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By Larry Huppin, DPM on 6/23/2011 7:19 AM
 I had a ProLab client call me today as he was having a problem with a 9-year-old patient’s parents. The child presented with calcaneal apophysitis and a rather severe pes planus foot type. Our client prescribed a pediatric flatfoot pathology specific orthosis. It was dispensed and they returned two weeks later stating that all symptoms were resolved and that they wanted a second pair. The second pair was ordered.

Apparently, then the child was seen by an Orthopedic Sports Medicine specialist and the parents were told that these were the “wrong type of orthotics” that the child should be in a more flexible orthosis.
By Larry Huppin, DPM on 6/20/2011 1:44 PM
Jenny Sanders, DPM (a former ProLab Medical Consultant) wrote a great article on high heels published this month in Podiatry Today. The following is the introduction to the article:

While podiatrists strongly advise patients to avoid wearing high heels, the reality is many patients will continue to wear them. With this in mind, this author emphasizes patient education on ensuring optimal fit and support, reviews key features to promote better stability, and discusses helpful shoe modifications.
By Larry Huppin, DPM on 6/16/2011 3:07 PM
 I had a ProLab client call me today with a question regarding a prescription for a patient who had suffered a lawnmower injury, which resulted in the loss of the posterior medial aspect of her calcaneus. After reconstruction she had a fairly normal shaped heel externally, but essentially had a narrow calcaneus which was resulting in plantar pain. The question was how to design an orthosis to help this problem?

Our goal is to transfer pressure off of the heel, and then also to provide some cushion. Cushion slows velocity of the foot and by doing so decreases force. The following is the prescription that we developed:
By Dianne Mitchell on 6/15/2011 10:20 PM
A patient with persistent forefoot callusing presented today for debridement.
By Larry Huppin, DPM on 6/13/2011 3:00 PM
 Patients with out-toed gait sometimes have trouble tolerating orthotic devices. This occurs primarily because the out-toed position of their feet forces them to rollover the medial edge of the orthotic device and they develop medial edge irritation.

To prevent this problem, simply make your orthotics wider. By choosing “wide” for the orthotic width, you will extend the medial edge of the orthotic to the medial aspect of the foot. These patients will have the surface area of their orthotic under the entire foot and will not come down on the medial edge of the orthosis.

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By Larry Huppin, DPM on 6/6/2011 3:42 PM
Below is an email we received last week from a client with questions on two patients.   If you are a ProLab client please email or call us with any questions you might have regarding the best othotic prescription for your patient:   

Hi, I would like your guidance with two patients.

1. Rigid pes planovalgus from cerebral palsy (CP). She used orthotics when she was 5-10 years old. They caused blisters along the medial arch. Is there something I shoud avoid to prevent this from happening again?  She would really like to
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