title: Treatment of Charcot foot and ankle with a prefabricated removable walker brace and custom insole.
abstract: BACKGROUND
  Removable walker braces have been used successfully to treat acute and chronic foot and ankle conditions including diabetic foot ulcers. We hypothesized that a removable walker brace may be successfully used in the management of the Charcot foot and ankle.
  
  
  METHODS
  Twenty-five feet and ankles with Charcot arthropathy in 21 patients (bilateral in 4 patients) were treated with a prefabricated, pneumatic removable walker brace fitted with a custom orthotic insole. Follow-up data were collected from patient interview, examination, and radiography.
  
  
  RESULTS
  Brace fitting was accomplished usually with a single visit to the prosthetist or pedorthist/orthotist. At the most recent evaluation, 17 (68%) feet and ankles had consolidation (stage III) of the Charcot arthropathy (average duration of brace use, 29+/-19 weeks) and were subsequently treated with rocker sole shoes, insoles, and ankle foot orthoses; 8 (32%) feet and ankles had ongoing brace treatment. Three feet developed new deformity during brace treatment, but average radiographic parameters of hindfoot to forefoot alignment had minimal change between initial and final radiographs at an average of 36+/-24 weeks after initial radiographic evaluation.
  
  
  CONCLUSIONS
  The prefabricated, pneumatic removable walker brace fitted with a custom insole was successful in the management of the Charcot foot and ankle and had a high satisfaction rate and safety profile despite frequent, albeit usually minor, complications.
authors.affiliation: Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Shawn
authors.initials: S
authors.lastname: Verity
authors.forename: Michael
authors.initials: M
authors.lastname: Sochocki
authors.forename: John M
authors.initials: JM
authors.lastname: Embil
authors.forename: Elly
authors.initials: E
authors.lastname: Trepman
mesh_terms: D000843:Ankle Joint; D001177:Arthropathy, Neurogenic / Q000628:therapy*; D001915:Braces; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies