More than fifty years ago, the profession of podiatric medicine gave to the medical world the latex toe jacket. The device is perfect for protection of a digit from ulceration. The way it is fabricated is by taking a negative cast impression of the involved toe with the area of prior ulceration marked using an indelible pencil or a marking pencil like we use in the O.R. The best way to take the toe impression is with dental alginate (Key to Alginate Normal Speed – the same stuff dentists use to take a dental impression.) Cover the whole digit with the alginate as well as some onto the plantar aspect and some onto the dorsum. Wait for it to harden to a rubbery consistency and then slip it off of the toe. Keep the negative impression under water until you are ready for the next step.
The next step is to pour a positive using dental stone. Fill the negative impression with a slightly loose mixture of the dental stone. After it hardens, break away the rubbery alginate and you have an exact duplicate of the toe with the problem area outlined on the cast. Tell the lab to pad for the indicated lesion. Send the cast to the Liquid Rubber Appliance Laboratory, West Orange, NJ. They will fabricate a latex toe jacket that will be a perfect fit.
Disclosure: I have no financial interest or any relationship with Liquid Rubber Appliance Laboratory.
Mike Boxer, DPM, Woodmere, NY
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