I’ve have been working with a young patient with spa
Dear List Serve,
I’ve have been working with a young patient with spastic CP affecting B LE
including the hips. He’s had achillies release.. (Initial Rx for FOs. I put
him in a solid AFO for midfoot break/pain in dorsum of foot. Pt puts majority
of weight on ball of the foot.) He’s unable to clear his feet during swing
phase and drags his medial hallux area on the floor B. He goes through a pair
of shoes about every two weeks. I’ve tried epoxy as well as thick shoe
leather. He burns through those within two weeks as well. I’ve tried putting
contoured steel shanks and glueing them to the affected area w/ thick leather
over top. He’s burned through those in about a month’s time. I’ve also
advocated that he get a taller walker (to get him out of a forward trunk lean
at the hip) so that his hips would be able to flex more efficiently but care
takers are reluctant b/c insurance has already paid for the shorter one. Is
there anything else I’m not thinking of to help his shoes last longer? or
increase ground clearance? (With or with out the AFO, he still drags his toe.)
Thank you for your help/responses.
– Bryan Rammell, CO
Northern Prosthetics
Maine.
