Effectiveness of a Modified Patella Tendon Weight Relieving Orthosis in the Management of Foot Ulcer: A Case Study

Background and Objective
Ulcerations of the foot, particularly in diabetic or neuropathic patients, pose a significant challenge due to impaired mobility and risk of infection. Offloading devices are vital for wound healing. The modified patella tendon bearing (PTB) orthosis is a clinically underutilized but beneficial intervention, designed to shift weight from the foot to the patellar tendon region. This case report documents the orthotic management of a chronic plantar ulcer using a modified PTB orthosis and assesses its impact on healing, gait, and patient independence.
Case Description and Methods
An adolescent male with a chronic non-healing ulcer over the plantar aspect of the foot and underlying neuropathy was fitted with a custom-molded modified PTB orthosis. The orthosis was designed to relieve pressure from the ulcer site by transferring body weight to the patellar tendon area. Wound healing progression, gait parameters, pain score, and device tolerance were assessed at regular intervals.
Results
After three months of intervention, there was marked improvement in wound healing, reduction of pain, increased walking distance, and restoration of independent ambulation. Comparison of pre- and post-orthotic gait parameters revealed increased step length and normalized cadence.
Conclusion
The modified PTB orthosis proved effective in promoting ulcer healing, restoring function, and improving quality of life for the patient. It remains a viable option for conservative management of non-healing ulcers in patients contraindicated for total contact casting or surgery.

Plantar Foot Ulcer, Bivalved Design, Rocker Sole, Functional Mobility, Offloading

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