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.
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.
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.
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.
How do you handle patients who do not tolerate or find comfort from... Read More.
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.
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.
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.
When it comes to understanding the effect of functional hallux limitus (Fhl) on foot function, Howard Dananberg, DPM, has published over 30 articles on the subject. “Early on, it was quite challenging to convince other DPMs of the relationship of the metatarsophalangeal joint’s mobility during walking to late midstance pronation,” notes Dr. Dananberg. “Since that time, many have gravitated to the... Read More.
Muscle strength testing is not always part of a standard podiatric biomechanical evaluation. Unfortunately, muscular weakness can often influence function and, if undetected, can lead to chronic pain in the joints which the weakened muscles support. There are several reasons for muscular weakness, but the most common cause is chronic inhibition signaling from the CNS. Since motor signals to... Read More.
Injuries to the second metatarsophalangeal joint (MPJ) can be challenging to treat. Our expert panelists discuss predisposing factors to injury and review pertinent biomechanical considerations. They also discuss conservative treatment options, including variations of orthotic therapy and modifications that they have employed in clinical practice.
Q: What are the predisposing factors (gender,... Read More.