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Nov 5

Written by: Larry Huppin, DPM
11/5/2009 4:03 PM

I have a patient with PTTD for whom I made a ProLab PTD Pathology Specific Orthosis. It has worked great and she is pain free when she wears them. As you may know, however, this is a pretty bulky device and fitting it into anything other than a lace-up shoe is difficult. My patient wants to be able to occasionally wear somewhat dressier shoes and was wondering if we could make her a dress orthosis.

Normally, this is not only easy, but expected. About 70% of my female patients will end up with two pair of orthoses. A full sized pair for exercise and a smaller pair for dressier shoes. The PTD foot, however, is so dramatically pronated that a standard dress orthosis simply does not provide any control of the excessive pronation.

We have come up with a solution that works well for patients with adult acquired flatfoot patient who need orthoses for dress shoes. Because the heel cup and heel post are the greatest limiting factor in fitting PTD orthoses into dress shoes, we simply eliminated the post and used a very shallow heel cup. The key is that we keep the medial flange. This allows for far more control than a standard dress orthosis but much more freedom in fitting into shoes compared to the standard PTD Pathology Specific Orthosis. It won’t fit into all women’s dress shoes, but it will work in many of them. Aravon and Aetrex are two brands that work well.
Here is the prescription:  

  • Material: Vacuum Formed Polypropylene, semi-rigid
  • Heel Cup: 8mm heel cup
  • Width: medial flange with standard width front edge
  • Post: None
  • Cover: None


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