CROW (Neuropathic Walker)

The Neuropathic Walker, or Charcot Restraint Orthotic Walker or C.R.O.W., as it is known, has become a very popular design for use in the treatment of Charcot Ankle in combination with Diabetic Plantar Neuropathy. And for good reason it  simply offers a high level of success. These devices are custom made to be light weight, comfortable, and to virtually eliminate shear forces on the plantar surface of the foot.

This simple design consists of three basic elements, the boot, the insole and the walking sole. Each element is designed to work in concert with the other to ensure a device which is well fitting, cosmetically acceptable and highly functional.

The boot is a custom made bivalve thermoplastic shell lined with a soft foam. This allows for a rigid outer shell to resist unwanted ankle motion, and a foam liner to provide a comfortable interface that is easy to clean and helps to reduce tissue breakdown. Of course, we offer a wide variety of materials for the shell and the foam liner so you can tune your designs to meet each patient’s specific needs.

Since most of the patients who need a C.R.O.W. exhibit some form of plantar neuropathy the removable plantar insert is an important component. Thermoformed from plastizote or a composite of several foams, it provides a compliant surface which diffuses plantar surface pressure. Carefully spreading this pressure promotes critical healing of a risk tissue.

Lastly, the walking sole is designed to serve two purposes. First, it eliminates the need for footwear, since the orthosis is too thick to fit into most footwear, the walking sole acts like the sole of a shoe. Secondly, the sole is designed to act as a “rocker”, since the brace is made to minimize ankle movement, the shape of the sole is turned to mimic the way the foot contacts the ground.