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History-Evolution-of-Foot-and-Lower-Extremity-Biomechanics-and-Foot-Orthoses_Kevin-Kirby

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3/26/2015<br />

Hugh Owen Thomas<br />

Newton Melman Shaffer<br />

Hugh Owen Thomas (1834-1891)<br />

was a British orthopedic surgeon<br />

with interest in treating feet<br />

In 1874, Thomas suggested using<br />

a “few pennies worth <strong>of</strong> leather”<br />

for lifts, bars, <strong>and</strong> wedges on<br />

shoes to treat foot problems<br />

Invented, in 1876, “crooking” <strong>of</strong><br />

shoe heel, to extend the heel<br />

under the antero-medial aspect <strong>of</strong><br />

shoe sole for treating pronated<br />

feet (now called “Thomas heel”)<br />

Hugh Owen Thomas<br />

(1834-1891)<br />

Newton M. Shaffer (1846-<br />

1928), a New York City<br />

orthopedist, first described<br />

high arched foot with<br />

multiple clawtoes<br />

Became widely known as<br />

“Shaffer’s <strong>Foot</strong>”<br />

Also designed a highmedial<br />

arched orthosis<br />

with a heel cup which<br />

became known as a<br />

“Shaffer Plate”<br />

Newton M. Shaffer<br />

(1846-1928)<br />

Royal Whitman<br />

Whitman’s “Weak <strong>Foot</strong>”<br />

Royal Whitman (1857-<br />

1946) was a 1882<br />

Harvard Medical School<br />

graduate <strong>and</strong> New York<br />

City orthopedic surgeon<br />

that had special interest<br />

in foot function<br />

Wrote numerous<br />

textbooks on orthopedic<br />

surgery <strong>and</strong> taught<br />

orthopedics for 40 years<br />

Royal Whitman<br />

(1857-1946)<br />

Whitman’s description <strong>of</strong><br />

“weak foot” very closely<br />

matches our current<br />

description <strong>of</strong> the pronated,<br />

flat-arched foot with an<br />

internally rotated tibia<br />

Whitman’s Three Grades <strong>of</strong> “Weak <strong>Foot</strong>”<br />

1 st Degree: The normal foot improperly used, as<br />

shown by the method <strong>of</strong> st<strong>and</strong>ing <strong>and</strong> walking<br />

2 nd Degree: The foot in which the range <strong>of</strong> voluntary<br />

motion is restricted, showing disuse <strong>of</strong> function, <strong>and</strong><br />

in which the elements <strong>of</strong> deformity are apparent<br />

when weight is borne<br />

3 rd Degree: That in which the passive range <strong>of</strong><br />

motion is restricted, or in which there are evident<br />

weakness <strong>and</strong> deformity. This limitation <strong>of</strong> motion<br />

depends, as a rule, on accommodative changes in<br />

structure to the habitual postures or to the deformity<br />

Whitman R: A study <strong>of</strong> the weak foot, with reference to its causes, its diagnosis, <strong>and</strong> its cure; with an<br />

analysis <strong>of</strong> a thous<strong>and</strong> cases <strong>of</strong> so-called flat-foot. JBJS, 8:42-77, 1896.<br />

Whitman’s <strong>Foot</strong> Brace<br />

Developed in 1885<br />

Made from plaster cast<br />

taken with foot in<br />

supinated position<br />

18-20 gauge sheet<br />

steel was formed into a<br />

high medial arch brace<br />

Goal was to raise<br />

medial arch so foot<br />

would be less pronated<br />

3

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