title: Biomechanics of postoperative shoes: plantar pressure distribution, wearing characteristics and design criteria: a preliminary study.
abstract: BACKGROUND
  Modern concepts in the postoperative treatment of first metatarsal osteotomies include special shoes that should decrease stress in the forefoot region. The purpose of this study was to determine plantar pressure distribution, wearing characteristics and stress-reducing effectiveness of five different types of commonly used postoperative shoes. Additionally, we wanted to modify the shoe that revealed the most favourable results in a way that improves forefoot relief as well as provides comfort to the patients.
  
  
  METHODS
  Eight persons consented to participate in the study. Plantar pressure distribution in five different types of postoperative shoes (Rathgeber(®) normal, Rathgeber(®) modified, 4. Darco(®) flat, Darco(®) VFE, Wocker(®)) was assessed using Mediologic(®) insoles. Also, subjective criteria considering wearing comfort, stability and rolling characteristics were evaluated. Based on the postoperative shoe revealing the most favourable results, further prototypes were developed. Each new model was targeted to meet the given requirements, minimal forefoot pressure, in a different way.
  
  
  RESULTS
  The Rathgeber(®) modified model revealed the most favourable results concerning plantar pressure distribution as well as subjective wearing characteristics. Therefore, it was chosen for further modifications. After adding an extra layer of high elastic and springy material for shock absorption at the hallux region, forefoot relief and wearing characteristics showed improved results.
  
  
  CONCLUSIONS
  The results of the present study indicate that damping material in the hallux region of postoperative shoes minimises stress in this region and improves patient's comfort.
authors.affiliation: Gait Analysis Lab, Foot and Ankle Center Vienna, Austria. reinhard.schuh@uki.at
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schuh
authors.forename: Hans-Joerg
authors.initials: HJ
authors.lastname: Trnka
authors.forename: Anton
authors.initials: A
authors.lastname: Sabo
authors.forename: Martin
authors.initials: M
authors.lastname: Reichel
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kristen
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D005528:Foot / Q000502:physiology*; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011312:Pressure; D012775:Shoes; D055815:Young Adult