Orthopedic Shoes Research Articles

ВИЗНАЧЕННЯ СИЛОВОГО НАВАНТАЖЕННЯ НА ВЕРХНЮ ЧАСТИНУ ОРТОПЕДИЧНОГО ТА ПІСЛЯОПЕРАЦІЙНОГО ВЗУТТЯ

The results of determining the force load on the upper part of orthopedic and postoperative shoes, taking into account the bending of the sole, are presented. To determine the force of the load on the top of the postoperative orthopedic shoes, the friction forces between the side surfaces of the shoes and the outer sides of the foot were neglected in the work. Thus, the task was reduced to the compilation of equilibrium equations of a plane system of forces. To determine the unknown forces, it was necessary to compile a system of two equilibrium equations, which will represent the algebraic sums of the projections of all forces on the horizontal and vertical axes, which will be equal to zero. The most common type of deformation acting on shoe parts during manufacturing and operation is stretching and bending. It is the last factor that affects the force load on the upper part of orthopedic and postoperative shoes. Deviation of the human musculoskeletal system from the normal anatomical structure and functioning is one of the serious and widespread ailments of the population. An important factor in reducing the inconvenience caused by this disease is the rational choice of orthopedic shoes. Compliance of orthopedic footwear with the functions that rely on it (supporting the arch of the foot, relieving painful areas, making the limb supportive, increasing the area of ​​foot support) is achieved by a reasoned approach to choosing the design of the product, including in the structure of special, special shape and size details, etc.. Degree compliance of this type of footwear with the real needs of the consumer depends on a complex of factors, and the ability to satisfy them is largely determined by the optimal ratio of indicators of reliability and comfort in the use of upper materials. Textile materials are widely used in the footwear industry for uppers, insoles, insoles, linings, and other parts of various types of footwear. This is caused by their valuable consumer properties, such as low hardness and surface density, pleasant texture, high heat-insulating properties, and a variety of artistic and colorful decoration.

Determination of Load Forces on the Upper Part of Orthopedic and Postoperative Shoes

Determined patterns of force load on the sole and upper of orthopedic and postoperative shoes when bending the foot while walking. To determine the force of the load on the top of the postoperative orthopedic shoes, the frictional forces between the lateral surfaces of the shoes and the outer lateral sides of the foot can be neglected. Thus, the task will be reduced to the compilation of equilibrium equations of a plane system of forces. As can be seen from the load diagram of the top of the shoe, we have a flat arbitrarily located system of forces. To determine the unknown forces, it is necessary to compile a system of two equilibrium equations, which will represent the algebraic sums of the projections of all forces on the horizontal and vertical axes. To automate the design process of orthopedic and postoperative shoes, a computer program was developed that allows you to perform calculations of the corresponding forces and tension depending on the design and types of material of individual elements, as well as obtain regression equations for determining the effect of tension on the magnitude of the detachment force.

Complex treatment of hoof of cows for ungulomycosis

Under modern conditions of cattle breeding, ungulates are often exposed to various adverse factors associated with errors in feeding, maintenance, and corrective cleaning during the winter-stalling period. The hooves of cows, which are often exposed to multiple adverse factors, lead, for the most part, to the development of inflammatory processes in the area of the base of the skin of the sole, sometimes to septic genesis, complicated by keratomycetes. As is known, the purulent inflammatory process in this part of the hoof contributes to a decrease in the productivity of cows, which leads to significant economic losses. Treatment methods used for ungulomycosis do not always give the desired effect. Therefore, the work aimed to develop an effective method of treating cows with ungulomycosis using medicinal substances with antibacterial, antifungal, stimulating, and regenerative action. For research, two groups of cows with 5 animals each were formed, selected according to the principle of analogs regarding the nature and location of the pathological process. For therapeutic purposes, cows of both groups underwent orthopedic cleaning, irrigation of the surface of the soles of the hooves with a 0.02 % furacilin solution. A finely grated (separately) mixture of potassium permanganate boric acid and syntomycin liniment was applied to the affected area of the animals of the control group, and povidone-iodine 10 % in combination with a 30 % dimexide solution was applied to the surface of the hoof (corolla and sole area) of the experimental group after novocaine blockade, diluted with a 0.5 % solution of novocaine and, subsequently, levomekol ointment; carried out ultraviolet irradiation of cows with a PRK-2 lamp at a dose of 250 mer/hour/m2 for 25 min. three times a week, and 10 ml of trivit was administered intramuscularly three times a week. Animals of both groups were given antiseptic bandages and orthopedic shoes on their hooves. Clinical, biochemical, biophysical, immunological, bacteriological, mycological, and statistical studies were conducted. The proposed method of treatment improves the quality of the hoof horn, ensures the restoration of its structure, contributes to the elimination of defects, and shortens the duration of treatment by 10 days, which is confirmed by the results of the research conducted.

Development of orthopedic support for patients with foot pathologies

The level of development and well-being of the population of Kazakhstan is directly dependent on the health of each person. In recent years, a significant increase in patients with diabetes mellitus has been observed all over the world and in Kazakhstan, because of which the number of patients with various foot diseases is growing. The works show that one of the causes of foot disease is uncomfortable shoes, since ordinary shoes do not provide the necessary structural elements, orthopedic products made of elastic, shock-absorbing and antibacterial materials that contribute to the normal functioning of the diabetic foot. The aim of the study is to determine the structural properties of the synthesized silicone composites with the addition of MCC, used in orthopedic products. In this work, studies of MCC and silicone composites were carried out using the DelsaNano particle size analyzer. Also carried out: IR - spectroscopic, electronic and optical-microscopic studies were conducted. The scientific results obtained in this work can be used to further study the problems of providing comfortable shoes for patients with various foot diseases in with DM; in the preparation and study of nanocomposite materials with antibacterial properties. They can be useful for diabetologists, orthopedists, as well as manufacturers of orthopedic products and shoes.

Effects of functional treatment of V metatarsal bone fracture in athletes – an evaluation of cases

This study presents the rehabilitation process for the management of six cases of fractures of the fifth metatarsal bone in players of various sports playing at high levels of competition in Poland. The course of treatment was based on an intensive rehabilitation protocol with the need for orthopaedic shoe inserts, with full weight bearing on the limb and under close supervision of a physiotherapist. The effectiveness of rehabilitation was assessed by physical examination, X-ray examination and the numerical pain rating scale - NRS. This study focuses on the rehabilitation process for managing fractures of the fifth metatarsal bone in high-level athletes in Poland. The treatment involved an intensive rehabilitation protocol with orthopaedic shoe inserts, full weight bearing, and physiotherapist supervision. The effectiveness of rehabilitation was evaluated through physical exams, X-rays, and the numerical pain rating scale. Introduction Fractures of the fifth metatarsal bone are common in athletes aged 10-29, especially in football, basketball, and dance. Complications include delayed bone fusion and repeat fractures, emphasizing the importance of quick return to fitness. The involvement of physiotherapists and patient positivity is crucial. The debate among clinicians stems from classification variations and interpretations of 'Jones fractures'. Diagnostic and Classification Methods The Lawrence and Bottle classification distinguishes three types of metatarsal fractures: avulsion, Jones, and fatigue fractures. The study presents six cases of conservative treatment for these fractures, showing positive outcomes in returning athletes to competition. Rehabilitation Procedure Patients underwent functional treatment with orthopaedic insoles, immediate weight-bearing, and various therapies like Orthokine®, Exogen, hyperbaric chamber sessions, ESWT, and EPTA. Post-workout treatments included Game Ready®, flossing, manual therapy, dry needling, and lymphatic drainage. Patients also engaged in self-managed rehabilitation exercises. Treatment Results Radiographic examinations showed progressive healing in all cases, with reduced pain and no edema after two weeks. Patients returned to sports within three weeks, with no complaints after 13 months. The study highlights the success of functional treatment in achieving full recovery without complications. Conclusion The study challenges the need for surgical intervention and immobilization in treating fifth metatarsal fractures. Functional treatment led to excellent outcomes and quick return to sports. Literature review supports early mobilization and functional therapy for optimal results. Further research is needed to establish a standard treatment protocol based on evidence-based medicine.

TREATMENT OF PAEDIATRIC ARTHROGRYPOTIC CLUBFOOT: 20 YEARS OF CLINICAL EXPERIENCE

BackgroundTreatment of arthrogrypotic clubfoot (AC) presents a challenging problem. Over time many different methods have been proposed, with variable rates of success, recurrence and other complications. In this study we describe our 20-year experience in treatment of AC.Materials and methodsBetween 1996 and 2016, 165 AC in 90 children (51 males and 39 females) were treated in our department. Their mean age was 7.6 years (3 months-16 years). Ponseti casting and Achilles tendon release (PCATR) was performed on 38 children (68 feet) and soft tissue release and casting (STRC) on 35 children (67 feet). The remaining 17 children (30 feet) underwent wide soft tissue release and correction using the Ilizarov method (STRIL). The results of each subgroup were graded according to clinical (pain, foot appearance, residual deformities, walking and standing status and shoe modifications) and radiological (anteroposterior and lateral talocalcanear angles, the angle between longitudinal axes of talus and the first metatarsal and the position of talus in the lateral view) criteria.ResultsThe average follow up was 6.4 (2–10) years. Results were excellent (plantigrade, painless, properly loaded feet, without deformities, adapted to common shoes) in 56 PCATR group feet, 59 STRC group feet and 23 STRIL group feet. Good results (required orthopaedic shoes) were obtained in 10 PCATR group feet, 6 STRC group feet and 7 STRIL group feet. Fair results (residual temporary pain and/or mild deformity) presented 2 PCATR group feet and 1 STRC group foot, while bad results (reoccurrence of clubfoot) were found in 1 STRC group foot.ConclusionsOn the basis of our 20-year clinical experience we believe that pediatric AC can be successfully treated with PCATR in the age of less than 1 year old (y.o), with STRC between 1–5 y.o. and with STRIL in children over the age of 5 y.o.

Implementing Additive Manufacturing in Orthopedic Shoe Supply Chains—Cost and Lead Time Comparison

Background: Additive manufacturing (AM) for patient-specific medical care products offers great opportunities. However, evidence about the supply chain (SC) performance impact based on empirical data is limited. Methods: In this case study, we gathered real-life data about a traditional manufacturing orthopedic shoe SC and developed future scenarios in which AM is introduced at various points and with different degrees of penetration in the SC. Results: Presently, AM can only replace traditional manufacturing of tools and shoe components at a higher total cost. However, with maturing technology, the complete AM production of orthopedic shoes is expected to become feasible. Theoretically, that could disrupt existing SCs, eliminating 70% of the SC steps, improving SC lead time by 90%, and altering SC relations. However, certain thresholds currently prevent disruption. Specifically, the AM of complete orthopedic shoes has to become possible, manufacturing prices have to drop, and traditional craftsmanship has to be integrated into the digital product design. Conclusions: A framework for transition pathways, including directions for future research, is formed. Findings provide valuable insights for scholars and decision makers in the patient-specific products industry, health insurance providers, and healthcare policy makers to be better prepared by adjusting SC designs, relationships, and remuneration programs while AM technology develops towards maturity.

Features of anthropometric indicators of the feet of adolescents of Zhambyl region

The comfort of shoes is one of the main indicators of the quality of shoes, which ensures the normal functioning and development of the foot in the process of growth and in general. In turn, the normal functioning and development of the foot determines the normal state of the whole organism, since the appearance of deviations in the foot leads to disturbances throughout the body. In the work, measurements of the feet of young men of the Zhambyl region were carried out in order to develop a size range of shoes, design shoe lasts and shoes with rational dimensional indicators. The measurements of the young men's feet were carried out using both standard and modern 3D scanning methods. The measurements were carried out among schoolchildren and students of higher educational institutions aged 15 to 18 years. As a result of measurements of young men's feet, variational series of dimensional characteristics, statistical data, and correlation-regression equations were calculated. The analysis of the obtained data was calculated using the methods of mathematical statistics and programming. The results of the study of the size of the feet will improve the socio-economic situation, which is expressed in providing the population of Kazakhstan with comfortable shoes that would take into account the anatomical, physiological and psychological characteristics of young men in Kazakhstan. The given data on the size of the feet of young men can be used in shoe factories, organizations for the tailoring of orthopedic and special shoes.

Technical methods of improving the biomechanics of feet in people with diabetes

This article discusses the role of orthoses in correcting biomechanics for patients with diabetic foot syndrome. It also analyzes literature on the use of specialized orthopedic shoes to address biomechanical foot issues and complicated forms of diabetes mellitus. Today, the general requirements for designing orthopedic shoes for patients with diabetes are described: a stiff sole with an artificial cushion; a suitable volume, a wide sole, an insole without a memory function; a thermally changeable elastic material; a minimum number of seams in the lining; an elastic upper and lining material in the toe area of the shoe; an increased fullness and additional volume in the toe region of the shoe, an angle of the bevel at the toe end of the sole, and the ability to adjust the interior volume of the shoe by using a hard heel that is stabilized with additional softness from the lining, as well as a smooth, non-traumatic upper. Indications for orthopedic unloading in patients with diabetic foot syndrome are highlighted.There is a negative approach towards conservative methods of treating patients with diabetic feet, but amputation in these cases cannot be considered a positive outcome of treatment. Nearly 70 to 90 percent of ulcers in this patient group heal without amputation. Techniques using specially designed shoes are less expensive and more cost-effective than limb loss. The use of orthotic shoes in diabetic foot patients serves as a method of both correction and rehabilitation.

Use, tolerability, benefits and side effects of orthotic devices in Charcot-Marie-Tooth disease

BackgroundShoe inserts, orthopaedic shoes, ankle-foot orthoses (AFOs) are important devices in Charcot-Marie-Tooth disease (CMT) management, but data about use, benefits and tolerance are scanty.MethodsWe administered to Italian CMT Registry patients...

Combining Computer Vision, Artificial Intelligence and 3D Printing in Wheelchair Design Customization: The Kyklos 4.0 Approach

In the current paper, we present our work towards developing a solution combining computer vision and AI to support footrest design customization in the wheelchair industry. Wheelchairs and postural systems are complex and often user centric in the design process. Those products require a wide range of adjustments to adapt to the various anthropometries and disabilities of patients. Most commercial products, dedicated to severe disability, also include a series of additional elements, designed to keep the patient in a comfortable but “fixed” position. Such systems do not allow to “fix and maintain” the position of patient foot, especially for patients who have no control over their lower limbs. For that reason, it becomes essential to supply wheelchairs with specific elements to hold patient's shoe in place. Commercial foot supports are typically developed on standard sizes and do not always cover the entire population. In addition, those designs are based on standard shoes, thus they do not lend themselves well to adapting to special shoes or orthopedic shoes. Feet final position therefore becomes a key element in correct postural management. In this paper, we investigate the use of computer vision and AI to correctly define customization parameters of the footrest. The proposed design has been developed based on the specifications received from the Pro Medicare S.r.l[ https://www.promedicare.eu/en/] orthopedic technicians. We present suitable algorithms, design principles and well defined components towards the implementation of our proof of concept. We also present the testing activities we have undertaken and the obtained performance results.

Effect of Subsensory Vibration on Postural Control of Healthy Elderly and Subjects with Simulated Reduced Plantar Feet Sensation: A Randomized Crossover Controlled Trial

Abstract Introduction Postural instability is considered a normal result of aging and is caused by some diseases such as neuropathy. Aim The purpose of the present study was to analyze and compare the effect of subthreshold vibration that was applied to the plantar surface of feet on balance control of healthy elderly and young subjects with simulated decreased plantar feet sensation. Methods Twenty-four subjects (12 elderly persons and 12 young persons with decreased plantar feet sensation) were included in this randomized, double-blinded crossover study. Participants were divided into two intervention groups: 1) orthopedic shoe with vibration mechanism on; and 2) orthopedic shoe with vibration off. Primary outcomes were center of pressure (COP) parameters including mean velocity, phase plane portrait, standard deviation (SD) of amplitude, and SD of velocity. Secondary outcomes were Berg Balance Scale (BBS) score and timed up and go test (TUG). The standing balance was tested with different conditions: eye opened/closed and foam/rigid surface. General linear mixed models tests were used for statistical analysis. The level of statistical significance was set at 0.05 for all analyses. Discussion This study showed very large effect sizes (partial η2 > 0.2) with application of vibration as compared with vibration off for COP parameters with greater effects in condition with more baseline fluctuations. There was significant change in BBS test (Cohen d, 0.6; confidence interval [CI], −0.215 to −1.421). The time on TUG test was decreased and approached significance (P = 0.06). Conclusions The immediate effect of the study showed that subthreshold vibration can improve static and dynamic balance in healthy elderly people and people with decreased plantar feet sensation. However, long-term studies are needed to establish the clinical value of the subthreshold vibration on balance control. Clinical Relevance Subthreshold vibration applied to the feet soles via custom-made shoes can reduce the postural sway in subjects with decreased feet sensation. By conducting more studies with conclusive results in the field of vibration effectiveness in the elderly, we can hope to reduce the rate of falls in the elderly.

Long-term results of corrective surgical interventions in patients with diabetic midfoot neuroosteoarthropathy

BACKGROUND: Diabetic neuroosteoarthropathy is a disabling complication of diabetes mellitus that develops as a result of impaired peripheral innervation and characterized by damage to bones and joints of non-infectious origin. As a result of pathological bone fractures, gross deformities of the foot are formed, which entails development of chronic ulcerative defects in areas of excessive load pressure. Currently, a number of surgical interventions are used to correct deformities, such as resection of bone structures, correction with metal structures and external fixation devices, but there is practically no data on their long-term results in the domestic literature.AIM: To study the results of orthopedic corrective interventions in patients with diabetes mellitus and midfoot neuroosteoarthropathy.MATERIALS AND METHODS: An analysis was made the data collected by questionnaire method of 55 patients operated in the diabetic foot department in the Endocrinology research centre from 2009-2019. All patients underwent a reconstructive operation aimed correcting a gross deformity of the midfoot. In postoperative period, the affected limb was off-loaded by total contact cast for a period of 3-6 months, and in the future, complex orthopedic shoes for permanent use and regular podiatric care were recommended to patients.RESULTS: After the first surgical intervention, 16 patients developed a recurrence of deformity, which required a second surgical intervention. The median period between interventions was 3 years. Chronic wounds of various localization of the operated foot were found in 25 patients.The median period between surgery and ulcer formation was 5 years. 9 patients with chronic wounds underwent minor amputations at the same foot. Amputations on the contralateral limb were performed in 7 patients. None of the patients underwent major amputations.CONCLUSION: Charcot foot is a severe complication of diabetes mellitus that can lead to loss of a lower limb. Due to results of the research orthopedic corrections of the midfoot deformities in patients with DNOAP can reduce the risk of ulcer developement and possible major amputations. Active monitoring and adequate orthopedic care in the postoperative period significantly reduce the risk of deformity recurrence and the need for repeated surgical interventions.

The effectiveness of motivational interviewing on adherence to wearing orthopedic shoes in people with diabetes at low-to-high risk of foot ulceration: A multicenter cluster-randomized controlled trial

AimTo evaluate the effectiveness of motivational interviewing (MI) performed by MI-trained podiatrists in improving adherence to wearing orthopedic shoes in comparison to usual care in people with diabetes at low-to-high risk of ulceration. MethodsPeople with diabetes with loss of protective sensation and/or peripheral artery disease, and with orthopedic shoes prescription were allocated to receive one MI-consultation by a podiatrist randomized to MI training (n = 53) or usual care only (n = 68). Adherence was measured as the percentage of steps taken while wearing orthopedic shoes, determined using an insole temperature microsensor and wrist-worn activity tracker during one week at 3 and 6 months. ResultsThe proportion of participants ≥80 % adherent to wearing their orthopedic shoes was higher in the control group than in the MI-intervention group at 3 months (30.9 % versus 15.1 %; p = 0.044), and not significantly different at 6 months (22.1 % versus 13.2 %; p = 0.210). Average adherence was also higher in the control group than the intervention group at both 3 months (60.9 % versus 50.9 %; p = 0.029) and 6 months (59.9 % versus 49.5 %; p = 0.025). ConclusionsOne podiatrist-led MI-consultation in its current form did not result in higher adherence to wearing orthopedic shoes in people with diabetes 3 and 6 months after inclusion.Trial registration: Netherlands Trial Register NL7710 (available on the International Clinical Trials Registry Platform).

Epidemiological clinical profile and closure of chronic plantar ulcers in patients with leprosy sequelae undergoing orthopedic surgery in a municipality in western Amazon.

Chronic plantar ulcers in leprosy are lesions resulting from motor and sensory alterations caused by Mycobacterium leprae. They are lesions refractory to conventional dressings and present high recurrence rates. To evaluate the epidemiological clinical profile of patients with chronic plantar ulcers associated with bony prominences in the lesion bed and to evaluate the efficacy of orthopedic surgical treatment of these lesions. This is a descriptive and analytical retrospective study with the evaluation of medical records of patients undergoing surgical treatment of chronic plantar ulcers from 2008 to 2018. The surgical technique applied consisted of corrective resection of bone prominences and the primary closure of the lesion with bipediculated local flap. 234 patients were submitted to surgery, 55.1% male with an average age of 69.5 years old. Of these, 82.9% were illiterate; and 88.5% with open lesions over 10 years. After surgical treatment, total wound healing occurred in an average time of 12 weeks. The variables that contributed to shorter healing time were: Patients' lower age group; regular use of orthopedic shoes and insoles and dressings performed by nurse aides in health units before surgery. Obesity was the factor that correlated with the delay of healing time. A higher incidence was observed in males and male and female illiterate patients. The regular use of shoes and insoles and dressings performed by nurse aides in health units contributed to shorter postoperative healing time. Orthopedic surgical treatment with corrective resection of bony prominences proved to be an efficient therapeutic method for the closure of chronic plantar ulcers. It is a reproducible method, justifying the importance of the orthopedic surgeon in the context of the multidisciplinary team to cope with these complex lesions.

Corrective shoes and inserts as treatment for flexible flatfoot in infants and children

We performedaprospective study to determine whether flexible flatfoot in children can be influenced by treatment. One hundred and twenty-nine children who had been referred by pediatricians, and for whom the radiographic findings met the criteria for flatfoot, were randomly assigned to one of four groups: Group I, controls; Group II, treatment with corrective orthopaedic shoes; Group III, treatment withaHelfet heel-cup; or Group IV, treatment withacustom-molded plastic insert. All of the patients in Groups II, III, and IV hadaminimum of three years of treatment, and ninety-eight patients whose compliance with the protocol was documented completed the study. Analysis of radiographs before treatment and at the most recent follow-up demonstratedasignificant improvement in all groups (p 0.01), including the controls, and no significant difference between the controls and the treated patients (p 0.4).
 We concluded that wearing corrective shoes or inserts for three years does not influence the course of flexible flatfoot in children.

SUBSTANTIATION OF THE NEED FOR THE USE OF AUXILIARY ORTHOPEDIC DEVICES FOR DISORDERS OF CHILDREN MUSCULOSKELETAL SYSTEM

The aim of the research is to evaluate the effectiveness and difficulties of wearing orthopedic equipment among children with disorders of the musculoskeletal system. In order to collect and analyze the research data, the study and analysis of professional literature, a sociological survey were carried out. The study involved parents of 50 children aged 4 to 14 years with problems of the musculoskeletal system. Thus, among children with musculoskeletal disorders, orthoses and orthopedic shoes are the most common orthotic products. According to the survey, most parents noted the effectiveness of wearing the equipment. During puberty, especially among girls, there are certain complications when wearing special equipment. Parents who participated in the survey state that children are ashamed and do not want to differ from their peers and friends, which is the reason for refusing to wear the equipment. Thus, the involvement of children with musculoskeletal disorders is one of the most important components of daily life, and the use of orthopedic equipment must be adapted to their lifestyle, be comfortable, especially if they are intended for long-term use. According to the results of the study, it is clear that parents need professional help. Based on the above, the need for constant monitoring and control is justified, which is important for the child's motor abilities and contributes to normal stage development and formation of independence.

Sexuality, Disability, and Aging: Queer Temporalities of the Phallus

Sexuality, Disability, and Aging: Queer Temporalities of the Phallus

Сравнение ортопедической реконструкции деформаций стоп при диабетической артропатии Шарко с консервативным лечением на стадиях 1-2 по классификации Eichenholtz

The objective was to evaluate the efficacy and safety of closed transosseous osteosynthesis in the treatment of patients with diabetic Charcot neuroosteoarthropathy at the acute radiographically positive stage (Eichenholtz 1-2) with hindfoot and midfoot deformity and immobilization using Total Contact Cast. Material and methods Eight patients of the treatment group underwent closed deformity correction and Ilizarov external fixation. The frame was removed with radiographic signs of consolidation and conservative methods of fixation and off-loading employed. The control group consisted of 11 patients who received outpatient conservative treatment with Total Contact Cast combined with crutches. Results The treatment length of surgical patients prior to the use of orthopaedic shoes was shorter than that of patients treated conservatively. Foot ulcers seen in the conservative group during the observation period were not detected in the surgical cases and were associated with the lack of deformity correction. Discussion The advantage of operative reconstruction includes more stable foot and lower risk of ulcers. Reduced rehabilitation period improves the patient's quality of life. Complications that developed in the treatment group were resolved and had no effect on the outcome. Conclusion Closed deformity correction using transosseous osteosynthesis can be an option for patients with diabetic Charcot neuroosteoarthropathy at the acute radiographically positive stage as compared to the conservative treatment.

Influence of the Type of Plastic and Printing Technologies on the Compressive Behavior of 3D-Printed Heel Prototypes

In this study, the possibility of using modern AM technologies to produce designed heels for personalized orthopedic footwear with a medium heel was explored. Seven variants of heels were produced using three 3D printing methods and polymeric materials with different natures: PA12 heels made using the SLS method, photopolymer heels made using the SLA method, and PLA, TPC, ABS, PETG, and PA (NYLON) heels made using the FDM method. A theoretical simulation with forces of 1000 N, 2000 N, and 3000 N was performed in order to evaluate possible human weight loads and possible pressure during orthopedic shoe production. The compression test of the 3D-printed prototypes of the designed heels showed that it is possible to replace the traditional wooden heels of hand-made personalized orthopedic footwear with good-quality PA12 and photopolymer heels made using the SLS and SLA methods, but also with PLA, ABS, and PA (NYLON) heels printed using a cheaper FDM 3D printing method. All of the heels made using these variants withstood loads of more than 15,000 N without damage. It was determined that TPC is not suitable for a product of this design and purpose. Due to its greater brittleness, the possibility of using PETG for orthopedic shoe heels must be verified by additional experiments.