Re: Fw: Torque Heels?
Harold R. Anderson
Description
Collection
Title:
Re: Fw: Torque Heels?
Creator:
Harold R. Anderson
Date:
7/20/1998
Text:
Torque heels are fairly inexpensive and don't do permanent damage to
shoes so, I'd say try it and let us know what your results were.
It's very difficult for me to say this will or will not work based on
what you've presented. Is there spasticity involved? Is the lack of
external ROM coming from the hip or from internal tibial torsion?
Even knowing this may not be enough to say yes or no.
I've worked with orthopedic surgeons who would put twister cables on
even a minor rotational deformity ignoring whether it comes from the
hip or tibia. However, the surgeons I've worked with who are
pediatric specialists tend to not use twister cables or bent knee
orthoses as they claim they don't get good results from them. In
severe cases, they will do osteotomies.
I'm very much interested in seeing what other practitioner's
experiences are concerning rotational deformities such as femoral
antiversion and Internal tibial torsion. Have you had documentable
success with orthotic intervention or is surgery the only effective
means of correcting these problems? I've put many bent knee orthoses
on children for ITT and many twister cables on children with problems
coming from the hip. Unfortunately, these are the cases that we
don't get to follow up on. The ones that do come back tend to be the
failures but does that mean the rest are successes? The twister
cables that I've been able to follow tend to be used to combat high
or low tone problems. The few (very few) that doctors have
prescribed for femoral (or, worse, ITT) rotational deformities have
never returned.
Back to the torque heels. I doubt that they could do any more than
address the symptom if they can do that. My experience is limited
with them and the few I've done have not been very successful. The
same goes for gait plates. When fit, some patients do very well.
Then, a week later, they return intoeing as much as without the gait
plate. One problem I see with them is that they assume fairly normal
gait. The child is supposed to have a heel/toe gait and, if they
avoid pressure on the heel, the torque heel doesn't work. If they
avoid using the toes for push off, then the gait plate doesn't work.
There are too many ways for them to get around the problem we've
introduced to their feet.
But, like I say, try it. You may have success. And let us know.
Harold Anderson, CO
> Date: 17 Jul 1998 18:05:59 +1000
> From: Ben McMurtrie < <Email Address Redacted> >
> Subject: Fw: Torque Heels?
> To: <Email Address Redacted>
> X-To: Orthotics & Prosthetics Listserver < <Email Address Redacted> >
> Reply-to: Ben McMurtrie < <Email Address Redacted> >
>
> Dear members
>
>
> I have a seven year old female with CP who has trouble with Toeing-In. She is a good walker and has a heel-toe gait. I am currently treating her with a hinged AFO to prevent foot drop and excess pron> As I am aware there is not a lot to offer in cont
> Geelong Orthotics
> 42 Bellerine St
> Geelong 3220
> Ph-(03) 52 242200
> Fax-(03) 52 242829
> E- <Email Address Redacted>
>
>
shoes so, I'd say try it and let us know what your results were.
It's very difficult for me to say this will or will not work based on
what you've presented. Is there spasticity involved? Is the lack of
external ROM coming from the hip or from internal tibial torsion?
Even knowing this may not be enough to say yes or no.
I've worked with orthopedic surgeons who would put twister cables on
even a minor rotational deformity ignoring whether it comes from the
hip or tibia. However, the surgeons I've worked with who are
pediatric specialists tend to not use twister cables or bent knee
orthoses as they claim they don't get good results from them. In
severe cases, they will do osteotomies.
I'm very much interested in seeing what other practitioner's
experiences are concerning rotational deformities such as femoral
antiversion and Internal tibial torsion. Have you had documentable
success with orthotic intervention or is surgery the only effective
means of correcting these problems? I've put many bent knee orthoses
on children for ITT and many twister cables on children with problems
coming from the hip. Unfortunately, these are the cases that we
don't get to follow up on. The ones that do come back tend to be the
failures but does that mean the rest are successes? The twister
cables that I've been able to follow tend to be used to combat high
or low tone problems. The few (very few) that doctors have
prescribed for femoral (or, worse, ITT) rotational deformities have
never returned.
Back to the torque heels. I doubt that they could do any more than
address the symptom if they can do that. My experience is limited
with them and the few I've done have not been very successful. The
same goes for gait plates. When fit, some patients do very well.
Then, a week later, they return intoeing as much as without the gait
plate. One problem I see with them is that they assume fairly normal
gait. The child is supposed to have a heel/toe gait and, if they
avoid pressure on the heel, the torque heel doesn't work. If they
avoid using the toes for push off, then the gait plate doesn't work.
There are too many ways for them to get around the problem we've
introduced to their feet.
But, like I say, try it. You may have success. And let us know.
Harold Anderson, CO
> Date: 17 Jul 1998 18:05:59 +1000
> From: Ben McMurtrie < <Email Address Redacted> >
> Subject: Fw: Torque Heels?
> To: <Email Address Redacted>
> X-To: Orthotics & Prosthetics Listserver < <Email Address Redacted> >
> Reply-to: Ben McMurtrie < <Email Address Redacted> >
>
> Dear members
>
>
> I have a seven year old female with CP who has trouble with Toeing-In. She is a good walker and has a heel-toe gait. I am currently treating her with a hinged AFO to prevent foot drop and excess pron> As I am aware there is not a lot to offer in cont
> Geelong Orthotics
> 42 Bellerine St
> Geelong 3220
> Ph-(03) 52 242200
> Fax-(03) 52 242829
> E- <Email Address Redacted>
>
>
Citation
Harold R. Anderson, “Re: Fw: Torque Heels?,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/210685.
