Silicone Orthoses in Podiatry: Applications and Uses

**Retrocapsular Orthoses**

Stability Goal: Angled floor redistributes force vectors, increases propulsion time, and provides an antalgic effect.

**Subphalangeal Orthoses**

Aligned with the target, it increases support, stops rolling. Headlamp goal for Dynamo goal cushion, metatarsal, and diminishes impact angle.

**Hardness**

• Crosslinking Time: Maximum 30-60 minutes, decreased 12-24 hours, lasts 3-4 weeks (defined). The same values apply to a maximum duration of 20 minutes.
• Catalyst Quantity: Double the amount of catalyst for softer silicones increases the maximum, but the definition varies. Do not crosslink before.
• Type of Paste: Paste is less than the maximum duration, crosslinked slower. Half paste (slow catalyzation) lasts less than the maximum and is less defined. Double dough (accelerated start) does not vary in maximum and definition, but it increases hardness when soft.
• Manipulation Time: Less than 35 (slows down reticulation and maximum definition, decreases duration, alters elasticity and resistance).
• Emollient

**Extensor Tendon Support**

Losses in range and contacts. The common pattern of the long finger extensor is developing during loading and unloading, as well as during lacing.

**Flexor Tendon Support**

Flexor longus hallucis during mid-stance appears and develops during static unloading and toe-off.

**Replaced Flexor Tendon Support**

Propulsion, dynamic claw, altered neuro and Achilles, visible lace, and that would load and unload.

**Paw Orthoses**

• Subphalangeal: Aligned with the metatarsals, it increases support, propulsion, and take-off, and cushions the metatarsals dynamically.
• Interdigital: Union, stability, and alignment.
• Dorsophalangeal: Decreases subluxations and their consequences in the proximal and middle phalanges, releases painful areas, increases the propulsion triangle, and stretches the fingers.

**Hallux Flexus Orthoses**

Subphalangeal raises the flat flexed back, reduces and eliminates friction of the long flexor tendon of the first toe, and provides interphalangeal unloading. Interdigital union method.

**Hallux Varus Orthoses**

Aligns the back with the metatarsals, descends the toe, aligns the diaphysis of the first radius. Interdigital and dorsal. Subphalangeal is not bound to maintain the physiological resting position.

**Hallux Limitus/Rigidus Orthoses**

Degenerates the goal of microtrauma, rolling, and radial dorsiflexion. Dismorphism of the first metatarsal, and joint block.

**Tailor's Bunion Orthoses**

The interdigital of the fifth toe aligns with the metatarsal, union. Subphalangeal lengthens the fifth metatarsal. Insufficient submetatarsal. Lateral diaphysis aligns the toe and unloads exostosis.

**Stability Retrocapsular Orthoses**

Distal triangular propellant base, the maximum tip height radius focuses on diaphysis stability, angulation goal, antalgic effect, distributes force vectors, propels and lengthens, increases creeping, and reconstructs the anterior arch. Use on non-adipose tissue, plantar flexion of the radial center, and decreased incidence of foot arches.

**Total Subphalangeal Orthoses**

Respects from the second to the fifth toe. The goal is to slow down rolling, lower the angle, align the toes, and increase the opening angle. Increases support and cushioning. Use on claw toes for altered loads, helomas, non-adipose tissue, and metatarsalgia.

**Subphalangeal Orthoses of the First Toe**

Alignment, brake bearings, leverage, slows down pronation of the first toe, and goal of joint congruence. Compensates for insufficiency of the first radius. Use on the first toe for hallux valgus, rigidus, hyperextension, hallux flexus, and plantar ulcers.

**Medial Diaphyseal Orthoses of the First Toe**

Decreases hallux abductus, aligns the hallux, and protects the valgus. Use for hallux valgus, hallux varus, and protection of helomas.

**Dorsophalangeal Orthoses of the First Toe**

Aligns and decreases subluxation, propulsion of the first radius. Use for extensus hallux, hallux varus, hallux valgus, hallux flexus protection, subungual heloma, and extensor heloma.

**Interdigital Space Orthoses of the First Toe**

Aligns, lowers pressure, decreases hallux abductus, decreases the interphalangeal angle, propulsion, and take-off. Use for hallux valgus, interdigital heloma, and second toe supraductus.

**Total Dorsophalangeal Orthoses**

Alignment goal, target impact angle decrease, lowers the proximal and middle phalanges, and increases the propulsion triangle. Use for claw toes, dorsal helomas, and supra- and infra-digital helomas.

**Fourth Interdigital Space Orthoses**

Aligns the fourth and fifth toes, decompresses, decreases the interphalangeal angle. Use for interdigital heloma, bottom of the sulcus, external fracture of the fifth toe, and fifth toe supra- and infra-ductus.

**Lateral Diaphyseal Orthoses of the Fifth Toe**

Normalizes the angle. Use for heloma on the outer edge of the fifth toe, external fracture of the fifth toe, and fifth toe varus.