Article

Clinical management of the patient with neuropathic foot is becoming
commonplace in orthotic clinics worldwide. The presentations that can result from
neuropathic foot are diverse, requiring clinicians to understand the
pathomechanics of ulceration, infection, and Charcot joint arthropathy to provide
effective interventions. OBJECTIVES: The purpose of this clinical perspective is
to provide a review of the literature regarding clinical concepts associated with
orthotic management of neuropathic foot.
METHODS: Relevant literature were reviewed and summarized,
and a clinical case study synthesizing reviewed concepts was presented. RESULTS:
Given the multifactorial nature of the neuropathic foot, treatments must be
multifaceted and patient-specific to effectively address the underlying disease
processes. While systemic issues such as peripheral arterial disease are treated
by physicians, local issues such as foot deformity are managed by orthotists.
Orthotic interventions commonly include custom footwear to reduce the risk of
ulceration through creation of a protective environment or targeted plantar
offloading. Patient and caregiver education to encourage management compliance is
equally as important to ensure successful treatment. CONCLUSION: Patients with
neuropathic foot benefit from an interdisciplinary care approach which engages
physicians, wound care practitioners, and orthotists to treat and manage systemic
and local problems. Addressing this pathology through interdisciplinary care may
positively affect the patient's health status while lowering associated
healthcare costs through improved treatment efficacy. CLINICAL RELEVANCE: The
commonality of neuropathic foot and associated complications including
ulceration, infection, and Charcot joint arthropathy requires that the patient
care team have a fundamental understanding of these pathologies and common
treatment modalities. We review orthotic treatment modalities to assist
clinicians with the management of patients with neuropathic foot.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS