The modified casual shoe. Like the original trainer, built for comfort & a bit of warmth but NOT for speed! As I said in the other footwear modifications page, those of you lucky enough to not have a foot ring as part of an Ilizarov frame can skip this bit. Those of you have got any pins through the foot, read on. This may help in the comfort stakes and also, give a degree of warmth to toes in the colder weather. Like I said on the other page if your frame has a foot ring, you've probably been finding it impossible to get something comfortable to wear that will; Be comfortable enough to allow you to start weight bearing. Give you any sense of security against stubbing or hitting your toes. Have a safe gripping sole for those first hesitant steps. Help to keep your foot warm. Even after a lot of cutting, shaping and exprimenting, I still found that the basic orthotic shoes provided by the hospital were just not designed for someone in a fixator that included the foot. They were uncomfortable, never felt secure and took ages to put on. I experimented with a few designs until I came up with the trainer shown on a previous page. This modification follows similar lines but provides additional coverage for the toes in the colder months. Again it's simple enough and if you hunt around, needn't cost too much. Luckily the casual shoe chosen had velcro fastening straps as standard which just needed a slight alteration. As previously they ought to be one or two sizes larger than you would normally wear although this may not be necessary. Where as before the extended sole offered protection to the toes, the inclusion of the original upper to the shoe also offers a similar degree of protection against unintended impacts with walls, doors, dogs etc!. As recommended previously, the next step is to make a paper template of your foot. You'll probably need someone's assistance with this. Place your foot on the paper and trace round the outline, marking clearly each pin. This will enable you to work out which parts of the shoe, if any may need to be cut away to allow it to be slipped onto your foot, over and around the pins. (See the lower pictures on footwear. The red lines indicate the positions of the pins through my foot, marked by using the template) The strap over the instep ran through a loop in the upper. This loop should be cut across the top only. This will allow it to be placed back under the upper strap where it will hold the upper of the shoe in place when it's being worn. The whole of the front upper of the shoe is then unpicked on both sides, right to where it meets the sole.This enables it to be folded back when putting the shoe on and then pulled back under the strap to secure it when tightened. The heel retaining strap is cut completely away from the shoe on one side (This will be a personal preference and depends on ease of putting the shoe on). This strap will need to be extended by a few inches. I suggest using soft leather as it's almost as easy to work with as material but is stronger. This extension then has some Velcro 'eye' sewn onto it that can be fastened to a similar piece of Velcro 'hook' fitted to the side of the shoe, adjacent to where the strap originally joined the shoe. The main retaining strap over the instep of the foot, will also probably need to be extended. As before I suggest using a strip of soft leather. This will then need an additional piece of Velcro fitted, suitable for locking into the original piece on the body of the shoe. After you have first tried wearing the shoe, you may well find that small amounts of the shoe and/or the added straps needs to be trimmed away so as not to rub on the pin sites. It is most important to check this out before wearing the shoe for anytime. Discomfort on the pins can take a hell of a time to settle back down!

The final three pictures show the modified shoe actually on my foot. I hope that these, combined with the costruction pictures mentioned above may give a clearer view of both how the shoe is modified and how well fits round the pins and pin sites. A couple of final comments are just to point out that my physiotherapy straps have been taken off of the frame for the pictures. They are normally tied to the first of the steel rings and then looped around the toes to combat the claw toe mentioned earlier. My skin looks awful in these photos. This is NOTHING to do with the fixator it self. I suffer from extremely dry skin. So, don't worry, neither a fixator frame or modified shoes will make your leg look like mine!