Total Contact Cast with Positioning Device for Diabetic Foot
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Solution Overview
Problem
The application of total contact casts for diabetic foot wounds is hindered by complexity, potential misapplication, high cost, and the need for assistance, leading to reduced usage due to practitioner concerns and patient compliance issues.
Innovation Solution
A method for constructing a total contact lower leg cast using adjustable components like foam pads and a foot and ankle positioning device, which allows for efficient application by a single practitioner, distributing weight to reduce pressure and shear forces, and incorporating a rocker bottom cast shoe for ease of use.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a traditional total contact cast is applied, then weight redistribution and wound protection are achieved, but the application process becomes complex and requires assistance
Solution Approach 1:
The cast construction process is divided into distinct segments: applying foam padding to the lower leg, applying cast padding to the foot and ankle, applying cast tape in specific layers, and incorporating a positioning device. This segmentation allows each component to be applied systematically, reducing overall complexity while maintaining effectiveness.
Solution Approach 2:
A foot and ankle positioning device is introduced as an intermediary tool during cast application. This device maintains proper foot positioning (90 degrees to the lower leg) during the hardening process, eliminating the need for assistant help and simplifying the application procedure while ensuring proper weight redistribution.
2Reliability
If a total contact cast is applied to redistribute weight, then pressure on wounds is reduced, but the application time increases
Solution Approach 1:
Foam padding is applied to the lower leg before the cast tape is applied and while it is still pliable. This preliminary action ensures proper positioning and cushioning are established before the cast hardens, reducing the need for adjustments and minimizing application time.
Solution Approach 2:
The cast tape is applied in a manner that allows it to self-harden and set in the correct position. The positioning device maintains proper alignment during this self-setting process, eliminating the need for continuous practitioner adjustment and reducing overall application time.
3Reliability
If traditional cast materials are used, then adequate protection is provided, but the cost of materials increases
Solution Approach 1:
The invention changes the material parameters by using foam padding instead of traditional bulky cast materials for the lower leg portion. This substitution maintains protective functionality while reducing material cost and quantity required.
Solution Approach 2:
The cast combines different materials strategically: foam padding for the lower leg (cost-effective and comfortable), cast padding for the foot and ankle (provides necessary cushioning), and cast tape for structural support. This composite approach optimizes protection while controlling material costs.
4Reliability
If a total contact cast is applied to protect healed tissues, then reinjury risk is reduced, but patient compliance becomes more difficult
Solution Approach 1:
The cast provides differentiated protection: foam padding in the lower leg area (more compliant and comfortable for long-term wear), cast padding in the foot and ankle areas (provides rigid protection where needed). This local quality variation improves patient comfort and compliance while maintaining protection effectiveness.
Solution Approach 2:
The cast incorporates a rocker bottom shoe component that allows dynamic movement and weight transfer through the heel and toe areas. This dynamic design reduces shear forces on healed tissues while allowing natural gait motion, improving patient compliance during the protection phase.
Data Source
AI summary
A lower leg and foot cast including foam padding, a stockinette, cast padding, one or more layers of conformable cast tape, a foam pad having a foot bed and left and right malleolar pads, and a foot and ankle positioning device configured to be positioned over the foam pad, the device including an under foot portion and left and right vertically-extending side extensions configured to be positioned covering the left and right malleolar pads of the foam pad.