PowerStep: The Postoperative Application

PowerStep: The Postoperative Application

Taking steps to protecting your patient and your surgical reconstruction

After extensive training throughout residency and fellowship comprised of everything from plantar plate repairs to total talus reconstruction, I’ve observed that certain post operative complications are avoidable. Precautionary tales of problems arising from poor support during the first steps of a surgically reconstructed foot has led me to implement my own “failsafe” when returning patients back to walking.

This is the one place in practice that cannot be pre-calibrated, until now. I have pivoted to support my post ops when they initially transition from the boot into a lace up sneaker; against those ground reactive forces with a pre-fabricated insert.

A custom insert can take six weeks to make in post operative setting, which does not take into account swelling. Postoperative swelling on average is present for around 12-18weeks, making it a challenging timeline. This is the ultimate transition that I have seen in my practice with instituting a custom like over-the-counter insert. This accommodates my reconstructive surgery without compromising time or support for my patients.

The PowerStep Protech line has a tear drop (heel cushion) which accommodates for the pull of the Achilles tendon and plantar fascia. These are common areas of discomfort after prolonged immobilization in a cast/boot.

Although each case is unique, I frequently recommend the ProTech Met Full length. I choose this for the support of the metatarsals and the intrinsic musculature of the forefoot, both of which can atrophy after being in a CAM walker or cast. The increased metatarsal support helps prevent muscle imbalances in the toes which if left unchecked can lead to digital deformities and contractures. This is part of my postoperative algorithm.

I have seen a drastic increase in patient satisfaction with preventative care instead of reactive care. I generally have patients wear the PowerStep insert for the first six months postop. Some patients with more severe deformities are advised to continue use on a permanent basis.

My favorite part about the PowerStep brand is that it was developed by a podiatrist, crafted over many years of casting. I have seen firsthand how early support when returning to weightbearing can be transformative in the recovery process. Adding this to my postoperative plan of care has greatly improved patient satisfaction and that’s what it’s all about.

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