Fabrication of an In-House Prepreg Carbon-Fiber Patellar-Tendon-Bearing Orthosis with Silicone Sock and Insole for a Vulnerable Skin Graft of the Foot: A Case Report

Abstract

Introduction: Nonweight bearing is crucial for managing foot and ankle injuries. This case report describes an in-house prepreg carbon-fiber patellar tendon-bearing ankle foot orthosis (PTB-AFO) enabling independent walking. Method: A 29-year-old female patient sustained multiple open fractures of the left foot in a car accident. After surgical intervention and skin grafting, she was unable to bear weight and used forearm crutches. A previously provided thermoforming plastic PTB-AFO was ill-fitting, and plantar skin wounds recurred. A prepreg carbon-fiber PTB-AFO with custom silicone sock and insoles was designed based on the patient’s measurements, with materials selected to protect vulnerable skin grafts. The prepreg carbon-fiber material presented challenges in balancing rigidity, weight, and functionality. Outcomes measured included vertical ground reaction forces, ankle range of motion, skin wound healing, and walking ability. Results: With the PTB-AFO, ground reaction forces normalized, ankle range of motion improved marginally, wounds healed, and the patient walked without crutches. The PTB-AFO could be worn under trousers. Conclusion: The prepreg carbon-fiber PTB-AFO combined with custom silicone socks and insoles improved walking ability and skin wound healing, illustrating the potential of these advanced orthotic materials. Clinical Relevance: The prepreg carbon-fiber PTB-AFO with custom silicone components enhances mobility and wound healing, potentially guiding future orthotic design and material choices in clinical practice.