Responses Toe Seperation

Responses Toe Seperation

Darrel Templeton

2/9/2010

Thank you very much to everyone who took the time to respond. Here's my
original post and the responses:

 

            I have a 12 year old CP patient currently wearing bilateral
solid ankle AFO's. He is non-ambulatory, but uses a standing frame at
school and home. He has hallux valgus on his right foot, but his 4th and
5th toes deviate medially. The result is that his toes are crowded
together and the 3rd sits under the 2nd. In the past we have used a
strap between the 1st and 2nd toe to address the hallux valgus, but it
does not correct the other overlapping toes. His toes aren't rigid and
correct easily; has anyone had any luck with a device to align the toes
used in conjunction with an AFO's and shoes?




Kind of a time consuming but worth the effort. Glue Foam Bumpers on AFO
between toes(Have to widen the footplate on toes in mold to accommodate
for this). Disadvantage is that he child has to wear the individual
toes socks but worth the outcome. Or simply have parents use gel toe
spacers in between toes inside of socks.

 

I have had good luck using Pedifix Pediplast
( <URL Redacted> is a silicon resin (about the
consistency of Silly Putty before it is catalyzed and set) that you can
mold directly on the patient to create custom toe spreaders/restrainers.
You can manipulate the durometer by the amount of catalyst used. When
cured, it is durable and non-absorbent so it is easy to clean. I have
used it on Parkinsons patients and even (once) made a great toe filler
for a young aspiring ballerina's ballet shoe that successfully replaced
a missing distal phalanx of the great toe.

 

silicone toe spacers worn inside the sock

 

What if you used a small hallux valgus night splint(if you cant find a
night splint for a bunionette) for the 5th digit and add straps to pull
the 3rd & 4th digit over.It has worked for me.

 

I am an adult who has spastic diplegic cerebral palsy. I also have
moveable hallux vulgas that has progressed over the years. Orthotist
once used pink putty to make more of a moveable brace for one or two
toes. This worked quite well for awhile. As I grow older and the case
becomes more complex, nothing fits right over both hallux vulgas and
other toes. I prefer to keep feet moveable via stretching than lose skin
off of my toes from friction of a custom brace for the seperation of
toes. My toes were always bleeding no matter what anyone made.

 

Maybe you should try pediplast to keep toes separated

 

Any chance you can cut a slit in the footplate and use an elastic strap
to go between/over/around the toes to separate them? I have done this a
number of times over the years for just such a reason. A bit bulky, but
works well.

 

Yes, u can (the patient can) purchase socks with toes, then we have
built vertical separators so each toe has it's place, and strap down
over the top. Once done those toes aint goin anywhere. Granted a tedious
job and a financial loss, but it works. Wheaton also makes a decent
halux valgus elastic sock-splint that works pretty good for at least the
great toe.

 

Google Vibram five fingers. Not meant for this but it just might work
since he is non-ambulatory. (And they look really cool!)

 

TRY PEDICURE FOAMS

 

I haven't seen the foot obviously, but I wonder about a toe comb.

 

I've used a silcone toe crest for this type of thing in the past.

 

When people are given pedicures, there is a whole range of toe-separator
devices that are used to keep the toes apart during the procedure and
while the nail polish paint is drying. I have seen various sponge
materials and some harder foams, all in one piece. Have you tried
anything like this? If the patient's toes are easily correctable,
perhaps one (or two or three) of these might work? They are deformable,
washable and might also work inside footwear. What I don't know is
whether they are stiff enough for the purpose, hence the need to search
out various materials and perhaps put several of them in a row.

 

Thanks,

Darrel Templeton CO