AUDIT OF LOWER-LIMB ORTHOSES IN RHEUMATOLOGY PRACTICE

A questionnaire survey was conducted of the use made of lower limb ort hoses by patients under the care of a Rheumatology Department. Orthose s included made to measure and ready made shoes, ankle-foot orthoses ( AFOs) and adaptations to existing footwear. Referrals between August 1 991 and July 1992 were included. The length of time taken to supply th e orthoses and the cost was monitored. Made to measure shoes took twic e as long to supply as ready made shoes. Of the total cost (26 243 pou nds), 73.5% was for shoes, 18.5% for adaptations and 8% for AFOs. Over all 6% of orthoses had been discarded 1 month after supply and 7% afte r 6 months. Plastic AFOs were most frequently discarded. Discomfort wa s highest for plastic AFOs and internal adaptations. Made to measure s hoes and calipers were worn more days per week and for longer periods than other orthoses. The dissatisfaction with plastic AFOs in terms of use and with internal adaptations in terms of comfort needs further i nvestigation if inappropriate prescribing is to be avoided.