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1. the hindmost part of the foot; called also calx.
2. the hindmost portion of an elongated structure, or something else comparable to the heel of the foot.
Thomas heel a shoe correction consisting of a heel one half inch longer and an eighth to a sixth of an inch higher on the inside; used to bring the heel of the foot into varus and to prevent depression in the region of the head of the talus.
A corrective shoe in which the heel is approx. 12 mm longer and 4 to 6 mm higher on the medial edge. This produces varus of the foot and prevents depression of the head of the talus.
See also: Thomas, Hugh Owen
Thomas,Hugh Owen, English surgeon, 1834-1891.
Thomas Allis forceps
Thomas cervical collar brace
Thomas collar cervical orthosis
Thomas extrapolated bar graft
Thomas fracture frame
Thomas full-ring splint
Thomas hinged splint
Thomas hyperextension frame
Thomas Kapsule instruments
Thomas knee splint
Thomas Kodel sling
Thomas posterior splint
Thomas splint - a long leg splint extending from a ring at the hip to beyond the foot.
Thomas splint with Pearson attachment
Thomas suspension splint
Thomas test of function
Thomas walking brace
Thomas heelmedial flare and distal extension of anterior heel border, giving additional support to medial longitudinal arch in cases of pes planus (see crooked and elongated heel; reverse Thomas heel; Table 1)
|Foot feature||Modification made to shoe|
|Excessive heel inversion/pronation||Buttressed heel; flared heel; floated heel: lateral/medial build out to heel to add lateral (for supinated rearfoot) or medial (for pronated rearfoot) support|
|Pes planovalgus||Thomas heel: anterior medial build out from medial distal margin of heel to give added support under waist of the shoe|
|Reverse Thomas heel: anterior lateral build out from lateral distal margin of heel to give added support under the lateral mid-third of the foot|
|Excessive calcaneal eversion and mobile whole-foot pronation or fixed whole-foot supination||Medial heel wedge added to the outer of the heel, or placed within the heel seat, in conjunction with a medial sole wedge, Thomas heel and medial heel flare|
|Excessive calcaneal inversion and mobile whole-foot supination||Lateral heel wedge added to the outsole, or placed within the heel seat, in conjunction with reverse Thomas heel|
|Painful plantar heel; plantar heel spur||Excavated heel seat, infilled with cushioning, shock absorber|
|Forefoot supinatus in children||Contralateral wedging: lateral sole wedge and medial heel wedge, to invert the hindfoot and evert the forefoot|
|Painful hallux limitus; fixed hallux rigidus||Rocker sole: additional outsole added to increased thickness at treadline, tapering distally and proximally to increase the toe spring and allow the foot to 'rock' rather than dorsiflex at the MTPJs|
Steel stiffener: the addition of a metal plate between the outsole and the midsole to reduce movement, and therefore pain, in a foot with painful hallux limitus
|Hammered toe||Star-shaped split release: slits cut through the upper so that the point of intersection of the splits is centred over the prominent joint|
Balloon patch (see below)
|Bunion; HAV||Longitudinal split release: splits cut through upper over the 1 MTJ, parallel to the medial edge of the sole, to increase the width of the upper and ease tension over the prominent joint|
Balloon patch: a hole cut in the upper over the prominence of the joint, repaired with a stretch patch of leather dyed to match the shoe upper, to provide a wide pocket to accommodate digital deformity
|Oedematous foot||Facings extended proximally with the addition of extra eyelets, to increase the internal dimensions of the vamp|
|Severe digital deformity||Vamp replacement: replacement of the vamp with one that incorporates extra depth and/or width|
|Digital and/or nail trauma; plantar heloma miliare||Tongue pad: clinical or orthotic padding added to the inner aspect of the tongue of a Derby or Oxford shoe, to retain the foot into the heel cup and prevent distal slip of the foot against the inner of the shoe|
MTPJ, metatarsophalangeal joint; HAV, hallux abductovalgus; MTJ, midtarsal joint.