A Charcot Restraint Orthosis Walker (CROW) is a specialized type of orthotic device used in the treatment of Charcot foot, a condition commonly seen in individuals with diabetes or peripheral neuropathy. Charcot foot is characterized by severe weakening of the bones, joints, and soft tissues of the foot and ankle, often resulting in deformities, fractures, and ulcers. The CROW is a heavily padded, hard-shelled walker, that fully restricts movement in the ankle and foot to protect and prevent further injury or trauma to the foot and ankle.
Clinical Indications:
- Neuropathic ulcerations due to diabetes
- Charcot deformities of the foot and/or ankle
- Calcaneal or toe amputations
- Trauma
- Pre or post surgical intervention of mid and hind foot
The primary goals of a Charcot Relief Orthosis Walker are to:
- Offload pressure: Redistribute weight and pressure away from areas of the foot at risk of ulcers or fractures.
- Immobilize the foot and ankle: Provide stability to allow healing and prevent further deformity.
- Support the structure of the foot: Maintain alignment and prevent progression of the deformity.
- Reduce risk of complications: Minimize the risk of infections, ulcers, and amputation.
Design Features
- Custom-molded shell: Usually made of lightweight, durable materials to ensure a snug fit for the patient’s specific anatomy.
- Padding and cushioning: Inside the walker, there is a thick multi-density insole with a plastazote top cover that can have accommodation added for any plantar prominences or ulcer presentations as well as fillers for any forefoot/digit amputations.
- Rocker bottom sole: To facilitate a smooth gait and reduce stress on the foot.
- Adjustable straps or closures: Allow for secure positioning and easy application.
Benefits of CROW
- Helps in early mobility while protecting the foot.
- Provides a cost-effective alternative to surgical intervention in some cases.
- Provides alternative to total Contact Casting, convenient access to the foot for wound care and bandage changes.
- Improves the quality of life for individuals with Charcot foot.
When is a CROW Prescribed?
- Acute or chronic Charcot foot (during the healing and stabilization phase).
- Following total contact casting (TCC), as a transitional device.
- As part of long-term management to prevent further deformity or ulceration.
It is not recommended to scan for CROWs with Foot ID or Structure Sensor scanning devices. Semi or full weight bearing impression required using Plaster, STS Bermuda sock, fiberglass Roll, or an existing positive model
