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1 ::  A. Turner
Archie Turner had been seriously injured while in the service 23 years before I met him. The bones of his right lower leg, ankle and foot had been shattered in an accident. Because of the extent of the injury the bones of the ankle and mid-foot needed to be fused-his ankle would no longer flex. Additionally because of the severity of the injury he had lost about 2 inches of length in his Tibia/Fibula, so the plan was to fuse the ankle with a built in 2" heel height so that, theoretically, he would walk with his pelvis level. (His footwear would need to have a 2" heel.)

Unfortunately, something went awry in the surgery and he ended up with a 3 " fused heel height. This created several problems: a) Archie now carried a great deal of weight on the ball of his right foot, and over time developed a callous that was about " thick. b)The foot became very unstable, and he would "run the boots over" at the heel. Within four to six weeks the heels of new boots would be tipped over to the point that they were not wearable (These were custom boots provided by the VA for which, I am told, they paid about $700/pr.) c)His left leg was now functionally 1 " shorter than the right, creating low back pain and dysfunction in the feet, and various other pains.

When I first saw Archie, he was managing a gated mobile home community, but he had great difficulty working more than 5 hrs/day due to feet problems.

The VA was not pleased with my quote, but they had a responsibility to Archie and were out of ideas of their own.

This is what I did: I cast his right foot and leg and created an "anatomical last" with the 3 " heel height. Over this last I built an orthotic with the correct heel height and a very, very strong lateral flare so that he would now have heel strike (lessening the pressure on the ball) and creating stability in the foot so that the boot was no longer tipping out. Over all of this I designed, patterned, and built a special boot that would support the foot/ankle/leg to increase the stability and laced firmly so that his foot did not slide into the toe area of the boot. I finished off the boot with a rocker bottom sole to improve the fluidity of his gait and additionally decrease the force against the ball of the right foot. For the left foot we made a boot that looked as much like the right, except with a 1 " leg length accommodation and an orthotic to correct for excessive pronation, and to give this foot as much benefit as possible, as it was quite overworked.

Everything worked as planned. Within several weeks the callous on the right ball was gone! Where previously there had been a " callous, the skin looked like that of a child. His first pair of boots (the only footwear worn) was still going strong after 14 months when he ordered a second pair for dress. Eighty to ninety percent of the pain Archie had suffered in his feet, ankles, legs, hips, and back was gone. One evening Archie plopped in a chair in his kitchen and exclaimed to his wife that he was tired. Lori looked at the clock and replied "No wonder, you have been going non-stop for 13 hrs."

P.S. Let's play with $'s for a minute - Archie told me that the VA paid $700/pr for the boots they provided him (and had been for 23 years) and that the boots would only last 4-6 weeks. The first pair of boots I built him was the only thing that he wore for the first 14 months, when he ordered a dress pair (the first pair were still going strong) at that 14 month point, assuming that the figures given me were accurate and giving the benefit of 6 weeks/pr. The VA saved over $5000.00 for that 14 month period of time.
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