Prosthetic toes improve shoe fit after amputation.
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Toe amputations can occur from traumatic injuries, infections or as a result of a medical condition such as diabetes. Toe prosthetics, or artificial toes, are used to improve balance for walking, prevent deformities of the remaining toes and enhance the appearance of the foot.
Single toe amputation -- even of the big toe -- does not usually affect a person's ability to walk. However, it can affect the position of the other toes, potentially causing deformities over time. For example, amputation of the second toe can cause the big toe to angle in toward the other toes. This condition requires an artificial toe filler, either as part of a shoe insert or a custom-made toe prosthesis. Artificial toes are made using the same toe on the opposite foot as a model. These prostheses slide over the foot like a slipper, providing a lifelike appearance.
Several treatment interventions are required before a prosthetic toe can be used. Immediately after amputation, wound care is performed until the skin has completely healed. Pressure from a prosthetic toe could cause the wound to reopen if the skin has not fully healed. Pressure wraps are used around the foot to reduce swelling and give a smooth shape to the area below the amputated toe. This is vital for proper fitting of the future toe prosthesis. Preprosthetic treatment typically takes 6 to 8 weeks to complete.
Physical therapy is often prescribed after toe amputation. Before prosthetic training, exercises are performed to strengthen the leg muscles used for standing and walking. Range of motion exercises are prescribed to maintain flexibility of the remaining toes. Gait training activities teach the person how to walk after the amputation. An individual's center of balance shifts after toe amputation, requiring the ankle muscles to work harder to maintain balance. An assistive device, such as a cane or crutch, may initially be needed for walking.
Physical therapy continues after the toe prosthesis is ready to teach a person how to walk with the artificial toe. A heel-to-toe walking pattern is practiced. This may be difficult at first due to lack of sensation in the toe prosthesis. Gait training activities progress to walking on uneven surfaces and climbing stairs and continue until a person is independent with his prosthesis. The skin is monitored for pressure areas -- redness that doesn't go away within 15 minutes after the prosthesis is removed. This must be addressed immediately to prevent skin breakdown.