Postoperative Care with Orthotics
The use of orthotics as a rehabilitative device following surgery of the foot is associated with the balanced corrective force provided to the lower limbs during ambulation.
With postoperative changes occurring in foot structure or function, it becomes essential to fabricate an orthotic which is able to accommodate the specific needs of the patient’s foot and promote speedy recovery.
A detailed gait analysis of the foot is essential both in the days leading up to a surgical procedure and postoperatively, to consider significant differences in foot mechanics that may have occurred post surgery.
Such an evaluation also serves as a good indication of any underlying biomechanical factors which need to be included in a post-surgical treatment strategy; this would protect the lower extremity from recurring pathomechanic forces.
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Depending on the type of procedure performed, it is possible that the patient may experience limited motion in the foot, facilitating the need for less rigid orthotic materials which allow the operated foot enough capacity for adaptability and movement.
In some instances, such as after a hallux valgus surgery, the feet will require orthotics which are designed to alleviate pressure from the first metatarsophalangeal joint. These would be used in combination with comfortable footwear to help prevent the recurrence of bunions in the future.
Reconstructive foot surgeries create the need for asymmetrical evaluations in order to determine the presence of structural or functional leg length discrepancy.
Prior to surgery, an early intervention in the form of orthotics with heel lifts can be used to treat leg length discrepancies of up to 10mm, helping restore alignment and optimal lumbopelvic biomechanics.
Leg length discrepancies that are over 10mm can be best addressed through shoe modifications.
Following reconstruction of the foot, customised orthotics can help correct variation in functionality which may have been caused as a result of abnormal movements such as hyperpronation; the operated foot may have previously functioned as the shorter side due to a collapse in the medial longitudinal arch.
MASS4D® custom made foot orthotics in postoperative care enable the patient’s foot to better adapt to changes induced by certain types of surgery such as a change in foot size or width, in addition to changes in the functionality of the foot.
This will assist the patient in making a gradual return to activity whilst reducing discomfort, eliminating biomechanical stressors and enhancing postural stability.
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References:
- Levine J. D. (2011) Post-Op Orthotics: Can They Have An Impact? Podiatry Today: January 2011, Vol. 24, No. 1
- Valmassy R. (2010) Inside Insights On Common Orthotic Dilemmas. Podiatry Today: April 2010, Vol. 23, No. 4
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