USE OF BIVALVED ANKLE-FOOT ORTHOSIS IN NEUROPATHIC FOOT AND ANKLE LESIONS

The neuropathic foot is a common complication of diabetes mellitus and is associated with development of chronic ulcers and Charcot joints. Treatment of these complications presents a complex management task. T his report presents long-term follow-up data on 16 patients with neuro pathic changes who were treated with a total contact, laminated, bival ved, rocker-bottom-soled ankle-foot orthosis (TCAFO). Of the 16 patien ts, 6 were treated for Charcot changes only, 10 were treated for ulcer s, and 2 of the 10 had ulcers bilaterally. Eight of the 12 ulcers (67% ) healed in an average of 10 months (range 1-24 mo), 1 patient require d amputation, and 2 patients with unhealed ulcers are still in TCAFOs. Of the 7 patients who had complete healing, 5 have resumed wearing TC AFOs secondary to recurrent ulcers. Three of the 5 patients with Charc ot changes no longer use the orthosis and have had negative bone scans after an average of 20.7 months (range 12-28 mo). In this retrospecti ve uncontrolled study, the TCAFO proved to be a safe, functional, and cost-effective therapy for complications of the neuropathic foot.