Orthotics Q&A

Guest Clinical Editor: Lawrence Huppin, DPM
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   The development of new materials and technologies has had an impact on orthotics and biomechanics. These expert panelists discuss the technologies they have found helpful. In particular, they assess the impact of pressure analysis and how it can influence the writing of effective orthotic prescriptions. They also discuss common orthotic modifications and which orthotic materials... Read More.
Guest Clinical Editor: Bruce Williams, DPM
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   Metatarsalgia is one of the more commonly seen complaints in any podiatry practice. Common treatments for the disorder include ice, removable metatarsal pads, antiinflammatories, injected steroids and physical therapy. While such treatments often completely resolve an acute bout of metatarsalgia, they often do nothing to remedy the true underlying biomechanical causes of the... Read More.
Guest Clinical Editor: Bruce Williams, DPM
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Although what one learned in podiatric medical school is invaluable in a podiatry career, sometimes podiatrists may encounter a different reality in clinical practice. These expert panelists weigh what they learned in school with their experience and the current research. They also detail which directions future orthotic research should take. Q: What is the current research telling us about how... Read More.
Guest Clinical Editor: Douglas Richie Jr., DPM
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   Over the last decade, there have been a variety of changes and trends that have shaped the evolution of orthotic therapy. Accordingly, our expert panelists discuss pertinent orthotic prescription trends. They also examine the importance of having a strong background in biomechanics and whether the podiatric profession is “giving away” its biomechanics expertise to non-podiatric... Read More.
Guest Clinical Editor: Lawrence Huppin, DPM
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      Given the increased emphasis on evidence-based medicine, our expert panelists review the impact of literature findings upon their prescription of custom foot orthoses for different pathologies.       Q: Is there evidence in the literature to support the use of functional orthotic devices?       A: The only supporting evidence relative to... Read More.
Guest Clinical Editor: Scott Spencer, DPM
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     In this month’s discussion, our expert panelists discuss the importance of an arthrometric exam, whether one should lean more toward accommodation or control with orthotic prescriptions, and share a few key pearls they have learned over the years in optimizing the effectiveness of prescription orthoses.      Q: Do you feel that the arthrometric examination plays... Read More.
Guest Clinical Editor: James Losito, DPM
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In this edition of “Orthotics Q&A,” the panelists discuss various issues ranging from indications for the Richie Brace, Arizona AFO and prefabricated orthoses to whether orthotic casting should reduce supinatus. Without further delay, here is what the panelists had to say. Q: What are the indications for using a Richie brace versus using an Arizona brace? A: For Doug Richie Jr., DPM, each... Read More.
Guest Clinical Editor: Edwin Harris, DPM
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Pediatric equinus can be a challenging condition to diagnose and treat. With this in mind, these expert panelists discuss the differential diagnosis, the positioning of orthoses to control the condition, and the benefits that various modalities can have in managing the condition. Q: How do you narrow down the differential diagnosis of pediatric equinus?A: Edwin Harris, DPM, cites several possible... Read More.
Guest Clinical Editor: David Levine, DPM, CPed
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Despite the success rate one may have with orthotic devices, sometimes patients may not tolerate the devices. These expert panelists discuss treating patients who do not tolerate orthoses, when orthoses need to be replaced, which orthotic materials may lead to success and how shoes affect orthotic function.     Q: How do you handle patients who do not tolerate or find comfort from... Read More.
Guest Clinical Editor: Scott Spencer, DPM
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Q: How do you evaluate a patient for foot orthotic devices? A: All three panelists will perform a gait analysis. Russell Volpe, DPM, begins by assessing what he wants the orthosis to accomplish once he decides a CFO is indicated. If control of motion is needed, he will tailor material selection and many of the plaster modifications and prescription items to help accomplish that goal. If Dr. Volpe... Read More.
Guest Clinical Editor: Edwin Harris, DPM
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Given that toe walking and other gait disturbances are common among children, these expert panelists take a closer look at these conditions, offer keys to the diagnostic assessment and share their insights on appropriate treatment modalities and physical therapy regimens. Q: What is your treatment plan for children with diplegia and hemiplegia?A: Mary Keen, MD, says most children with diplegia... Read More.
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Charcot arthropathy is an extremely challenging disease process to treat for many reasons, according to David Levine, DPM, CPed. He says one of the big problems is not being able to rely upon the patient for feedback. Given the profound peripheral sensory neuropathy present in these patients, Dr. Levine says vigilant monitoring of any changes in the foot is essential for preventing further... Read More.