CHARCOT RESTRAINT ORTHOTIC WALKER

Five patients (three with insulin dependent diabetes mellitus (IDDM), one with noninsulin dependent diabetes mettlitus (NIDDM), and one with hereditary sensorimotor neuropathy (HSMN)) with stage 1 Charcot's neu roarthropathy involving the midfoot and or subtalar and ankle joints w ere fitted with a Charcot restraint orthotic walker (CROW). The ration ale for this orthotic management was to maintain a plantigrade foot fo r ambulation and to protect the joints and skin by the uniform transfe r or distribution of weight over the foot until the time when the path ology reached the stage of coalescence. The patients were able to full y bear weight and to ambulate with the CROW, All patients noted varyin g measures of improvement in symptoms and function at an average 12-mo nth follow-up. The CROW is a useful orthosis in the armamentarium for treating neuroarthropathy of the pedal joints.