Saturday, May 17, 2008

Insoles with Custom Shoes - 5th Toe Amputation

DIAGNOSIS: Diabetes and osteomyelitis and 5th toe amputation left foot.

RX: Shoes and insoles

HISTORY: 58-year-old female no known allergies, diabetic 5th toe amputation due to infection. Patient presents with residual Charcot joint with a history of previous ulcerations. Her skin integrity is good. She has neuropathy below the knee bilaterally. Patient can dorsiflex to 90 degrees bilaterally, but the left foot only dorsiflexes to 90 degrees through pronation by pronating. She has pitting edema bilaterally.

ORTHOTIC GOAL: To protect the foot from mechanical stresses and shear forces.

PLAN: Fabricate bilateral total-contact insoles with custom shoes. Custom shoes chosen because of the difference between the left and right feet.

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