1、Biomechanical Biomechanical Considerations in Considerations in Preventing Plantar Preventing Plantar UlcerationsUlcerationsJOSEPH C DAMICO DPM,DSCJOSEPH C DAMICO DPM,DSCNEW YORK,NEW YORKNEW YORK,NEW YORK2025Opening StatementOpening Statement Plantar foot ulcerations are precipitated or perpetuated
2、by pedal pathomechanics Functional imperfections occur not only in the foot but may have their origin in the superstructure resulting in an often-overlooked source of pedal stressors Identification and neutralization of these osseous or soft tissue deficiencies is critical in the prevention and mana
3、gement of plantar ulcerations Plantar pressure and temporal parameter analysis reveals and documents these abnormal otherwise invisible forces occurring under the foot and inside the shoe while the patient is walkingHowardHoward80 active MDMIIPNHTNCAD 5 stentsPADGoutPedal and superstructural deformi
4、ty and dysfunctionsevere peritalarsubluxationmedialward displacement body weightgouty arthritic changesDSISDynamic Stabilizing Innersole SystemDynamic Stabilizing Innersole Systemcentral slitmedial lateral control armssagittal plane forgivenessmedial lateral flangescalcaneal inclination enhancement
5、1/8”Jay RM Schoenhaus HD Hyperpronation control with a dynamic stabilizing innersole system JAPMA 1992rightmedialDSISDynamic Stabilizing Innersole System50 childrenreduced RCSP 6 6Jay RM Schoenhaus HD et al The DSIS in the management of hyperpronation in children Jrn Foot&Ankle Surg 1995Disadvantage
6、sDisadvantagesforefoot posts cannot be extended to sulcusunable to add metatarsal padprone to fractureDSIS Limitations barefootbarefootbarefootbarefootbarefootbarefootbarefootbarefootbarefootsneakerbarefootsneakerbarefootsneakersneakersneakerDSISDSISDSISDSISDS