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Application procedure I<br />
Valve functions<br />
Attaching and changing the sole<br />
(1) (2)<br />
Bean bag becomes s<strong>of</strong>t:<br />
Pull valve rim, then bend<br />
valve gently sideways<br />
guiding line<br />
2.)<br />
1.)<br />
Open valve on vacuum cushion (see also valve functions)<br />
and remove the front shell. Place foot in inner boot and<br />
close Velcro tabs. Then insert foot with inner boot in shell.<br />
Application procedure II<br />
Bean bag fixed in place:<br />
Push down the valve rim<br />
and <strong>use</strong> the pump<br />
Removal: Pull down both levers at the same time to<br />
unlock (1) and the push the sole toward the back to<br />
remove (2).<br />
Insert front (ventral) adapter<br />
• Insert adapter on one side (top and bottom at<br />
the same time, see diagram)<br />
• Pull rubber and insert in the same way<br />
on the other side<br />
• For freedom <strong>of</strong> movement at ROM 10° - 0° - 10°,<br />
remove front adapter and do not replace<br />
Insert spreader (1)<br />
In cases <strong>of</strong> a severely swollen ankle, the spreader creates<br />
more space in the rear (dorsal) shell.<br />
• Attach spreader (as illustrated) to the guiding line<br />
on the dorsal shell<br />
• Press the center <strong>of</strong> the spreader inwards with both<br />
hands and assure that the spreader clicks into place<br />
Close valve cap<br />
2.)<br />
Replacement: Do not depress side levers when replacing<br />
sole. Align the raised plastic barbs on the foot sole to the<br />
open slots <strong>of</strong> the boot. Push the sole forward and an<br />
audible click will be heard. Inspect that all the connectors<br />
are secured.<br />
1.)<br />
Use <strong>of</strong> Achilles pad (VACO ® achill only)<br />
Remove spreader (2)<br />
• Press the locking spring inwards on one side with the<br />
thumb, keeping the index and middle fingers on the<br />
outer edge <strong>of</strong> the spreader<br />
• Repeat this procedure on the other side<br />
• Remove spreader<br />
Note: In the US, the ankle spreader is sold separately.<br />
Put on front shell and close straps. The recommended<br />
sequence is as shown in the diagram. For optimum adjustment,<br />
patients who are allowed weight bearing should take<br />
a few steps and then re-adjust the tension <strong>of</strong> the straps.<br />
Application procedure III<br />
Attach the vacuum pump to the valve stem and<br />
evacuate the air. The vacuum cushion will feel hard to the<br />
touch. Remove pump and close valve cap. Check and if<br />
necessary re-adjust the tension <strong>of</strong> the straps.<br />
Exchange <strong>of</strong> terry cloth liner<br />
Opening<br />
for valve<br />
The vacuum cushion is placed inside a terry cloth liner<br />
similar to a pillow inside a case. To get it out, open the<br />
zipper in the back and pull out the vacuum cushion. When<br />
getting the vacuum cushion back into a liner, please<br />
assure that all the wings are inserted properly. Evacuating<br />
the vacuum cushion will make insertion easier. Close the<br />
zipper all the way.<br />
Adapter<br />
The rear adapter is <strong>use</strong>d to change the position <strong>of</strong> the<br />
boot to 0°, 15° or 30°. When the adapter is placed in the<br />
boot the number 0° is at the top and the 30° at the<br />
bottom. The adapter screw has two openings for the key.<br />
Turn the key, positioning the arrow to the open position<br />
and remove the adapter. Adjust the boot by moving the<br />
back (calf) portion. Once in the correct position, insert the<br />
key, turn until the arrow on the adapter points to the<br />
lock position. When the rear adapter is set in a neutral or<br />
0° position, the 0° band on the front shell should be <strong>use</strong>d.<br />
It is recommended to insert the Achilles Pad while using<br />
the VACO ® achill in the 30° plantar flexion position. Place<br />
the Achilles Pad on the inside <strong>of</strong> the posterior rigid shell.<br />
Slide the top portion <strong>of</strong> Achilles Pad under the boot strap,<br />
then snap the hooks in place.<br />
Important safety <strong>instructions</strong><br />
If any pain, numbness in the toes or blueness <strong>of</strong> the<br />
feet cannot be corrected by repeating the adjustment<br />
procedure, see a doctor immediately. Medical<br />
treatment is required in these circumstances.<br />
Always check that the sole is firmly in place and<br />
never walk without a sole – DANGER OF SLIPPING! Do<br />
not walk without front shell being properly attached<br />
and secured by girth straps.<br />
• It is not recommended that patients drive an<br />
automobile while wearing the VACO ® ped<br />
• Ensure that all girth straps are securely tightened<br />
• Inspect the device prior to application for tears,<br />
holes or other damage, particularly after washing.<br />
If you suspect that a device is damaged, contact<br />
your OPED representative