Application Technique Metatarsal Shoe

Indications:

  • Fractures of the forefoot and metatarsal.
  • Diabetic forefoot gangrene.
  • Positioning splint.
  • Physio purposes.
Application: The materials should be pre-prepared to enable rapid application of the bandage. All the necessary materials should be placed within reach to avoid hold-ups in the procedure.

The patient should be in a position which is comfortable to him/her and the person applying the bandage. This may vary depending on the extent of the injury, the diagnosis, the treatment method and the patient's condition.

Materials required: 1 x 5 cm Delta Cast Conformable polyester support bandage and hydrogel-coated casting gloves, toweling tubular bandage, fleece padding, adhesive bandage, bandage scissors, felt-tip pen.

Photo 1:
The toweling tubular bandage is pulled over the foot and ankle joint to form a layer of padding underneath. A narrow strip of fleece padding is inserted on the outer side beforehand to help with the cutting. In order to achieve maximum stability in the middle foot area, a three-layer ready prepared longuette is applied to the sole (1 layer in the heel area), starting at the basal toe joints.

Photo 2:
The cast is applied using circular movements, in two to three layers from the toes ending above the ankle joint. The cast should be wrapped around relatively tightly, extending it by about 70%. This achieves the best fit and bonding of the layers.

Photo 3:
The cast is molded to the arch of the foot for four to six minutes. Corrections of position or cast corrections can be carried out at this stage. Any folds in the cast can be easily smoothed out by pulling the distal end of the cast lengthwise.

Photo 4:
Following the molding phase, the cutting lines are marked with a felt-tip pen and the dressing opened on the outer side, along the inserted fleece strip, using bandage scissors. If a dressing has been applied too tightly, it loosens by itself after opening (special feature of Delta Cast Conformable).

Photo 5:
The dressing is removed and trimmed for individual fit. The fit of the cast on the patient is then checked.

Photo 6:
The cast is fixed in place using an adhesive bandage ending above the ankle joint, taking into account the state of the swelling.

The small number of layers means that the cast remains semi-flexible and can be adjusted depending on the individual state of the swelling (looser or tighter). To do this, the adhesive bandage is removed and the cast altered for a perfect fit. Re-application is carried out as described above.

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Variant:

Combicast: Combination of metatarsalshoe and ankle brace. This variant allows for plantar and dorsal flexion with reduced supination and pronation.
The cast is applied up to 15 cm above the ankle. This proximal extension is cut like an ankle brace.

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