Richie Brace AFO for Posterior Tibial Tendon Dysfunction and Drop Foot
Dr. Ernest Isaacson discusses how he treats patients with posterior tibial tendon dysfunction (PTTD) and drop foot using the Richie Brace Ankle Foot Orthoses (AFO).
Posterior Tibial Tendon Dysfunction (PTTD)
is a painful flatfoot condition which affects adults, primarily over the age of 50. Also known as Adult Acquired Flatfoot, this pathology affects women more than men and is linked to obesity, hypertension and diabetes. Most people with PTTD have had flat feet all of their lives. Then, for reasons not fully understood, one foot starts to become painful and more deformed.
PTTD begins with a gradual stretching and loss of strength of the posterior tibial tendon which is the most important tendon supporting the arch of the human foot. Left untreated, this tendon will continue to lengthen and eventually rupture, leading to a progressive visible collapse of the arch of the foot. In the early stages, patients with PTTD will notice a pain and swelling along the inner ankle and arch. Many times, they are diagnosed with "tendonitis" of the inner ankle. If the foot and ankle are not properly supported during this early phase, the posterior tibial tendon can rupture and devastating consequences will occur to the foot and ankle structure. The progressive adult acquired flatfoot deformity will cause the heel to roll inward in a "valgus" or pronated direction while the forefoot will rotate outward causing a "duckfooted" walking pattern. Eventually, significant arthritis can occur in the joints of the foot, the ankle and even the knee.
The Richie Brace® has been successfully prescribed for over 20,000 patients with PTTD over the past 7 years. The custom contoured footplate and the orientation of the leg uprights of the Richie Brace® are ideally suited to control the abnormal pronation forces occurring with PTTD. Most patients find the lightweight, low-profile design of the Richie Brace® to be far more comfortable than traditional long leg solid shell ankle foot orthoses. Thus the Richie Brace® has now become the preferred method of non-surgical treatment of PTTD by foot and ankle specialists.
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