We assess patients with previous surgery, sequelae or complications from earlier treatment, accidents, neurological conditions, major asymmetry or orthoses they have not tolerated.
Some patients arrive after surgery, accidents, sequelae or complications from previous treatment, neurological disease, major asymmetry or orthoses they could not tolerate. In these situations, oversimplifying can be a mistake.
At MEDIPIE we organise the clinical information, review reports, footwear, previous orthoses and realistic goals. Treatment, when appropriate, should be cautious, progressive and reviewable.
When indicated, an orthosis, adaptation or footwear modification may help unload sensitive areas, provide stability or enable progressive adaptation.
If the case requires rehabilitation, trauma/orthopaedic assessment, neurology or another approach, we explain that. Orthotic care can be part of the plan; it does not replace other disciplines.
Trying to modify every finding at once can reduce tolerance and make it difficult to know what is helping.
We prioritise what limits the patient most: pain, pressure, stability, shoe fit or walking capacity.
We select an intervention compatible with skin, mobility, footwear and the person's real ability to adapt.
The response to the first adjustment guides whether to maintain, modify, add another approach or stop treatment.
If there are signs requiring medical assessment, if the skin or sensation cannot tolerate safe adaptation, if the objective is unrealistic or if the main problem lies outside orthotic care, we do not force a solution with orthoses.
In some cases the right decision is to coordinate, refer, complete further testing or wait before changing foot support.
When previous lifts, orthoses or adaptations exist, we review what they were trying to achieve, how long they were used, with which footwear and what caused poor tolerance. An asymmetry is not automatically compensated from one isolated number either.
Cases involving previous surgery or trauma, deformity, neurological disease, major asymmetry, sensory impairment, several possible causes or previous treatment that was not tolerated. Complexity depends not only on the diagnosis but also on footwear, skin, mobility, goals and the ability to adapt.
Not always. Before fabricating anything we assess whether there is an achievable objective, whether the foot and skin can tolerate the intervention, whether it fits the footwear and whether it can realistically be used. Sometimes a partial solution, progressive adaptation, another device, coordination with another professional or no orthosis is the better decision.
See how to prepare reports, tests, footwear, aids and previous treatment so the case can be reconstructed in an orderly way.
Bring reports, previous orthoses, footwear and relevant tests. We will organise the history and define a realistic assessment objective before considering treatment.
Clinical content reviewed by Juan Bautista Calero Márquez, podiatrist registered no. 115 in the Region of Murcia.