Foot Focus Podiatry

Mon - Fri : 08:30 - 5:30   |   08 9258 4152
reception@footfocuspodiatry.com.au | Google Review
Mon - Fri : 08:30 - 5:30   |   reception@footfocuspodiatry.com.au
08 9258 4152 |
Google Review
Mon - Fri : 08:30 - 5:30
08 9258 4152
reception@footfocuspodiatry.com.au
Google Review
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Orthotic Therapy Using Chairside Orthotics.

 

Why Our Clinic Uses Chairside Orthotics

  • Improve orthoses outcomes & patient satisfaction
  • Link chair-side orthoses modifications to the FFO prescription form
  • Increase podiatrist confidence when prescribing FFO

Why Chairside Orthoses?

  • Prescription aid for customised orthoses
  • Immediate intervention in painful presentations
  • Longer effectiveness than strapping
  • Temporary devices as backup while FFO are being fine-tuned or refurbished
  • More realistic biomechanical change than strapping (Primarily symptom relief)
  • When FFO’s are not needed for various reasons

When to Use Orthotics?

  • Symptoms – short term (heel pain) or long term (OA, TP dysfunction)
  • Signs – bunions, hallux limitus, long 2nd metatarsal?
  • Severity – extent of poor foot biomechanics
  • Family History – foot, knee, back problems

What to Consider?

  • Short term need
    – symptom relief for temporary conditions like heel pain. 

  • Long Term need
    – chronic symptoms, e.g. OA of foot, TP dysfunction
    – preventative care
  • Trial basis
    – testing effectiveness for knee and back pain
    – shoe requirements and restrictions

Where to Start?

  • Determine foot type
  • Define treatment goals

– Biomechanics – target forces, pressure points, and desired changes

– Pain relief – identify areas needing tension or relief (Note: Initial approach may differ from long term strategy) 

  • Begin with chair-side orthoses
  • Schedule initial and follow-up reviews
  • Evaluate need for FFP – consider improved outcomes and cost benefits

– Foot Type: Pronated, Neutral, Supinated

  • Severity level
  • Consider age and related conditions (weak ankles, sever back pain, etc.)

Types of Modifications:

  • Wedging
    –Medial or lateral
    –Extrinsic or intrinsic (e.g. Kirby skive)
    –Rearfoot or forefoot
    –Amount in degrees
  • Padding – EVA/felt etc.
    – Medial or lateral
    –Midfoot or forefoot
    –Amount in layers?

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  • Winograd procedure- This procedure will be done in hospital setting under local and or general anaesthesia and it is reserved upon failure of the phenolization or if there is significant amount of skin overlapping the nail with soft tissue growth. This procedure involves removing a portion of the skin along with the nail down to the level of the bone. Sutures (stitches) will be applied to close the surgical site. The procedure takes about 10-15 minutes to be performed and your foot will be bandaged. You will be seen within first 5 days and then the sutures will be removed in 10-14 days. Currently this procedure can only be performed by Reza Naraghi (podiatric surgeon).  He will prescribe appropriate pain medication for your post-operative pain management. You will be in open sandal and or post op shoe for 2 weeks. This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a Winograd then please click here.
  • Zadik Procedure- This procedure is used with permanent total nail removal is desired. The indications for the procedure are significant ingrowing nail on both borders, thickened and painful nails and bony growth under the nailbed. This procedure can be done under local with sedation and or under general anaesthesia at a hospital and or day surgery centre. Sutures will be applied and will be removed 14 days post surgery. You can not get your foot wet and your foot will be in a sterile bandage for 2-3 weeks. You may need pain medication post surgery. On average it will take six weeks for your nail bed area to heal. Following that you can wear most close shoes.
  1. This procedure involves:
  • Removing the nail partially or totally and ablating (destroying) the root using a weak acid called phenol.
  • The phenol cause permanent ablation of the root of the offending nail and prevent ingrown nail recurrence.
  • The procedure is successful 95% of the time. The procedure takes about 10-15 minutes to perform.
  • It can be done in our rooms using local anaesthesia with or without sedation.

2. Post operative care:

  • Soak your toe.
  • Apply a daily dressing.
  • Wear open toe shoes for at least 3-4 days.
  • You may be required to take oral antibiotics

3. Pain management:

  • Most patients do not require pain medication
  • If needed, Panadol is usually sufficient
  • You can return to regular shoes after one week
  • This procedure is not suitable for everyone, especially those uncomfortable with surgical procedure
  • For those interested in seeing a step-by-step process of a partial nail matrixectomy with phenolisation, click here.
  • Winograd procedure- This procedure will be done in hospital setting under local and or general anaesthesia and it is reserved upon failure of the phenolization or if there is significant amount of skin overlapping the nail with soft tissue growth. This procedure involves removing a portion of the skin along with the nail down to the level of the bone. Sutures (stitches) will be applied to close the surgical site. The procedure takes about 10-15 minutes to be performed and your foot will be bandaged. You will be seen within first 5 days and then the sutures will be removed in 10-14 days. Currently this procedure can only be performed by Reza Naraghi (podiatric surgeon).  He will prescribe appropriate pain medication for your post-operative pain management. You will be in open sandal and or post op shoe for 2 weeks. This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a Winograd then please click here.
  • Zadik Procedure- This procedure is used with permanent total nail removal is desired. The indications for the procedure are significant ingrowing nail on both borders, thickened and painful nails and bony growth under the nailbed. This procedure can be done under local with sedation and or under general anaesthesia at a hospital and or day surgery centre. Sutures will be applied and will be removed 14 days post surgery. You can not get your foot wet and your foot will be in a sterile bandage for 2-3 weeks. You may need pain medication post surgery. On average it will take six weeks for your nail bed area to heal. Following that you can wear most close shoes.

Matrixectomy with phenolization – This procedure involves removing the nail partially or totally and ablating (destroying) the root using a weak acid called phenol. This will cause permanent ablation of the root of the offending nail and prevent ingrown nail recurrence. This procedure is successful 95% of the time. The procedure takes about 10-15 minutes and can be performed in our rooms using local anaesthesia with or without sedation. Post operatively you will be required to soak your toe and apply a daily dressing. Wearing open toe shoes for at least 3-4 days is recommended. You maybe required to take oral antibiotics. Most patients do not require pain medication following the procedure, and if needed Panadol is sufficient for pain management. You can go back to regular shoes after one week.  This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a partial nail matrixectomy with phenolisation then please click here.