What are Paediatric Supramalleolar Orthoses (SMO)?
Supramalleolar orthoses (SMO) are a form of ankle-foot orthosis (AFO) for children, which is a medical device to help guide the gait development of a child. Unlike the AFO, SMO’s support extends just above the ankle bones (malleoli) and is less visible when worn in shoes.
SMO are most commonly in children with paediatric flat feet, particularly to improve their stability and allow them to develop better motor functions. SMOs are also used in other conditions such as toe-walking or metatarsus adductus.
Function of SMO
Children with flat feet or excessively hypermobile foot joints struggle to stabilise themselves when standing or walking. They often trip or fall, or even complain of tired legs. These are due to excessive pronation in gait, where their ankles are rolling in excessively and creating a chain effect up their lower limbs.
The function of SMO is therefore to align the structure of the foot through compression support. It aims to control the amount of pronation when a child walks and increase the structural stability of the foot, allowing motor functions to develop normally. This is only achievable when the devices are made unique to the child’s feet and are worn snugly.
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Conditions Managed with SMO
Children with flat feet or excessively hypermobile foot joints struggle to stabilise themselves when standing or walking. They often trip or fall, or even complain of tired legs. These are due to excessive pronation in gait, where their ankles are rolling in excessively and creating a chain effect up their lower limbs.
The function of SMO is therefore to align the structure of the foot through compression support. It aims to control the amount of pronation when a child walks and increase the structural stability of the foot, allowing motor functions to develop normally. This is only achievable when the devices are made unique to the child’s feet and are worn snugly.
Conditions Managed with SMO
SMO are custom-made devices prescribed by Podiatrists, and they are multiple additions or modifications that can be made to treat specific conditions.
Conditions managed with SMO include:
- Paediatric flat feet
- Joint hypermobility or hypotonia
- Developmental delays in lower limb functions
- Toe-walking
- Metatarsus adductus
- Club foot
SMO @ Straits Podiatry
Paediatric lower limb conditions are a niche within Podiatry. Podiatrists need to be able to recognise problems, differentiate between normal and abnormal development, and perform the right assessment and treatment. We frequently see cases where parents fall prey to anxiety and put children through unnecessary treatments.
At Straits Podiatry, children will undergo a thorough assessment before we recommend any treatment options. Should SMO be necessary, the child will first undergo the following:
- Foot posture analysis using 3D scanning technology
- Musculoskeletal assessment
- Visual gait analysis
- Postural assessment
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