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Prosthetics Lower Extremities - Kinetech Medical

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Page 3 of 3<br />

Modular Foot System<br />

Chopart Plate<br />

Min. clearance: 17-24 mm<br />

Crepe soles are included in delivery.<br />

Please indicate the footshell and the glue set in the selection<br />

below (footshell, fill foam).<br />

1E80 Chopart with 0 mm heel height<br />

1E81 Chopart with 9 mm heel height<br />

1E82 Chopart with 19 mm heel height<br />

Chopart Plate Pediatric<br />

Minimal clearance: 17 mm<br />

Crepe soles are included in delivery.<br />

1E87 Chopart with 6 mm heel height<br />

Lo Rider<br />

A spectra-sock and crepe soles are included in delivery.<br />

Axtion®<br />

A spectra-sock and crepe soles are included in delivery.<br />

Please indicate the footshell in the selection below<br />

(footshell).<br />

1E56 Axtion® with 13 mm heel height<br />

firm medium soft<br />

(Standard heel firmness is medium.)<br />

SL Profile Pediatric<br />

A spectra-sock and crepe soles are included in delivery.<br />

Please indicate the footshell in the selection below<br />

(footshell).<br />

1E79 SL Profile with 6 mm heel height<br />

Please indicate the footshell in the selection below<br />

(footshell).<br />

1E57 Lo Rider with 9 mm heel height<br />

Alternative adapter<br />

XO Coupler for Lo Rider<br />

SL=LR-XOCS-M6<br />

SL=LR-XOCL-M6<br />

SL=LR-XOCL-5/16<br />

(diameter 73 mm)<br />

(diameter 85 mm*)<br />

* Delivered version depends on Mobility Grade and body weight.<br />

Footshells<br />

for Chopart, Lo Rider (sizes 24 – 31 cm), Axtion®<br />

Quantity Order no. Sizes Colors<br />

2C5= /<br />

Side Size Color<br />

22-31 cm<br />

4 15<br />

beige light brown<br />

SL=P078 Chopart Bonding Kit<br />

SL=PO71 Footshell Foam Kit (optional)<br />

2C100 Removal Tool (steel)<br />

SL=Spectra-Sock Protective Sock<br />

for Lo Rider (sizes 22 – 23 cm)<br />

Quantity Order no. Sizes<br />

SL=M<br />

SL=F<br />

Size<br />

Size<br />

Side<br />

Side<br />

23 cm for men<br />

22 – 23 cm for women<br />

for Chopart Plate Pediatric<br />

Quantity Order no. Sizes<br />

2E3=<br />

Side<br />

Size<br />

13 – 21 cm<br />

Date _____________ Place _____________________________<br />

Signature ___________________________________<br />

Otto Bock HealthCare GmbH | <strong>Prosthetics</strong> – <strong>Lower</strong> <strong>Extremities</strong> | www.ottobock.com 283

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