Charcot-Marie Toothe Disease - ankle bracing
Ankle braces are used for a number of reasons including instability and swelling. Instability can be due to a number of reasons including lateral ankle ligament injury, mal-alignment of the heel and forefoot and trauma to the lateral ankle ligaments. Charcot-Marie Tooth Disease (CMT) is an inherited neuromuscular disorder that causes foot drop and lateral ankle instability. It's a rare case when I see someone with an inherited neuromuscular condition respond to over-the-counter (OTC) bracing. Inherited neuromuscular conditions like CMT usually require the use of custom made prescription braces like an ankle foot orthotic (AFO).
I saw a patient today who I've seen for years who inherited CMT. His development as a child was normal but as he reached his late teens he developed atrophy of the muscles of the lower leg, characteristic of CMT. He's fought against using an AFO and has marginally controlled his drop foot with high top tennis shoes. But the high top tennis shoes weren't enough to control his lateral ankle instability. He was suffering from recurrent ankle sprains that would eventually result in a fracture or other permanent disability.
To prevent long term injury, we tried thinking out of the box. I placed the patient in a Malleoloc Ankle Brace. The Malleoloc Brace is typically used as a sports brace controlling inherited lateral ankle instability or used as a brace following injury or surgery. The Malleoloc Brace is light weight so it wouldn't tax already weak lower leg muscles as seen in CMT. The patient presented back to the office today after wearing the brace for 6 weeks and was happy as could be. Most importantly, he was happy that we had respected his wishes to not wear a large AFO. We found a way to keep him as the person he wanted to be.
Jeffrey A. Oster, DPM