueing the ankle joint

Besides different padding materials for the lining, ex-changeable padding fabrics can also be used (e.g. 623P3 Terry Cloth Padding Fabric). These can be removed by the patient for washing and afterwards reattached by hook and loop closure. For the hook and loop connection we recommend self-adhesive 623Z4=50-6 Micro Hook Strip. For optimal adhe-sion of the micro hook strip, apply a small amount of 636N9 Otto Bock Contact Adhesive to the orthotic surfaces to which the strip will be attached.

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The 623P5 Padding Tape serves as padding below the hook and loop closures. For fixation, again, use micro hook strop.

Apply the orthosis.

For evaluation of the sagittal alignment we recom-mend verification of the patient with applied orthosis on the L.A.S.A.R. Posture. The load line, projected by the laser onto the leg, should at best be 15 mm before the compromise pivot point according to Niet-ert (also refer to the alignment instructions contained in the UL knee joint’s Instructions for Use 647G200).

25


Final fit and function control of the orthosis on the patient.

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Fitting examples with the UL Joint System

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RGO 17H100Please use separate measurement form for ordering.Information sheet, ref. no. 646S3=4.04GB.

Connectors between RGO and 17LK1=* Knee Joint 17LH100=2–3 17LH100=1–2 17LH100=2–2 17LH100=1–1

Unilateral Knee Joint17LK1=L/R3-5 L R 17LK1=L/R2-5 L R17LK1=L/R1-5 L R

17LS1=* System Bar

3

2

1

100 cm / 39,4 inch length

Unilateral Ankle Joint17LA1=3 17LA1=2 17LA1=1

Foot Stirrup Split Foot Stirrup17LF1=3 17LF2=3 L R 17LF1=2 17LF2=2 L R 17LF1=1 17LF2=1 L R

Company

Customer no.

Technician Signature

Fax Order Form for Unilateral Joint System

Name Weight kg lbs

First name Lower leg length cm inch

Indication Age years

Side left right bilateral reciprocating gait orthosis

Otto Bock HealthCare GmbHMax-Näder-Straße 15 · 37115 Duderstadt · www.ottobock.com

Europe Otto Bock HealthCare Deutschland GmbH Max-Näder-Str. 15 · D–37115 DuderstadtTel. +49 5527 848-3411 · Fax +49 5527 848-1414e-mail: [email protected] · www.ottobock.com

Otto Bock Healthcare Products GmbH Kaiserstraße 39 · A–1070 WienTel. +43 1 5269548 · Fax +43 1 5267985e-mail: [email protected]

Otto Bock Adria Sarajevo D.O.O. Omladinskih radnih brigada 5 · BIH–71000 SarajevoTel. +387 33 766200 · Fax +387 33 [email protected] · www.ottobockadria.com.ba

Otto Bock Suisse AG Pilatusstrasse 2, Postfach 87 · CH–6036 DierikonTel. +41 41 4556171 · Fax +41 41 4556170e-mail: [email protected]

Otto Bock ČR s.r.o. Protetická 460 · CZ–33008 Zruč-SenecTel. +420 37 7825044 · Fax +420 37 7825036e-mail: [email protected] · www.ottobock.cz

Otto Bock Algérie E.U.R.L. 32, rue Ahcène outalab - Coopérative les MimosasMackle-Ben Aknoun - Alger · DZ–AlgérieTel. + 213 21 913863 · Fax + 213 21 913863e-mail: [email protected] · www.ottobock.fr

Otto Bock Iberica S.A. C/Majada, 1 · E–28760 Tres Cantos (Madrid)Tel. +34 91 8063000 · Fax +34 91 8060415e-mail: [email protected] · www.ottobock.es

Otto Bock Egypt S.A.E. 115, El- Alameen St. · Mohandeseen – Giza · ET–EgyptTel. +20 23 302 43 90 · Fax +20 23 302 43 80e-mail: [email protected] · www.ottobock.com.eg

Otto Bock France SNC 4 Rue de la Réunion · B.P. 11F–91941 Les Ulis CedexTél. +33 1 69188830 · Fax +33 1 69071802e-mail: [email protected] · www.ottobock.fr

© DiskArt™ 1988

Otto Bock Healthcare plc 32, Parsonage Road · Englefi eld GreenGB–Egham, Surrey TW20 0LDTel. +44 1784 744900 · Fax +44 1784 744901e-mail: [email protected] · www.ottobock.co.uk

Otto Bock Hungária Kft. Tatai út 74. · H–1135 BudapestTel. +36 1 4 5110 20 · Fax +36 1 4 5110 21e-mail: [email protected] · www.ottobock.hu

Otto Bock Adria D.O.O. Dr. Franje Tuđmana 14 · HR–10431 Sveta NedeljaTel. +385 1 3361544 · Fax +385 1 3365986e-mail: [email protected] · www.ottobock.hr

Otto Bock Italia S.R.L Via Filippo Turati 5/7 · I–40054 Budrio (BO)Tel. +39 051 692-4711 · Fax +39 051 692-4720e-mail: [email protected] · www.ottobock.it

Otto Bock Benelux B.V. Ekkersrijt 1412 · NL–5692 AK-Son en BreugelTel. +31 499 474585 · Fax +31 499 4762 50e-mail: [email protected] · www.ottobock.nl

Industria Ortopédica Otto Bock Unip. Lda. Av. Miguel Bombarda, 21 - 2º Esq.P–1050-161 LisboaTel.: +351 21 3535587 · Fax: +351 21 3535590e-mail: [email protected]

Otto Bock Polska Sp. z o. o. Ulica Koralowa 3 · PL–61-029 PoznańTel. +48 61 6538250 · Fax +48 61 6538031e-mail: [email protected] · www.ottobock.pl

Otto Bock Romania srl Șos de Centura Chitila-Mogoșoia Nr. 3RO–Chitila 077405, Jud. IlfovTel. +40 21 4363110 · Fax +40 21 4363023e-mail: [email protected] · www.ottobock.ro

OOO Otto Bock Service p/o Pultikovo, Business Park „Greenwood“, Building 7, 69 km MKADRUS–143441 Moscow Region/Krasnogorskiy RayonTel. +7 495 564-8360 · Fax +7 495 564-8363e-mail: [email protected] · www.ottobock.ru

Otto Bock Scandinavia AB Koppargatan 3 · Box 623 · S–60114 NorrköpingTel. +46 11 280600 · Fax +46 11 312005e-mail: [email protected] · www.ottobock.se

Otto Bock Slovakia s.r.o. Čajákova 25 · SK–81105 Bratislava 1Slovenská RepublikaTel./Fax. 00421 2 52 44 21 88 e-mail: [email protected] · www.ottobock.sk

Otto Bock Sava d.o.o. Maksima Gorkog bb · 18000 Niš, Republika SrbijaTel./Fax +381 18 539 191e-mail: [email protected] · www.ottobock.rs

Otto Bock Ortopedi ve Rehabilitasyon Tekniği Ltd. Şti. Ali Dursun Bey Caddesi · Lati Lokum SokakMeriç Sitesi B Block No: 6/1TR–34387 Mecidiyeköy-İstanbulTel. + 90 212 3565040· Faks +90 212 3566688e-mail: [email protected] · www.ottobock.com.tr

AmericasOtto Bock Argentina S.A. Piedras, 1314 - Código Postal: RA–1147 Ciudad Autônoma de Buenos AiresTel. + 54 11 4300 [email protected]

Otto Bock do Brasil Ltda. Rua Jovelino Aparecido Miguel, 32 BR–13051-030 Campinas-São PauloTel. +55 19 3729 3500 · Fax +55 19 32 69 [email protected] · www.ottobock.com.br

Otto Bock HealthCare Canada Ltd. 5470 Harvester Rd, Burlington, Ontario L7L 5N5CA–CanadaTel. +1 289 288-4848 · Fax +1 289 288-4837e-mail: [email protected] · www.ottobock.ca

Otto Bock HealthCare Andina Ltda. Clínica Universitária Teletón, Autopista Norte km 21La Caro · Chia, Cundinamarca, Bogotá/ColombiaTel. +57 1 8619988 · Fax +57 1 8619977e-mail: [email protected]

Otto Bock de Mexico S.A. de C.V. Av. Avila Camacho 2246 · Jardines del CountryMEX–Guadalajara, Jal. 44210Tel. +52 33 38246787 · Fax +52 33 38531935e-mail: [email protected]

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Asia/Pacifi c© DiskArt™ 1988

Otto Bock Australia Pty. Ltd. Suite 1.01, Century Corporate Centre62 Norwest Boulevarde · Norwest Business ParkAUS–Baulkham Hills NSW 2153Tel. +61 2 88182800 · Fax +61 2 88182898e-mail: [email protected]

Beijing Otto Bock Orthopaedic Industries Co. Ltd. HengXiang Tower · No.15 Tuanjiehu South RoadChaoyang District · Beijing 100026 · P.R.ChinaTel. +86 10 85986880 · Fax +86 10 [email protected] · www.ottobock.com.cn

Otto Bock Asia Pacifi c Ltd. Suite 3218, 32/F., Sun Hung Kai Centre30 Harbour Road, Wanchai · Hong KongTel No. +852 2598 9772 · Fax No. +852 2598 7886e-mail: [email protected]

Otto Bock HealthCare India Pvt. Ltd. Behind Fairlawn Housing SocietySion Trombay RoadChembur · IND–Mumbai 400 071Tel. +91 22 2520 1268 · Fax +91 22 2520 1267e-mail: [email protected]

Otto Bock Japan K. K. Yokogawa Building 8F · 4-4-44 Shibaura, Minato-kuJ–Tokyo 108-0023Tel. +81 3 3798-2111 · Fax +81 3 3798-2112e-mail: [email protected]

Otto Bock Korea HealthCare Inc. Beakyoung B/D 2FL · 37-22, Samsung-dongGangnam-gu · ROK–Seoul 135-090Tel. +82 2 577-3831 · Fax +82 2 577-3828e-mail: [email protected]

Otto Bock South East Asia Co. Ltd. 1741 Phaholyothin Road,Kwaeng Chatuchark, Khet Chatuchark,T–Bangkok 10900Tel. +66 2 930 3030 · Fax +66 2 930 3311e-mail: [email protected]

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Otto Bock HealthCare GmbHMax-Näder-Straße 15 · 37115 Duderstadt / Germany · www.ottobock.com

fabrication of lower extremity orthoses in lamination technique … · 2015. 3. 8. · fabrication...

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