The orthosis has proven itself well for fractures of the calcaneus. The device is often used by victims. According to their reviews, the use of the orthosis gives good results. The rehabilitation process is accelerated almost 2 times. The period of incapacity for work is reduced to just 12 weeks. Treatment costs are halved.
With the help of an orthosis, the foot is fixed in its natural position. The device prevents the development of flat feet. The orthosis can be used after surgery or during conservative treatment.
Product Description
The literal meaning of the word “orthosis” is “straight”, “equal”. This term refers to external medical devices. Orthoses are intended to influence the functional and structural properties of damaged parts of the body. Used for injuries of the skeletal system and neuromuscular system during the restoration of motor abilities of the lower extremities.
There are 3 main components in the design of the orthosis. These are a soft toe section, a hard back section, and straps. Closed toes are made primarily from leather.
The back part is made of dense material. Reaches up to half the shin in height. Must provide reliable fixation. Helps relieve pressure on the heel area.
For fastening on the lower leg, 2 belts are used. Another belt secures the orthosis to the foot. The product is equipped with adjustable fasteners. Thanks to this, the orthosis can be quickly and easily removed or put on.
The orthosis optimally relieves the heel bone. This happens due to the uniform distribution of gravity. The device supports the longitudinal arch of the foot and covers the metatarsus. The supporting function is partially transferred to the calf muscle.
More often, orthoses are supplied to consumers in disassembled form. Requires assembly of the product and fitting of parts. It is better to do this in an orthopedic workshop. The patient must be present during the procedure.
Oral recommendations from the attending physician are not grounds for adjusting or transforming the orthosis. You must provide one of the documents: prescription, extract from the medical history, prescription, referral. Orthotics are carried out in strict accordance with a written document.
Orthoses are the result of a synthesis of a wide variety of medical knowledge. For the design and use of orthoses, data from anatomy, physiology, pathophysiology, engineering, and biomechanics are important.
How to choose insoles for heel spurs
Orthopedic devices for the foot are available in the form of insoles, heel pads, braces, and Strasbourg socks. The optimal type of corrective product for the foot should be advised by a traumatologist (orthopedist), depending on the diagnosis and goals of therapy. Individually made devices are more effective than factory ones. Below we consider the features of each product, advantages and disadvantages.
Orthopedic insoles
This is a removable lower inner part of the shoe, which is located directly under the foot. Customized orthopedic insoles are available for sale, which are made using an average orthopedic last with additional elements. Therapeutic insoles based on an individual cast are more effective, as they provide an accurate reproduction of the anatomy of the arches of the feet.
According to the method of influencing the musculoskeletal system, there are arch-supporting, arch-forming, corrective and unloading insoles. To treat and prevent heel spurs, unloading shoe inserts are usually used. The insole has arch linings, recesses for painful areas, corns, ulcers, and special orthopedic elements. Made from materials of varying hardness.
Other advantages of orthopedic insoles made from natural materials:
- strength;
- hypoallergenic;
- shock-absorbing properties;
- ability to absorb moisture;
- the presence of antibacterial impregnation, which improves sanitary and hygienic properties;
- comfort;
- minimize the risk of changes in the arch of the foot, loss of its spring functions in the presence of risk factors for flat feet;
- distribute the load evenly, protecting the foot from static and dynamic overloads;
- low cost - starting price from 400 rubles.
Orthopedic shoe inserts are unable to get rid of bone growth in the area of the heel bone tubercle. They have a symptomatic effect - they relieve pain, increase work capacity and endurance, increase the range of voluntary movements, reduce the likelihood of complications and the formation of new spurs.
Heel pads
The heel pad looks like part of the insole with low edges, measuring from 3 to 15 mm in diameter. Some models have a heel shock absorber and a recess for the heel. Fix the product under the heel using a special adhesive base. Orthopedic devices differ in shape (round, oval, rectangular with smoothed corners), size, and material of manufacture (leather, silicone, gel, carbon).
If the spur has formed as a result of an injury, a specialist may prescribe shock-absorbing heel pads with a rigid insert. They provide a light massage effect, normalize blood circulation, due to which active restoration of ligaments and muscles occurs.
The principle of heel pads is that they elevate the foot, giving it the correct anatomical position, stretching and strengthening the plantar fascia. In addition, they act as a shock absorber, protecting the heel from impact while walking, and preventing the occurrence of pain when moving. Other therapeutic and prophylactic properties:
- restore blood circulation;
- unload the Achilles tendon and calcaneal fascia;
- provide comfort when walking;
- relieve tired legs;
- correct the position of the foot;
- increase motor activity.
Heel pads are used in any shoes: shoes, sneakers, boots, shoes, shoes with heels. The products do not have a front section, so they can be used for open summer shoes. The average price for a high-quality heel pad in Moscow varies between 700-900 rubles.
Brace
This is an external medical device in the form of a boot with open toes, with a plastic or metal bar for abduction of the foot. They provide fixation of the foot in an elongated state, which leads to healing of micro-tears, minimizes the risk of new injuries in the morning, during the first steps, and helps to activate and correct the functions of the foot and ankle joint. Use at night or at rest. Walking in braces is prohibited. Depending on the complexity of the disease, the presence of concomitant diseases, and the body’s response to the treatment, braces are used for 1-6 months.
There are standard serial models on sale, prefabricated ones that consist of individual elements. Individual production of devices is possible, but their price starts from 10 thousand rubles and above. Factory models are cheaper, but inferior in quality (made from cheap, non-natural materials), bulky, heavy, inappropriate in size and fullness.
Strasbourg sock
The Strasbourg sock has the appearance of a long stocking, equipped with a fastener at the shin, with the ability to adjust the tension force. They are made from a special material (polyester spandex, polyamide) that retains heat well, allows the skin to breathe, absorbs excess moisture, and prevents the sock from slipping on the foot.
The mechanism of action of the Strasbourg sock differs from orthopedic insoles and heel pads. The fact is that it fixes the plantar fascia of the foot in a stretched position, which prevents the fascia from contracting. The absence of muscle contractions prevents the deposition of calcium salts, which reduces the risk of soft tissue injury from bone growths. With regular use, it helps to heal microtraumas, restore ligaments, and reduce pain.
Use the product at night and remove it in the morning. On average, the course of treatment is 2-3 months, but positive dynamics are noticeable after a few days. Patients report that the pain is less severe in the morning, occurs less frequently during the day when moving, and increases endurance and motor activity.
Compared to braces, it has a number of advantages:
- gently fixes the plantar fascia without disrupting blood circulation in the lower extremities;
- easy to use, no additional fasteners;
- the ability to adjust the tension level during the period of adaptation to the product;
- average price - 1350 rubles.
In the manufacture of orthopedic devices, natural, hypoallergenic materials are used, which makes their use more comfortable and safe. The main contraindications for use are related to pregnancy, diabetes, wounds, and skin lesions in the heel area.
Materials and manufacturing features
In the production of orthoses, materials are used containing:
- Elastic elements;
- Metals;
- Ethylene vinyl acetate (EVA);
- Carbon fiber;
- Textile;
- Thermoplastic.
Models made from a combination of several components are popular.
Traditionally, before making an orthosis, the limb is measured and its contour is created. This ensures maximum efficiency from using the device.
First, a plaster mold can be made. It serves as the basis for the production of the orthosis. Then, using the plaster sample, an orthosis is made from plastic or other materials.
The latest orthopedic production uses devices with various automated systems. The module prepares a special program for computerized production. The devices are equipped with three-dimensional printing and CAx computer-aided design systems (CAD, CNC, CAE/CAD/CAM).
The use of computer technology makes it possible to produce orthoses with maximum compliance with individual shapes. The 3D printing method is combined with different materials. In the production of orthoses, polymer gypsum (USA), low-temperature plastic (Netherlands), and polylactide (Russia) have been used.
Indications for use
In medical practice, fractures of the calcaneus are quite common. This unpleasant injury results from:
- Unsuccessful jump;
- Strong blow;
- Pathological transformations (osteomyelitis);
- Falls on straightened limbs;
- Road traffic accidents;
- Violations of safety regulations (athletes, conscripts).
In 65% of cases, injuries are classified as work-related among construction industry workers.
It takes 3–4 months for the fracture to heal. Not every patient can afford such a long period of complete inactivity. For such patients, an orthosis comes to the rescue. The device provides fairly comfortable walking. The orthosis can be put on and worn instead of shoes.
You can use a heel orthosis for a fracture regardless of the type of injury. Also, the use of the orthosis is not influenced by the characteristics of the primary treatment.
The orthosis helps overcome the consequences of unilateral and bilateral calcaneal fractures.
It is recommended to use orthoses only after the calcaneus has fused. Fixing part of the lower limb speeds up the rehabilitation process and brings the moment of absolute recovery closer.
A heel orthosis is used in the process of preoperative preparation of the talocalcaneal plexus (joint). The device is used at the preparatory stage for arthrodesis of the heel joint.
When trying on the orthosis, the patient must not have:
- Plaster casts;
- Leg swelling;
- Open wounds.
When wearing an orthosis, moderate loads on the injured limb are allowed and even stimulated. There should be no pain.
The heel orthosis belongs to the category of “safe shoes”. The device is used at any time to impart vertical loads to injured limbs. During the rest period, the orthosis can be removed.
Symptoms of a fracture
A heel fracture is accompanied by classic symptoms that are characteristic of a violation of the integrity of the bones. Among them:
- pain in the heel area;
- swelling with local spread to the Achilles tendon;
- change in the shape of the heel: flattening;
- hematoma in the center of the sole, as well as bruises in the ankle area.
When a fracture occurs, the pain syndrome is severe: supporting the injured leg becomes impossible. If there is a displacement of bone fragments, then a characteristic crunching sound is detected - crepitus. However, this sign may be absent in situations where no displacement of the fragments has occurred.
Efficiency and benefits of use
An orthosis for a heel fracture shortens the rehabilitation period by 2 times. On average, treatment lasts 12 weeks.
The mechanism promotes physiological rolling of the injured foot. Special inserts reduce the load on the heel bone. The calcium content in the fracture zone does not decrease.
The use of orthoses for calcaneal fractures minimizes the risks of insufficient functional load. The patient is practically not at risk of “atrophy from inactivity.” Unimpeded muscle contractions protect against the occurrence of venous thrombosis. There is no need for prophylactic antithrombotic therapy. Long-term physiotherapeutic treatment may be avoided.
The orthosis provides the victim with the opportunity to move already in the early phases of rehabilitation. Rapid activation of the patient accelerates the regeneration of bone tissue. The device does not interfere with walking on the street.
A heel orthosis prevents the appearance of flat feet. The foot takes a natural position thanks to special bends.
When using a heel orthosis, there were no cases of complications or negative consequences due to prolonged immobilization. During treatment, the device allows for visual and radiological monitoring.
Walking in an orthosis has a physiological pattern. The patient feels comfortable during treatment and rehabilitation. The victim's quality of life improves markedly.
Types of fasteners
To fix the foot in a physiological position in case of a heel fracture, ankle orthoses are used. With their help, it is possible to shorten the rehabilitation period after traumatic injuries and prevent inflammatory and degenerative complications of joints. The main functions performed by the orthosis:
- Fixation in a physiological position
Helps to evenly distribute the load and promotes proper bone healing. - Restoring foot mobility after injury
In cases of lower extremity fractures, it is extremely important to maintain normal function. Wearing an orthosis contributes to this. - Reducing pain
Rest and lack of constant movement help reduce pain.
Main types of ankle braces:
- Soft orthosis
Used for therapeutic purposes when it comes to minor damage to the heel. Gently fixes the limb, helps relieve inflammation from surrounding tissues and prevents the development of complications. - Semi-rigid orthosis
Allows you to fix the ankle more firmly. Plastic and metal inserts are used as material for the manufacture of the product. They are actively used in the rehabilitation period after injuries and surgical interventions on the foot. - Rigid orthosis
is an alternative to a plaster cast. Used in the early period after injuries and operations. A rigid orthosis ensures reliable tissue immobilization. - Swedish orthosis
A special type of design that is used for foot drop. Can be used in cases where a heel fracture is combined with damage to nerves, joints and/or ligaments.
Step-by-step plan for using an orthosis
The treatment plan provided is indicative. The step-by-step order was compiled through the processing of many years and numerous statistical data.
This is a brief description of the step-by-step application of a heel orthosis.
- 8 – 12 days. The stitches have been removed, the swelling has gone down, and the orthosis is being adjusted. Loading of the injured limb with the use of crutches is allowed. The patient adapts to walking in a heel orthosis. It is recommended to give up crutches as quickly as possible;
- Week 4. The 1st X-ray control is carried out. Usually the following are examined: the lateral projection of the ankle joint, the same projection at maximum load, specifically the calcaneus;
- Week 6. The 1st load liner is used;
- Week 8. The 2nd x-ray control is carried out. A 2nd load liner is used;
- Week 10 A 3rd load liner is used;
- Week 11 The anatomical and functional state of the feet is studied (plantography, plantogram). If necessary, orthopedic shoes are made (within 4–6 days);
- Week 12. The final stage of treatment. The patient is tested for performance (if there has been a work-related injury).
The decision to start using a heel orthosis is made by the attending physician. In each specific case, the doctor independently decides when to move to the next stage of treatment.