Penny suffered a traumatic injury to her Achilles complex in December 2017. She had palpable swelling near the insertion to the calcaneus and musculotendinous junction and her SDF remained intact, a suspected Type IIc Achilles lesion. Penny’s veterinarian and owners opted to pursue PRP injections and to support her Achilles mechanism with a splint and orthosis with the hopes of a pathofunctional curative outcome.

The goal of her orthosis was a “pathofunctional curative intent.” This device design is amenable for use with patients who have had recent surgery, have it planned for the immediate future, or who have had PRP injections (regenerative medicine). Penny’s tarsus paw orthosis features a motion-limiting bar at the tarsus allowing for complete static immobilization for the Achilles Complex during the initial 8-week period. The motion-limiting bar allows the veterinarian to gradually return flexion range-of-motion to reload the Achilles Complex over time allowing functional fibrosis development and linear fiber patterning to be achieved. The articulating paw segment has a motion limiting strap to slowly increase paw range of motion over time as well.

Since Penny’s paw range of motion was limited due to the SDF contracture, she required external paw wedges to support her MTPJ’s at the angle she was most comfortable at. One primary goal is focused on improving the MTPJ’s range of motion over time through rehabilitation and toe stretches. As the range of motion begins to improve, her veterinarian will be able to assess her and begin removing the external wedges until she achieves a normal standing paw angle. When patients have extensive external wedges such as in Penny’s case, it’s important to be committed to formal rehabilitation to address the contracture to accomplish normal standing limb length.

Above: Penny’s limited range of motion due to SDF contracture

Penny quickly regained functional ambulation with her orthosis and has adapted to it quickly. Her owners are committed to her rehabilitation program and treatment plan. The OrthoPets tarsus paw orthosis creates the mechanical environment enabling Penny’s biology to create and establish functional fibrosis develop to stabilize her Achilles complex. Once this process has occurred, Penny will graduate to the sports brace configuration to be used during high-impact activities.