title: Use of bivalved ankle-foot orthosis in neuropathic foot and ankle lesions.
abstract: The neuropathic foot is a common complication of diabetes mellitus and is associated with development of chronic ulcers and Charcot joints. Treatment of these complications presents a complex management task. This report presents long-term follow-up data on 16 patients with neuropathic changes who were treated with a total contact, laminated, bivalved, rocker-bottom-soled ankle-foot orthosis (TCAFO). Of the 16 patients, 6 were treated for Charcot changes only, 10 were treated for ulcers, and 2 of the 10 had ulcers bilaterally. Eight of the 12 ulcers (67%) healed in an average of 10 months (range 1-24 mo), 1 patient required amputation, and 2 patients who had complete healing, 5 have resumed wearing TCAFOs secondary to recurrent ulcers. Three of the 5 patients with Charcot changes no longer use the orthosis and have had negative bone scans after an average of 20.7 months (range 12-28 mo). In this retrospective uncontrolled study, the TCAFO proved to be a safe, functional, and cost-effective therapy for complications of the neuropathic foot.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, PA 15213, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Boninger
authors.forename: J A
authors.initials: JA
authors.lastname: Leonard
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint; D001177:Arthropathy, Neurogenic / Q000503:physiopathology / Q000628:therapy*; D003625:Data Collection; D017719:Diabetic Foot / Q000503:physiopathology / Q000628:therapy; D003929:Diabetic Neuropathies / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D012189:Retrospective Studies; D016896:Treatment Outcome