Obravnava pacienta z delno amputacijo stopala: načrtovanje in izdelava ortopedske obutve : diplomsko delo

Georgiev, Blaž (author), Lampe, Tomaž (mentor), Muršec, Aljaž (comentor), Gomišček, Gregor (reviewer)

Uvod: Amputacije spodnjih okončin, zlasti delne amputacije stopala, predstavljajo pomemben funkcionalni problem, ki vpliva na stabilnost, vzorec hoje in kakovost življenja pacienta. Pri pacientih s sladkorno boleznijo so te spremembe še izrazitejše zaradi prisotnosti diabetične nevropatije in povečanega tveganja za nastanek razjed. Ortopedska obutev ima pri takšnih pacientih ključno vlogo, saj omogoča razbremenitev preobremenjenih področij, izboljšanje stabilnosti in preprečevanje zapletov. Namen: Namen diplomskega dela je predstaviti postopek načrtovanja in izdelave ortopedske obutve pri pacientu z delno amputacijo stopala ter ovrednotiti vpliv izbranih rešitev na funkcionalnost hoje in stabilnost. Metode dela: Metode dela so vključevale pregled literature ter študijo primera pacienta s sladkorno boleznijo in delno amputacijo stopala. Praktični del je obsegal klinično oceno stopal in analizo hoje, na podlagi katerih smo izvedli odvzem mer ter oblikovali načrt izdelave ortopedske obutve. Sledila je izdelava individualno prilagojene ortopedske obutve z ustreznimi prilagoditvami. Postopek smo zaključili s preizkusom, pri katerem smo ocenili prileganje, funkcionalnost in udobje obutve. Rezultati: Pri končnem preizkusu je bila hoja pacienta bolj stabilna, prenos teže bolj enakomeren, pacient pa je obutev ocenil kot udobno. Izbrane rešitve so omogočile kompenzacijo biomehanskih primankljajev, ki nastanejo zaradi amputacije. Razprava in zaključek: Rezultati potrjujejo, da lahko ustrezno načrtovana ortopedska obutev pomembno izboljša funkcionalnost hoje in prispeva k večji stabilnosti pri pacientih z delno amputacijo stopala. Kljub temu ortopedska obutev ne more v celoti nadomestiti izgubljenih anatomskih struktur, zato ostajajo določene biomehanske spremembe prisotne. Poleg funkcionalnega vidika ima ortopedska obutev tudi pomembno preventivno vlogo pri zmanjševanju tveganja za nastanek razjed, zlasti pri pacientih s sladkorno boleznijo.

• Language: Slovenian
• Keywords: diplomska dela, ortotika in protetika, ortopedska obutev, delna amputacija stopala, diabetično stopalo, ortopedski vložki, biomehanika hoje
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [B. Georgiev]
• Year: 2026
• Number of pages: VIII, 32 str., [2] str. pril.
• PID: 20.500.12556/RUL-183338
• UDC: 617.3
• COBISS.SI-ID: 281233411
• Publication date in RUL: 11.06.2026

Secondary language

• Language: English
• Title: The treatment of a patient with a partial foot amputation: the design and the fabrication of the orthopedic footwear : diploma work

Abstract

Introduction: Lower limb amputations, particularly partial foot amputations, represent a significant functional problem that affects the stability, the gait pattern, and the quality of life of a patient. In patients with diabetes mellitus, these changes are even more pronounced due to the presence of diabetic neuropathy and an increased risk of ulcer development. The orthopedic footwear plays a key role in the management of such patients, as it enables the offloading of pressure areas, improves the stability, and helps to prevent the complications. Purpose: The purpose of this thesis was to present the process of designing and manufacturing the orthopedic footwear for a patient with a partial foot amputation and to evaluate the impact of selected design solutions on the gait functionality and stability. Methods: The methods included a literature review and a case study of a patient with a diabetes mellitus and a partial foot amputation. The practical part consisted of a clinical assessment of the feet and gait analysis, followed by the taking of the measures and the development of a plan for the orthopedic footwear production. This was followed by the fabrication of individually customized orthopedic footwear with the appropriate modifications. The process was completed with a fitting, during which the fit, the functionality, and the comfort of the footwear were evaluated. Results: During the final assessment, the patient’s gait was more stable, the weight transfer was more even, and the patient evaluated the footwear as comfortable. The selected solutions enabled the compensation of the biomechanical deficiencies resulting from the amputation. Discussion and conclusion: The results confirm that properly designed orthopedic footwear can significantly improve the gait functionality and contribute to a greater stability in the patients with a partial foot amputation. However, the orthopedic footwear cannot fully replace lost anatomical structures, and certain biomechanical alterations remain present. In addition to its functional role, the orthopedic footwear also has an important preventive role in reducing the risk of ulcer development, particularly in patients with diabetes.

• Keywords: diploma theses, orthotics and prosthetics, orthopedic footwear, partial foot amputation, diabetic foot, orthopedic insoles, gait biomechanics