Orthoses in the treatment of rearfoot problems

Abstract

Orthotic management is helpful in the treatment of most orthopedic conditions involving the rearfoot, including plantar fasciitis, Achilles tendon disorders, posterior tibial tendon dysfunction, flatfoot, ankle sprains, and problems associated with diabetes, arthritis, and equinus disorders. A review of the effectiveness of orthoses in the treatment of these conditions is presented here. An in-depth analysis of the orthotic management of plantar fasciitis and a critical review of foot orthoses for the pronated foot are presented. Also discussed are the rationale and effectiveness of the tension night splint in the treatment of plantar fasciitis, orthotic devices for the different stages of posterior tibial tendon dysfunction, and the various categories of orthoses for off-loading the diabetic foot. The modern ankle brace, the effectiveness of prefabricated versus prescription foot orthoses, and recent developments in the ankle-foot orthosis are also reviewed.

Therapeutic footwear for people with diabetes

“…Shoes with no loadbearing surface under the forefoot have been shown to be effective in healing plantar ulcers in 70 days [13], and various forms of braces or walkers are also in use [14]. The TCC, as originally proposed by the Carville group, [12] may completely unload the ulcer site since soft foam placed over the wound forms a cavity in the cast.…”

Assessment of the influence of foot orthoses in the hip loading conditions during walking: a single case study

“…The major studies taking into account large series concern healthy subjects ( Lafortune et al 1994;Crenshaw et al 2000;Stacoff et al 2000;Nester et al 2003) or patients affected with knee or foot pathologies (Eng and Pierrynowski 1994;Giffin et al 1995;Sobel et al 1999). Patients affected with coxarthrosis are rarely treated with foot orthoses due to the difficulty to predict the influence of foot orthoses at the hip joint.…”

“…The major investigations usually concern the effect of foot orthoses on the treatment of pathologies such as gonarthrosis (Yasuda and Sasaki 1987;Keating et al 1993;Giffin et al 1995;Pham et al 2004), patellofemoral pain syndrome Pierrynowski 1993, 1994;Saxena and Hadda 2003), rearfoot problems (Thompson et al 1992;Sobel et al 1999), deficiencies due to cerebral palsy (Hassani et al 2004;Davids et al 2007) and scoliosis (D'Amico 2002). Even if foot orthoses are useful in the treatment of a very large range of painful conditions, to our knowledge, results about the treatment of coxarthrosis have not been published yet.…”

Recurrence after correction of acquired ankle equinus deformity in children using Ilizarov technique

“…Prevention is achieved through avoiding the predisposing factors, physical therapy and splinting. In cases with established equinus, treatment includes physical therapy, manipulation and casting in mild cases [ 2 , 3 ]. In severe cases, this may need a soft tissue release by tendo-Achilles lengthening, with or without a posterior ankle capsulotomy, and lengthening of other contracted soft tissues including the skin by microsurgical soft tissue transfer [ 4 , 5 ].…”