Management strategies for lower extremity trauma require highly specialised attention and individual care depending on the severity and full extent of the injury.
In his clinical review titled ‘Current Controversies in Foot and Ankle Trauma’, Michael P. Swords defines complex injuries of the foot as “those injuries that occur infrequently, have a major impact on the quality of life, frequently lead to disability, are accompanied by high complication rates, require special expertise, and should therefore be treated in a dedicated level 1 trauma centre.”
Rehabilitation of a patient following a traumatic injury of the foot needs to focus on restoration of muscle strength, optimal alignment and maximum motion in the foot and ankle complex.
This can be achieved through an extensive understanding of the subsequent structural and functional changes occurring in the musculoskeletal system that can significantly affect lower limb functionality.
An evaluation of biomechanical deficits would help in directing treatment modalities towards a more focused approach in stabilising gait patterns and normalising functional range of motion in the lower limbs.
One of the most well-cited studies regarding the use of foot orthotics in treatment modalities for traumatic foot and ankle injuries involving ankle fractures, calcaneal fractures, subtalar joint dislocations and tarsometatarsal joint dislocations was carried out by Joseph E. Tomaro and Spencer L. Butterfield.
The authors emphasised on the need for individual assessment while recommending foot orthotics because of the complexity of the foot/ankle structure and the distinct nature of each traumatic injury.
The goal of orthotic intervention in traumatic foot injuries could involve providing shock absorption, decreasing joint irritation, controlling compensatory movement, preventing instability or stabilising the articulations.
As part of a broader active rehabilitation programme tailored specifically for a patient’s condition, customised foot orthotics such as MASS4D® work to enhance physical strength and mobility in an individual, most often following a passive care programme if surgery was involved.
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Repetitive plantarflexion can lead to pain and mechanical limitation in the posterior ankle joint which is known as posterior ankle impingement syndrome. This pathology commonly occurs in ballet dancers and football players.