Medical Shoe Replacement for 66-Year-Old Male Patient
The patient should receive a replacement for his medical shoes as they show signs of excessive use, and replacement is appropriate since his last medical shoes were provided in 2023.
Assessment of Need for Replacement
When evaluating the need for medical shoe replacement, consider:
- Signs of excessive wear indicate compromised functionality of the therapeutic footwear
- Duration since last replacement (approximately one year in this case)
- Risk factors for foot complications
Factors Supporting Replacement
- Visible wear and tear: Excessive use compromises the protective and therapeutic functions of medical footwear 1
- Time since last replacement: Medical shoes from 2023 are approaching or exceeding their functional lifespan
- Age-related risk: At 66 years old, the patient is in a higher risk category for foot complications
Appropriate Footwear Selection
The type of replacement footwear should be determined based on the patient's foot condition:
For Patients with No/Limited Foot Deformity (IWGDF Risk 1-3):
- Educate on footwear that accommodates foot shape and fits properly 1
- Ensure adequate length, width, and depth
For Patients with Foot Deformity (IWGDF Risk 2-3):
- Consider prescribing extra-depth shoes, custom-made footwear, or custom-made insoles 1
- These accommodate deformities such as hammer toes, prominent metatarsal heads, or bunions 1
For Patients with Healed Plantar Foot Ulcer (IWGDF Risk 3):
- Prescribe therapeutic footwear with demonstrated plantar pressure-relieving effect 1
- Encourage consistent wearing of prescribed footwear both indoors and outdoors
Patient Education During Replacement
When providing replacement footwear, include education on:
- Daily inspection of shoes for foreign objects before wearing 1
- Proper sock selection (natural materials, seamless, preferably light-colored) 1
- Importance of consistent use of prescribed footwear
- Signs of excessive wear that would indicate need for future replacement
Considerations for Improved Adherence
To improve adherence to wearing therapeutic footwear:
- Advise storing therapeutic footwear in a visible place at home 2
- Recommend storing conventional footwear out of sight 2
- Encourage consistent choices about which footwear to wear 2
- Explain the relationship between proper footwear and prevention of foot complications
Follow-up Plan
- Schedule regular follow-up appointments to assess footwear condition
- Evaluate for any new foot deformities or complications
- Consider more frequent examinations for high-risk patients 1
Medical shoes showing signs of excessive use require replacement to maintain their therapeutic benefit and prevent foot complications. Proper selection and consistent use of appropriate footwear are essential components of preventive foot care, especially for patients at risk of foot ulceration.