Total Contact Cast in Equinus?

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Recently, at the Advance Pratice Symposium in Melbourne, keynote speaker Dr Roukis emphasised the need to apply a TCC for an active Charcot in an equinus position. I understood his reasons for this were to minimise rearfoot fractures as well as reduce midfoot joint destruction, and to preserve the Plantar Fascia.

Does anyone know of any literature available describing or evaluating this technique? We frequently use TCC for Charcot and ulceration off-loading and are keen to apply the practice, but the TCC articles we have found either specify 90 degrees or no angle.

Thank you for any information you can provide,

Regards

Helen McCausland
Royal Hobart Hospital

 

Have you ever tried to walk in a cast that is >90 degrees .... you can't. There is no data that I am aware of on this, but if you don't want them to ambulate, you cast them in an equinus position.

 

Hi, did he not say that the patients were "tied to the bed" I thought they were not ambulating anyway with the cast on? Did I miss the next sentence, sitting in the back row was difficult to both see and hear?

Cheers