A good plan for prevention and treatment of diabetic foot usually focuses on the prevention of diabetic foot. Two important preventive measures are health education and reasonable use of shoes. Unfortunately, it's only when diabetic patients have foot problems (such as diabetic ulcers) that they begin to seek health advice. These patients have never even had peripheral nerve tests, or they haven't recently, which often happens. Many of these patients simply do not understand the risk of diabetic neuropathy or its related complications. For a patient who has never experienced foot ulcers or foot discomfort, it is challenging to persuade and restrict the use of footwear (recommended by their health counselor). If you have a diabetic foot care team, this work will become very efficient. The members of the team support each other, cooperate and be responsible for patients of common interest. Mao Wei, Department of orthopedics, Beijing Tongren Hospital

Doctors and patients are the foundation members of the team, as well as other supporting staff (essential for a successful diabetic foot care group).

Other members of the team include qualified diabetes education specialists, wound care nurses, physiotherapists, foot shoe makers and orthosis surgeons who work with doctors and patients to prevent foot ulcers and amputations.

Full contact plaster is known as the gold standard for healing diabetic foot ulcers. It should be pointed out in this paper that foot shoe makers and orthosis will play a fundamental role in healing ulcers and fractures and in long-term care to prevent further ulcers and fractures. But for the treatment of open ulcer and active Charcot's fracture, this method is not ideal.

Duty of foot shoes manufacturer

Foot shoes manufacturers should be full of artistic and scientific thinking to design, make suitable and modified shoes and foot pads, so as to alleviate foot problems caused by disease, fatigue and trauma. Foot shoes manufacturers should install foot pads, shoes and modified shoes according to the doctor's requirements.

A shoemaker with foot disease should receive education on foot anatomy, pathology, shoe and foot pad making and use. In order to obtain the qualification certificate granted by the committee, the foot shoe manufacturer must pass the examination and be recognized by the Orthopedic Association of foot (BCP), and be subject to strict ethical regulations.

Foot shoe maker plays a key role in the prevention of ulcers and amputations. His main task is to provide patients with comfortable and comfortable shoes, including customized insoles that can be placed in shoes, or internal or external modifications of shoes. Foot shoes manufacturers not only need to install and provide the above products, but also to adjust and maintain them.

Another duty of the foot shoes manufacturer is to educate the patients, which plays an extremely important role in teaching each patient how to choose shoes, including the basic requirements for comfort, instructions for use, appropriate materials and types. As a member of the diabetic foot prevention and treatment team, he also needs to strengthen the information and suggestions delivered by other members of the team.

Foot shoes manufacturers also play a part in monitoring the improvement of patients' condition, which is very useful for doctors to follow up and remind other members to follow up when necessary.

The role of orthosis orthosis

The word orthosis is derived from the Greek word orthosis, which means straight, upward or corrective. The word orthosis means to affect or change the structure or basic characteristics of the nervous, muscular and skeletal systems through the use of external devices. The word bracket and "orthosis" are often used. But "orthosis" is a more commonly used term, and "orthotics" is often used to describe the theory, practice, construction and transformation of orthosis. Professionals in this field are known as "orthopedics".

Orthosis is the most qualified member of the team in the use of foot and ankle orthosis. To become an orthosis, he must pass a series of examinations and be certified by one of the following two institutions: the American Orthopaedic and prosthetic Association, and the orthopaedic and prosthetic assembly Certification Committee. Qualified foot shoe manufacturers and orthosis orthosis orthosis practitioners must receive continuous and strict re education and strictly follow the ethical guidance of authorized organizations.

The role of orthosis orthosis is very similar to that of foot shoe makers, educating patients and monitoring disease progression. Because shoes and optional braces can not only be compatible with each other, but also complement each other. There is a close cooperation between orthosis and foot shoe manufacturers.

Sometimes, the work of orthosis orthosis and foot shoe maker intersects each other, but more often they fill in the gap. The work scope of foot disease shoes manufacturer mainly concentrates on the foot, while the orthopedic brace technician provides orthopedic devices for the whole body. The foot sick shoes manufacturers who work in the regular institutions have a certain number of treatment shoes and know the users of each product. Many orthosis support mechanisms have a large number of skeletal orthoses.

shoes

It has been proved that inappropriate shoes are a common cause of diabetic foot ulcers, and therapeutic shoes can significantly reduce the risk of ulcers. According to the following functions of diabetic treatment shoes, it is very important to deeply understand the following functions when discussing different types of treatment shoes. They are:

Protective foot: the loss of sensation of the foot needs to avoid external damage and various adverse factors

Reduce the area of excessive pressure: in daily life, repeated high pressure on certain areas of the foot can lead to skin ulceration. It is usually the part of the plantar bone process, such as the tarsal head area, the callosum area of the foot, mallet toe and Haglund's deformity. Reducing the pressure area and making the pressure evenly distributed can reduce the incidence and recurrence rate of ulcer

Reduce shock: reduce the pressure or vibration in the vertical direction, which is very important for patients with abnormal bone process or bone structure, such as Charcot's foot.

Reduce shear force: shear force is the force generated when the foot moves back and forth inside the shoe. Reducing shear force can reduce the formation of corpus callosum, blister and heat generation.

Matching with deformities: deformities usually result from Charcot's disease, atrophy of plantar fat pad, amputation, and shoes used should be well adapted to foot deformities. This is also important for forefoot deformities such as pollicis, saculitis, mallet toe and claw toe.

A lot of deformities can be carried out with further stabilization of the deformity, and the deformity can be further stabilized with support from the foot.

Matching with foot orthoses or foot ankle orthoses: these orthoses may affect the comfort of shoes. This factor must be taken into account. Not all shoes can match these braces. If l orthoses are used on the outside of shoes, shoes must be modified to adapt to them.

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