The Mueller TPD Foot Orthotic is a custom made foot orthotic design that was developed by Terrance J Mueller DPM in the late 1980's. It was mainly for posterior tibial tendon dysfunction where there was a lot of transverse plane movement (planal dominance) and a high degree of forefoot supinatus. The device had a deep heel cup, high medial and lateral flanges that extend distally to limit that transverse plane motion and a 'pocket' or accommodation for the navicular. The device is typically made on a neutral position non-weightbearing cast with the midtarsal joint locked and the forefoot supinatus corrected.
The device was offered by Allied OSI Lab until early 2014. There was a brief announcement on the Lower Extremity Review website in June 2014 that the "The new Mueller TPD AFO (tibialis posterior dysfunction ankle foot orthosis) is now available exclusively from Integrated Orthotic Lab". However, that announcement has been removed and there is nothing on the IO Lab's website and no reply was received to queries (as at 14 February 2015).
It was described by Dr Mueller on an email list in 2001:
The TPD Orthotic is designed to control abnormal pronation at the subtalar and midtarsal joints, as well as forefoot supinatus. These conditions are most commonly associated with adult TPD (whether a complete, partial, or functional rupture of the Tibialis Posterior tendon), as well as other types of dysfunctional flatfoot, pediatric or adult.
The rationale for its use is to address the underlying deformities of the complex issue which we now label as dysfuntional flatfoot (American College of Foot and Ankle Surgeons) as completely as possible. This includes rearfoot eversion, medial column collapse, midfoot dorsiflexion/abduction, and dorsal hypermobility of the first ray. This serves to minimize the further
development of desmopathology of the rearfoot/midfoot ligamentous system, and reduces abnormal biomechanical stress on the TP tendon/muscle unit.
In thousands of cases over the last decade, the TPD orthotic has been used to help arrest the progressive flatfoot deformity of TPD and other types of dysfunctional flatfoot. This has dramatically reduced the need for a surgical approach to the deformity.
The learning curve for proper casting for the TPD orthotic is quite minimal, and I'd be happy to personally discuss this issue with anyone at the TPD website.
The 'TPD website' referred to no longer exists but a snap shot of some pages are available at the webarchive of the site.
Dr Mueller does have a manufacturing laboratory (Mueller TPD AFO Lab) to manufacture what appears to be an AFO version of this type of device, but doesn't appear to offer the original Mueller TPD Foot Orthoses.
- there have been a few comments that the device as originally described may be too bulky and a cut down design may be more appropriate
Mueller TPD Orthotic info (Podiatry Arena)
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