Understanding Your Pedorthist Exam Results

Provide continuing patient care and periodic evaluation to assure/maintain/document optimal fit and function of the pedorthic device. Obtain feedback from patient and/or caregiver to evaluate outcome (e.g., wear schedule/tolerance, comfort, proper usage and function). Assess patient’s function and note any changes. Assess fit of pedorthic device with regard to strategic contact and to anatomical relationships to determine need for changes relative to initial treatment goals. Address evidence of excessive skin pressures or lack of corrective forces and formulate plan to modify pedorthic device accordingly. Revise treatment plan based on assessment of outcomes.

At a follow-up visit for a patient who was fit with bilateral UCBLs you note redness at the navicular on the right side. What modifications should you make to the UCBL?

1. Add an ST pad

2. Refabricate the UCBL out of softer material

3. Add padding to the navicular area

4. Reduce the trimline to below the navicular

A patient with a history of Charcot arthopathy has been wearing custom molded shoes for the past eight months. The patient has developed a new ulceration under the medial midfoot aspect of the right foot. The pedorthist should:

1. Suggest that new shoes be fabricated

2. Instruct the patient to change out the inserts with the second pair they received with the shoes

3. Instruct the patient to discontinue wearing the shoe and contact their physician

4. Have the patient stop wearing the shoes for two weeks and return for another follow up appointment

A patient was fit with a pair of custom semi-rigid foot orthoses two weeks ago. They are now complaining of discomfort on the plantar aspect of their feet just proximal to the 1st metatarsal heads. The MOST likely cause of this problem is:

1. Lack of relief for the 1st metatarsal head

2. Lack of relief for the flexor hallicus longus

3. The modifications of the peroneal arches are too aggressive

4. The base materials are too rigid

A patient is seen for follow up after receiving a pair of corrective semi-rigid foot orthoses. The physician wants the orthoses modified to address new peroneal tendonitis symptoms. The pedorthist should:

1. Add a heel elevation to the orthoses

2. Add padding to the heel sections

3. Add a medial rearfoot wedge

4. Add a lateral rearfoot wedge