Name of the Procedure:

Custom Molded Shoe (A5501) Fitting, including follow-up, custom preparation and supply of shoe from cast(s) of patient’s foot.

Summary

This procedure involves creating a custom-molded shoe specifically designed to fit the unique contours of a diabetic patient's foot. It includes taking a cast of the foot, designing the shoe, and fitting it properly, along with any necessary follow-up adjustments.

Purpose

This procedure addresses foot deformities and complications commonly found in diabetic patients, such as pressure sores, ulcers, or neuropathy. The goal is to prevent these issues by ensuring proper foot support and pressure distribution, hence fostering better foot health and preventing future complications.

Indications

• Diabetic patients with foot ulcers or at high risk of developing ulcers
• Foot deformities, such as Charcot foot or hammertoes
• Peripheral neuropathy causing changes in foot shape or gait abnormalities
• Previous foot amputations or surgeries

Preparation

• No fasting or medication adjustments typically required
• Thorough foot examination and measurement by a healthcare professional
• Patient history review, focusing on diabetic complications and foot health

Procedure Description

1. Initial Assessment: The healthcare provider performs a comprehensive foot evaluation.
2. Casting: A cast of the foot is made using plaster or fiberglass to ensure a precise mold.
3. Custom Shoe Design: Based on the cast, a custom-molded shoe is designed to accommodate and support the foot's specific structure.
4. Fitting: The patient returns for a fitting session to ensure the shoe fits correctly; adjustments are made as necessary.
5. Follow-Up: Regular follow-up visits are scheduled to assess the shoe’s effectiveness and make any further adjustments.

Duration

• Initial assessment and casting: Approximately 30-60 minutes
• Custom shoe fabrication: A few weeks
• Fitting and adjustments: 30-60 minutes per session

Setting

Primarily conducted in outpatient clinics or specialized orthotic centers.

Personnel

• Podiatrist or specialized healthcare provider
• Orthotist or prosthetist skilled in custom footwear design

Risks and Complications

• Improper fit leading to discomfort or worsening of foot issues
• Allergic reactions to materials used in the shoe
• Potential delays in shoe fabrication impacting effectiveness

Benefits

• Improved foot support and pressure distribution
• Reduced risk of ulcers and foot sores
• Enhanced mobility and comfort
• Better overall foot health

Recovery

• Minimal recovery time; patients can typically walk out of the clinic
• Follow any specific care instructions provided for maintaining and using the custom-molded shoe
• Regular follow-up appointments to ensure the shoe remains well-fitted and effective

Alternatives

• Off-the-shelf orthopedic shoes
• Customized insoles
• Regular foot care and monitoring
• Pros and Cons: Custom-molded shoes offer superior fit and support compared to off-the-shelf options, but they are more expensive and time-consuming to produce.

Patient Experience

Patients may experience a bit of discomfort during the casting process but generally feel significant relief once the custom molded shoe is fitted. Pain management is usually not required, but regular communication with the healthcare provider ensures any issues are promptly addressed, making the overall experience positive.