Fabrication of an In-House Prepreg Carbon-Fiber Patellar-Tendon-Bearing Orthosis with Silicone Sock and Insole for a Vulnerable Skin Graft of the Foot: A Case Report

ABSTRACT Introduction Nonweight bearing is crucial for managing foot and ankle injuries. This case report describes an in-house prepreg carbon-fiber patellar tendon-bearing ankle foot orthosis (PTB-AFO) enabling independent walking. Method A 29-year-old female patient sustained multiple open fractures of the left foot in a car accident. After surgical intervention and skin grafting, she was unable to bear weight and used forearm crutches. A previously provided thermoforming plastic PTB-AFO was ill-fitting, and plantar skin wounds recurred. A prepreg carbon-fiber PTB-AFO with custom silicone sock and insoles was designed based on the patient’s measurements, with materials selected to protect vulnerable skin grafts. The prepreg carbon-fiber material presented challenges in balancing rigidity, weight, and functionality. Outcomes measured included vertical ground reaction forces, ankle range of motion, skin wound healing, and walking ability. Results With the PTB-AFO, ground reaction forces normalized, ankle range of motion improved marginally, wounds healed, and the patient walked without crutches. The PTB-AFO could be worn under trousers. Conclusion The prepreg carbon-fiber PTB-AFO combined with custom silicone socks and insoles improved walking ability and skin wound healing, illustrating the potential of these advanced orthotic materials. Clinical Relevance The prepreg carbon-fiber PTB-AFO with custom silicone components enhances mobility and wound healing, potentially guiding future orthotic design and material choices in clinical practice.