ORTHOMEDICES FOR Diabetic patient
 Diabetic foot care Preservation To Avoid Amputation
Diabetic shoe cover any change in size , soft, light weight.

diabetic patient who has peripheral neuropathy, forefoot deformities, ulcer should have:
  • Extra depth
  • Blucher closure
  • Wide high toe box
  • Soft leather upper
  • Removable insoles
  • Cushioned crepe soles.
Reduce  Weight bearing on heel, metatarsal so avoid ulcer formation by use
full length silicon insole.

Neuropathy and/or poor circulation could be prevented with careful foot care.
Atrophy of fat prevent it by use.
 Ankle Gel support
Laxity in Ligment  instability of Ankle.
Medial, lateral support.
Soft gel inside.
Sprain , Strain.
 Offloading insole
If occur ulcer use offloading insole
If ulcer formation offloading. distribute weight bearing healing to ulcer.
Offloading v soft avoid formation new ulcer.
With offloading easy to dressing ulcer.
 Basic Principles of Ulcer Care
Reduce pressure at the ulcer site.
Optimizing blood flow to the foot.
Frequent debridement of the ulcer.
Prevention and treatment of infection.
Controlling of blood sugar.
 The Total Contact Cast (TCC).
TCC transfers weight away from the foot and redistributes weight-bearing forces        proximally to the leg
 The Total Contact Cast Disadvantages
Prolonged immobilization of the ankle.
 joint lead to stiffness and muscle atrophy.
Increased areas of pressure lead to formation of new ulceration.
There is no universally accepted technique or single method for applying a total        contact cast.
 Charcoot join (Air walker.)
 Protection from trauma.
 Limb immobilization.
 Reduction of edema.
 Reduction of pressure over the ulcers.
 Removable Walkers
 pressure reduction that is simple and practical for both patient and physician.
 Allow easy access to an ulcer for evaluation, debridement, or topical therapy.
 Used in cases of mildly infected ulcers.
 Reused.
 DH Pressure Relive Walker
 Air walker with a diabetic health pressure insole
 Combines protection, stabilization and plantar pressure reduction.
 Removable hexagonals disperse plantar weight-bearing pressure.
 ORTOMEDICES WITH DIABETIC PATIENT STEP BY STEP
1ST  Diabetic shoe
Silicon insole to distribute pressure
Ankle gel support if ankle instability
Air walker if charcot joint
Silicon insole to avoid ulcer
Offloading insole in case of ulcer
DH walker if ulcer+ Ankle instability
Good quality prosthesis in case of amputation
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