pressure sore - Foot Problems Message Board

blackbelt · 12-29-2000, 10:31 PM

I wear an AFO (brace) on my right foot/leg. The brace is constructed out of hard plastic. When I first got the brace, the orthost (orthotic maker), told me to check each night for pressure sores and/or calluses on my foot. My question are, what does a pressure look like? I think I have a callus on my foot. Is this something to be worried about?

Please respond if you have any suggestions.

Thanks,
Blackbelt

Foot Pro · 12-30-2000, 09:17 PM

A pressure sore usually starts out as an irritation point. Say for instance, you AFO may rub a callus over your ankle and with time, the callus gets hard and thick and may ulcerate underneath the callus wothout you knowing about it. If you don't have much feeling in your legs or feet you need to be seen by your physician on a regular basis. More importantly, if you have a callus or think your brace is causing a problem such as a pressure sore, you should probably see a podiatrist who takes care of these problems more than any other healthcare professional. Why are you wearing the brace? Do you have foot drop for some reason? Did you have a stroke? Braces need to be adjusted periodically. This can be done by any orthotist at a limb and brace shop. Was the brace designed for your leg? ie did they make a cast or impression of your foot and leg prior to you receiving the brace? Hope this helps.

blackbelt · 12-31-2000, 09:05 AM

Foot Pro, here is some more info. about my AFO.
I wear an AFO because I have mild cerebral palsy on my right side. Specifically, my right ankle and knee overpronate, I cannot achieve a normal heel-toe gait when I walk, I have mild spasticity in my right leg, and my leg hurts and/or feels tired when I stand and/or walk for a long time without support from the brace. I am not sure if I have foot drop. The brace improves all of the above conditions, and even allows me to stand up straight and have better balance.
The brace was designed for my leg.
I will check with my orthotist and/or a podiatrist because I think I have a callus on the ball of my foot, and an irritation on the top of my ankle (which is nowhere near the brace). I have a rough spot on my left foot in the same place, so I am not sure if this is just from my body adjusting to a more normal gait, or if it is from the brace. Will a podiatrist/orthotist be able to determine this? How often do you suggest that braces be checked by an orthotist to ensure a good fit? I have had my brace for 5 months.
Thank you so much for the advice Foot Pro!

Foot Pro · 01-02-2001, 12:31 AM

I am a podiatrist by trade. I also work with alot of orthotists and prostheticians. With cerebral palsy, people usually have contractures of their tendons especially the achilles tendon. The afo's work wonders for these patients / individuals. If you have a rough spot or callus in the same place on the opposite foot then it is probably not from the afo itself. It's is probably due to your gait pattern which is very specific for your condition. If you have good sensation in your feet, you might want to try a softening agent to the callus such as eucerin plus. In addition, you might want to take an emory board or pumis stone to help smooth the callus down. If the callus is deep, then do not attempt to "cut it out". Let a podiatrist do this. As for having your brace checked, I would recommend at least after the 1st month. When I order braces such as afo's or double upright braces I'll check the brace myself to make sure there is no irritation point. Most my patients have very little sensation in their feet and are at increased risks for developing "pressure sores" and all of the complications that come with it (infection, delayed healing etc...). Also, I have seen AFO's rub blisters over the outside portions of the ankle. Anyway, the orthotist should check the AFO out to make sure it's a proper fit. Some orthotists as well as podiatrists and orthopedists will order prefabricated AFO's which I dont believe in. These devices should be ordered and made for the individual person. They should be custom. As you probably know the custom devices are fairly expensive. But I feel that they are far more superior. I've babbled on long enough. But if you're having any problem that you are concerned about, you should definitely see someone. The orthotist will be able to make any adjustment necessary to correct your brace problem if you have one. Good Luck.

blackbelt · 01-13-2001, 02:03 PM

Thanks for the advice. I have seen the orthotics person who made the AFO for me. He made a dent in the brace right where it was rubbing my foot (and making the callus), and he put a pad in the bottom of the brace to cushion it against my foot. I have also been putting some cocoa butter on the callus, which seems to soften it. The callus seems to be smaller now.

Thanks,
blackbelt