Effect of the Foot Orthosis for Children Scoliosis Caused by Inequality of Resting Calcaneal Stance Position Angle

OBJECTIVE: To evaluate the effect of custom molded foot orthosis without heel lift in scoliosis patients who had different pelvic height caused by inequality of RCSPA (resting calcaneal stance position angle). METHOD: We retrospectively reviewed the medical data of all patients who had been prescribed custom molded foot orthosis without heel lift in our institution from 2005 to 2009 and chose 38 scoliosis patients with Cobb's angle (> or =10degrees) and different pelvic height (> or =5 mm) caused by inequality of RCSPA (> or =2degrees). Radiologic findings of whole spine AP and RCSPA were measured pre and post treatment and compared. RESULTS: Twenty two females and sixteen males were included in this study. Their mean age was 7.76+/-3.72 years. Their mean period of wearing orthosis was 14.11+/-3.25 months. Initial average Cobb's angle of 13.18+/-3.16degrees were reduced to 7.42+/-3.45degrees (p<0.001). Initial difference of height between right and left iliac crest of 0.87+/-0.26 cm reduced to 0.55+/-0.28 cm (p<0.01) and angle of pelvic inequality of 3.98+/-1.55degrees reduced to 2.54+/-1.27degrees (p<0.05). Initial difference of RCSPA between right and left of 3.69+/-1.54degrees decreased to 1.69+/-1.54degrees (p<0.01). Each parameter has significantly reduced 12 months after the wearing of the custom molded foot orthosis in scoliosis patients whose age was 9 or below, whose Cobb's angle at 15degrees or lower. CONCLUSION: The custom molded foot orthosis without heel lift was effective for scoliosis patients, who had different pelvic height caused by inequality of RCSPA.

Diabetic Muscle Infarction in a Chronic Stroke Patient: A Case Report

Diabetic muscle infarction is a rare complication of diabetes and is characterized by acute or subacute onset of painful and non-pitting swelling of the thigh or the calf, and rarely in the upper limbs. Diabetic muscle infarction and cerebral vascular accidents ocurr in patients with advanced diabetic complications. Painful swelling of the extremities is very common manifestation in patients with hemiplegia. Thus, early correct diagnosis and differential diagnosis of the underlying causes of painful swelling of the extremities are very important in these patients. We report a case of diabetic muscle infarction in a patient with hemiplegia, and suggest that diabetic muscle infarction should be considered as a disease of differential diagnosis for acute pain and swelling on the extremity.