Fabrication Notes of an Interlock Style T.L.S.O.
by Jeff VanSickle, R.T.O.

Working with T.L.S.O.'s

  1. Use sisal rope for vacuum. Wrap around the pipe and staple in place as shown in figures A and B.
    Fig. AFig. B

  2. Add a layer of cotton stockinet and staple in place on anterior side with no loose spots.
  3. Apply 3/16 inch aliplast with vacuum to posterior covering entire area without any wrinkles. Staple in place with tension. Perforate the aliplast.
  4. Use scraps of 1/8 inch anliplast to cap top, bottom, and anterior to ensure vacuum.
  5. Use 3/16 inch polyethylene to pull posterior section. Heat oven to 350 degrees.
  6. Cut posterior section leaving excess material on all sides, especially where the overlap of the posterior and anterior occurs.
  7. Using a marker, draw exact trim lines on posterior and trim down to those lines given by the clinician.
  8. Buff those edges.
  9. Remove sisal rope an any unwanted cotton stockinet. Fill staple holes with plaster or any areas damaged by cutting off posterior sections
  10. Put cotton stockinet over cast to fit tightly (down size if necessary) using staples only on top and bottom beyond trip lines.
  11. Put trimmed and buffed posterior section on coast.
  12. Rubber cement a 3.4 X 1/2 inch strip of plastazote to run from tope to bottom in the middle of the posterior section. Use heat from the oven to make the strip easier to apply on top of the posterior section.
  13. Wrap a piece of sisal rope around the pipe and run it over the top of the plastazote securing it with electrical tape. also continue the rope into the bottom of the cast so vacuum extends to the bottom.
  14. Apply another layer of cotton stockinet (again tight) with staples on the top and bottom beyond trim lines. Flip anterior side up.
  15. Using 3/16 inch aliplast, vacuum from a measured piece around the anterior. Perforate inside trim lines.
  16. Remove this piece and trim the overlapping edge leaving a 1/2 inch overlap. Scythe the edge (see figure C).
  17. Staple trimmed anterior liner of 3/16 inch aliplast in place and again cap with 1/8 inch aliplast for vacuum.. Staple only beyond trimlines. spray overlap with silicone.
  18. Using 3/16 inch polyethylene, pull anterior section.
  19. Trim and buff anterior section according to trim lines. Note that 2 1/2 inch is the standard overlap length except on tiny TLSO's which are smaller to match in proportion.
  20. Add straps and chafes as indicated. Most commonly used is 6-1 1/2 inch chafes (3 on each side) located at the anterior, and 6- 1 1/2 inch x 13 inch dacron straps located at the posterior.
  21. Add ventilation holes.