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Mar 22

Written by: Larry Huppin, DPM
3/22/2010 1:13 PM

In parts 1 - 3 of this series we discussed the following casting rules:

Today, we are going to look at how closely the negative cast must conform to the arch of the foot. More importantly, we want to know how close the orthosis should conform to the arch of the foot. If it is important for the orthosis to conform to the arch of the foot, then the negative cast must do the same.

Studies on conditions associated with excessive forefoot pressures, pes cavus, and tarsal tunnel syndrome indicate that an orthosis should conform extremely close to the arch of the foot (total contact orthosis) in order to provide best clinical outcomes For example, Mueller et al showed that a total contact orthosis best transfers force off of the forefoot. There is evidence that orthoses made with a minimum cast fill (minimum fill orthoses conform closely to the arch) also improve clinical outcomes for patients with hallux limitus The casting technique, then, must provide a perfect representation of the plantar surface of the foot in order to optimize clinical outcomes.

Casting Rule #5: The negative cast must capture a perfect representation of the plantar aspect of the foot while the foot is held non-weightbearing in subtalar neutral position.


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