Use of bivalved ankle-foot orthosis in neuropathic foot and ankle lesions

J Rehabil Res Dev. 1996 Feb;33(1):16-22.


The neuropathic foot is a common complication of diabetes mellitus and is associated with development of chronic ulcers and Charcot joints. Treatment of these complications presents a complex management task. This report presents long-term follow-up data on 16 patients with neuropathic changes who were treated with a total contact, laminated, bivalved, rocker-bottom-soled ankle-foot orthosis (TCAFO). Of the 16 patients, 6 were treated for Charcot changes only, 10 were treated for ulcers, and 2 of the 10 had ulcers bilaterally. Eight of the 12 ulcers (67%) healed in an average of 10 months (range 1-24 mo), 1 patient required amputation, and 2 patients who had complete healing, 5 have resumed wearing TCAFOs secondary to recurrent ulcers. Three of the 5 patients with Charcot changes no longer use the orthosis and have had negative bone scans after an average of 20.7 months (range 12-28 mo). In this retrospective uncontrolled study, the TCAFO proved to be a safe, functional, and cost-effective therapy for complications of the neuropathic foot.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ankle Joint
  • Arthropathy, Neurogenic / physiopathology
  • Arthropathy, Neurogenic / therapy*
  • Data Collection
  • Diabetic Foot / physiopathology
  • Diabetic Foot / therapy
  • Diabetic Neuropathies / physiopathology
  • Diabetic Neuropathies / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Orthotic Devices*
  • Retrospective Studies
  • Treatment Outcome