Antia N H
Foundation for Research in Community Health, Bombay, India.
Lepr Rev. 1990 Mar;61(1):73-8. doi: 10.5935/0305-7518.19900009.
The anaesthetic foot in leprosy poses the most major problem in the rehabilitation of its patients. Various attempts have been made to produce protective footwear such as the microcellular rubber-car-tyre sandals. Unfortunately these attempts have had little success on a large scale because of the inability to produce them in large numbers and the stigma attached to such unusual footwear. While such footwear may be superior to the 'tennis' shoe in protecting the foot from injury by the penetration of sharp objects, it fails to distribute the weight-bearing forces which is the major cause of plantar damage and ulceration in the anaesthetic foot. This can be achieved by providing rigidity to the sole, as demonstrated by the healing of ulcers in plaster of paris casts or the rigid wooden clog. A new type of moulded plastic footwear has been evolved in conjunction with the plastic footwear industry which provides footwear that can be mass produced at a low price and which overcomes the stigma of leprosy. Controlled rigidity is provided by the incorporation of a spring steel shank between the sponge insole and the hard wearing plastic sole. Trials have demonstrated both the acceptability of the footwear and its protective effects as well as its hard wearing properties.
麻风病患者足部的麻醉状态是其康复过程中最主要的问题。人们曾尝试制作多种防护性鞋具，比如微孔橡胶汽车轮胎凉鞋。遗憾的是，由于无法大量生产以及这种特殊鞋具所带来的污名，这些尝试在大规模应用上收效甚微。虽然这类鞋具在防止尖锐物体刺入而保护足部方面可能优于“网球鞋”，但它无法分散负重压力，而这正是导致麻醉足部足底损伤和溃疡的主要原因。通过使鞋底具有刚性可以实现这一点，就像用石膏绷带固定或使用硬木屐时溃疡得以愈合所证明的那样。一种新型模压塑料鞋具已与塑料鞋具行业合作研发出来，这种鞋具能够以低价大量生产，并且消除了与麻风病相关的污名。通过在海绵鞋垫和耐磨塑料鞋底之间加入弹簧钢鞋帮来提供可控的刚性。试验已证明这种鞋具具有可接受性、防护效果以及耐磨性能。
