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Foot Care - Alternative Offloading Devices
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Prefabricated sandals or healing
shoes vary in design, materials and intention of use. For
some patients these devices offer better fit, support, protection
and comesis than our standard options.
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If the treatment of choice
being cast or splint is contraindicated there are numerous
choices available. It is our experience that these devices
still require some type of molded footbed to adequately provide
pressure relief and structural support.
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We intend the use of such
devices, much like the use of the Carville sandal, as an interim
or a household device. We consider the use of these devices
as adequate but not optimal.
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Toe pillows and toe crests
can be fabricated from a variety of different materials to provide
local direct relief to one or more toes.
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Adhesive backed felt cut out
to relieve the ulcerated area can also be applied to the foot
and left on for up to a week. The wound is covered with
one 2" x 2" gauze and all is wrapped with a 2"
kling. The felt can be worn inside a shoe or with an orthopedic
shoe/sandal (ex. Darco, Ambulator).
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An offshoot of the "Carville"
sandal is the plastizote boot. The footbed is molded the
same as a sandal but the upper is made of plastizote and rises
to just below the gastroc muscle belly. This device offers
added support for moderate to severely deformed feet such as resolved
Charcot fractures for in-house and shower/bath use.
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Heel ulcers are also a common
occurrence in the insensitive foot population secondary to long
term bedrest or positioning during surgery. These ulcers
can be located on the medial, lateral or posterior aspect with
some plantar component. The boot is cut out to appropriately
relieve the area. The boot is to be worn at all times especially
when the involved foot is in contact with any surface (i.e.
bed, recline, foot stool or sofa).
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