Safety principles of orthotic fabrication include all of the following except:

• A. Avoid bony prominences
• B. Follow proper biomechanical principles
• C. Avoid shear forces
• D. Ensure client will wear orthotic at all times

Answer: (D)

Safety in orthotic fabrication focuses on preventing tissue injury by designing a device that distributes pressure properly, follows the body's biomechanics, and minimizes sliding that can cause shear. Contouring to avoid bony prominences helps prevent pressure ulcers, so the device doesn’t press directly on delicate bony areas. Adhering to proper biomechanical principles ensures the orthosis applies forces and supports in the intended directions, promoting stability and function without causing new misalignments. Reducing shear forces means smoothing contact surfaces, avoiding sharp edges, and securing components so the foot or limb doesn’t slide inside the device, which protects skin and underlying tissues from friction injuries.

The statement about ensuring the client will wear the orthotic at all times isn’t a fabrication safety principle. While patient adherence is crucial for effectiveness and outcomes, it relates to clinical use and education rather than the safety considerations built into the fabrication process. The orthosis should be designed to be as comfortable and functional as possible, but you can’t guarantee wear at all times just from fabrication principles.