Custom Dynamic Orthoses to Reduce Articular Contact Stress

Inclusion Criteria: * Between the ages of 18 and 65 * Sustained unilateral fracture of the tibial pilon * The fracture has completely healed * Ability to walk 50 feet without use of an assistive device (cane, crutch, etc.) * Ability to walk at a slow to moderate pace * Shoe size between women's 8 and 13.5 or men's 6.5 and 12 * Ability to read and write in English and provide written informed consent * Individuals with elevated contact stress according to model generated using standing CT images (will be answered after completing visit one) Exclusion Criteria: * Pain \> 6/10 while walking * Increase in pain during testing of 3/10 or greater * Neurologic, musculoskeletal (including bilateral fractures) or other condition limiting function of the contralateral extremity * Medical or psychological condition that would preclude functional testing (ex. moderate or severe brain injury, stroke, heart disease) * Wounds to the calf that would prevent CDO fitting * Fractures secondary to neuropathy or severe osteopenia * Classification as non-ambulatory * Previous fractures near the tibial pilon on the involved limb * Surgery on involved limb anticipated in the next 6 months * Requirement of a knee stabilizing device (i.e. KAFO, KO…) to perform daily activities * Visual or hearing impairments that limit walking ability or limit the ability to comply with instructions given during testing * BMI greater than 40 * Pregnancy- Per participant self-report. Due to the expected small number …