CROW stands for Charcot Restraint Orthotic Walker. It is a custom made rigid boot which completely immobilises the foot and ankle. These are commonly used in a charcot foot after coming out of a total contact cast.
Just like a total contact cast, a CROW relies on an intimate fit to reduce pressure on specific areas of the foot. This in turn supports damaged bones of the foot which are common in a charcot deformity.
A CROW is made from a carbon fibre posterior (back) shell and a plastic anterior (front) shell. This is all lined with a support custom foot orthosis and a soft thermofoam lining. The two shell are held together using Velcro straps. There is a rocker sole on the base of the CROW to further minimise movement through the foot and ankle.
Total Contact Casts are a special type of cast which is used to treat ulcers of the foot or a charcot foot deformity.
A total contact cast is fabricated from many different layers of material. These include gauze between the toes, stockinet, felt padding over bony areas and ulcers, cotton padding, plaster and fiberglass.
The aim of a total contact casts is to have an extremely intimate fit to decrease swelling, reduce pressure on areas of the foot (i.e. ulcers) and prevent further deformity in a charcot foot. Total contact casts need to be changed every week, as the swelling decreases an intimate fit is still required. The use of the total contact casts is discussed in the ‘conditions’ section of the website.
Casts can be used to treat various fractures of the upper and lower limbs. Casts can be made from either fiberglass or plaster. At Orthotics Plus casts are usually fabricated from fiberglass as they are lighter, stronger, more durable and more breathable than plaster. These casts can either be waterproof or non-waterproof.
Plaster casts are commonly used in the acute treatment of an injury for the first 10 days to 2 weeks. Plaster can be heavy and brittle, but do mould very well to the shape of a limb.
At Orthotics Plus all fiberglass casts are fabricated from either a layer of stockinet and some cotton padding or a waterproof lining. If a non-waterproof cast gets wet it must be changed immediately, especially if there is wound underneath.
CAM stands for Controlled Ankle Movement. The CAM walker, frequently referred to as a ‘Moon Boot’ or ‘CAM boot’, is an orthosis designed to immobilise the foot and ankle. It is often used instead of a cast. The CAM walker can be removed for showering and small range of motion exercises if instructed by the treating doctor.
Orthotics Plus’ CAM walkers have a rocker sole bottom to make walking with a rigid ankle a little easier. CAM walkers are commonly used for stable ankle fractures, post-operative immobilisation, pre-surgical intervention, severe ankle ligament injuries, stress fractures and foot fractures.
These are referred to in the ‘conditions’ section of the website.
If you need a CAM walker:
The orthotists at Orthotics Plus Malvern or Orthotics Plus Heidelberg will discuss various CAM walker options with you based on your injury, leg shape and budget and will fit you on the day.
It is important you are measured and fit properly for your ‘moon boot’ as a poorly fitted or incorrectly sized device can create a multitude of issues for a patient including lower back pain, knee issues, hip issues, contralateral (opposite) foot pain or even pressure injuries. It is not uncommon for a patient to wear a CAM walker for over 8 weeks, a long time to be wearing a poorly fitted or uncomfortable device!
Part of the Orthotics Plus difference is our commitment to patient education. You will be instructed on the best practice, so you will know how to wear the CAM walker effectively for your injury to heal and also how to manage hygiene and walk safely.
As an example of our bespoke service, we will measure your pelvis height and visually analyse your gait. From this we can ascertain whether we will need to manufacture heel wedges for your opposite shoe to avoid the leg length discrepancy which can create the hip and back issues associated with wearing a ‘moon boot’.
All CAM walkers are covered by a warranty to last the course of treatment.
If you want the best management for your injury or for a second opinion on your current device, call (03) 9077 6414 to book an appointment today. No referral required.
The Arizona brace is a custom made lace-up ankle brace. It circumferentially wraps around the ankle (up to mid-calf level) and the foot. It is fabricated from leather, thermofoam padding, thin flexible co-polymer plastic and has either Velcro straps or laces running down the front section.
The Arizona provides large amounts of support to the ankle, despite not being fabricated from a rigid plastic (like the AFO’s). It is commonly used in elderly patients who have thin skin which are prone to pressure areas which a rigid AFO is more likely to cause.
The Arizona is commonly used for severe deformities around the foot and ankle including tibialis posterior dysfunction, severe pes planus or ankle arthritis. These are referred to in the ‘conditions’ section on the website.
A carbon fibre AFO is a pre-fabricated Ankle Foot Orthosis used to treat footdrop. There are different types of carbon fibre AFO’s, but the two most commonly used are the ‘walk-on’ and the ‘toe-off’.
All carbon fibre AFO’s require a custom made foot orthosis attached to the carbon fibre footplate. The carbon fibre AFO is extremely lightweight, slim line and has spring-like qualities to provide energy return during gait. These are used to treat footdrop.
Jointed Ankle Foot Orthoses (AFO’s) come in a variety of designs and materials depending on the condition being treated. They must be custom made from either carbon fibre or polypropylene plastic.
A jointed AFO is generally made from tamarack joints which can either be regular joints or dorsiflexion assist joints. A jointed AFO can either be free range of motion or have a plantarflexion stop.
A jointed AFO has the same trim lines as a posterior shell AFO (immobilising the subtalar joint), but can allow some movement at the ankle joint. Jointed AFO’s are used for a variety of conditions which are referred to in the ‘conditions’ section of the website.
A leafspring Ankle Foot Orthosis (AFO) is a custom made orthosis fabricated from polypropylene. It is similar to a posterior shell AFO except the trim lines are behind the ankle, thereby not immobilising the ankle or sub-talar joints.
A leafspring AFO is smaller and less bulky than a posterior shell AFO. It is most commonly used for footdrop, as referred to in the ‘conditions’ section of the website.
Ankle Foot Orthoses (AFO’s) come in a variety of designs and materials depending on the condition being treated. The most common AFO is a solid ankle posterior shell AFO.
A solid ankle posterior shell AFO is generally fabricated from polypropylene plastic, but can also be made from carbon fibre if required. A posterior shell AFO immobilizes both the subtalar and ankle joints.
A posterior shell AFO is commonly used in subtalar or ankle arthritis, but can be used for a variety of other conditions. These are referred to in the “conditions” section of the website.
The Strassburg Sock is the least bulky night splint. It is designed to keep tension on the tissue (plantar fascia) and allow it to be in a stretched position over night.
Most people find the morning heel pain which they experience reduces with the use of the Strassburg Sock.
It is easy to use and minimally invasive.
The ASO is a supportive ankle brace commonly used as a preventative measure, post-operatively or in an acute setting post ligamentous injury.
It is a low profile brace which provides side-to-side stability around the ankle whilst allowing for free up and down movements of the ankle. This makes it extremely easy to use from day to day and also when returning to sport.
The ASO stabilises the ankle using laces as well as figure 8 strapping system. This provides maximal stability and comfort.