Hallux Rigidus. Treadeasy(R) foam box. Langer. NOPCO National Orthotics and Prosthetics Company.
Don Saklad
Hallux Rigidus, Acquired,
Limited 1st MPJ ROM with arthritic changes, left foot
is one part of the diagnosis.
Taking foot impressions this time in this Treadeasy(R) foam box
http://www.treadeasy.com/Products/ProductDetail.aspx?catid=178&subcatid=218
looked problematical with me seated while the orthotist pressed my foot in the box.
Years ago a different NOPCO orthotist
http://www.nopcoclinics.com
did the foot casting with me prone on the table
and my feet extended over the edge.
I'm concerned when the orthoses will be back
in a few weeks from Langer
http://www.langerbiomechanics.com/pg_1_1b.htm
that the new orthotics will not work so well
as did the previous Langer orthotics that worked okay
for years then made by casting my feet with me prone.
Current readings
http://en.wikipedia.org/wiki/Orthotics
Don Saklad
chronic posterior tibial tendinitis, plantar fasciitis,
hallux limitus and arch strain aggravated by severe pes planus
Joe Jared
> Thank you Joe Jared !
>
> Hallux Rigidus, Acquired,
> Limited 1st MPJ ROM with arthritic changes, left foot
> is one part of the diagnosis.
That explains why you asked the difference between accommodative and
corrective devices. For your condition, corrective is likely out of the
question. If it were _functional_ hallux limitus, you would likely see a
cutout just behind the first metatarsal, but in your case, comfort is
about the best you can hope for. If it's a hard shell device, I wouldn't
be surprised at all if they used either a full morton's extension or at
minimum, a first met extension. This is simply a flat extension either of
full width or primarily to immobilize the first metatarsal. In my
software it would be exky, exly, and mdexangle, ldexangle. A hard shell
device in this case would immobilize with a morton's extension, but not
necessarily provide comfort.
> Taking foot impressions this time in this Treadeasy(R) foam box
> http://www.treadeasy.com/Products/ProductDetail.aspx?catid=178&subcatid=218
> looked problematical with me seated while the orthotist pressed my foot
> in the box.
Personally, I don't like biofoam. I like non-weight bearing
casting/scanning because the mid-tarsal joints are neutral (hopefully),
which is much the same as just before that first heel strike in the gait.
On many occasions, the arch is not completely formed because the foam
isn't high enough, and the slightest movement, as with scanning feet, can
fool the laboratory when it comes to forefoot/rearfoot width.
>
> Years ago a different NOPCO orthotist http://www.nopcoclinics.com did
> the foot casting with me prone on the table and my feet extended over
> the edge.
That is absolutely the best method of casting a patient's foot.
> I'm concerned when the orthoses will be back in a few weeks from Langer
> http://www.langerbiomechanics.com/pg_1_1b.htm that the new orthotics
> will not work so well as did the previous Langer orthotics that worked
> okay for years then made by casting my feet with me prone.
From what I'm seeing, you've defined your left foot only. I know within
my own software we can either split the orders and treat each foot
uniquely, or alternatively, we can split the orders to treat them uniquely
with entirely different prescription information. I'm not sure how
elaborate Langer's software is. If you're not satisfied with the product
and Langer isn't able to fix it, you could ask your podiatrist to
visit http://www.oretek.com/customers.html and give one of my customer's a
try. In particular, Piedmont, Earthwalk, and Newgen all make
soft accommodative devices, and all of my customers have the capacity to
produce them. Only the above however are actually setup to do so.
A couple years ago, I heard of quality problems with Langer's milling
machines, but by this time, I'm assuming that they figured out what they
were doing wrong. These days, I can improve the production quality of my
customer's machines from home without even asking for remote intervention
other than to push a button.
--
http://www.oretek.com
If you see weird responses, please do not reply to them.
Simply visit http://www.oretek.com/kookwatch/
Joe Jared
The core problem looks like the tendinitis. Plantar fascia can be
accommodated by a fascial groove from the heel across the arch
longitudinally, and is a common code for my customers.
Pes plantus, sever pronation, or leaning inward towards the medial side of
the foot, exasperated by the tibial tendons being damaged. A kirby skive
would help on this in some cases, as well as a firm arch support. You're
likely going to get a hard shell device with a light arch fill (only
minimal change in the arch)and if they're capable, a kirby skive to
compensate for the tibial tendons.
It's good that you're getting some kind of treatment. Without treatment,
it is very likely that your arch will eventually collapse.