In a recent online forum with our colleagues we were debating the merits of various techniques for capturing foot structures in order to manufacture custom functional orthotic devices.
Most experts in our field will agree that in general the foot should be captured non weight baring with the patient ideally lying face down on a couch. So that rules out foam boxes, pressure mats, weight baring scanners, and little beds of funky nails to contour the weight baring foot (I kid you not!).
If we are making a true functional custom orthotic you can accept that if the shape of the foot is captured weight baring it’s kind of like closing the stable door after the horse has already run off and is grazing someone else’s grass.
The goal is to capture the architecture of your foot at its best so we can fabricate an appliance to enable you to function in the most efficient, ,stable orientation.
For most, that leaves us with two real options, the first of which is using plaster of paris.
This was how we functioned for the first 20 or so years of our careers and it works well in skilled hands. It is however messy, time consuming, labour intensive, and not particularly environmentally friendly.
The second method, 3 Dimensional scanners come in various shapes and levels of accuracy. The stand out of the pack for us was the Veriscan system, which we first adopted for use in conjunction with Integrity Orthotics. The system has been revised and improved several times over the years. Essentially it utilized two laser and camera combinations on a carousel to capture a very accurate 3D image. The digital image is transferred to the Integrity laboratory enabling them to mill out an exact replica or custom modified version of the foot using a CAD/CAM system.
In our busy practices we quickly found a significant improvement in clinical fit and accuracy of the orthotic devices and an increased level of patient satisfaction. The environmental impact of reduced cleanup costs, shipping, waste and material, helped hammer the final nail in the plaster coffin. That said there are still occasional cases for very problematic Diabetic foot types (Charcot feet) where we still revert to a semi weight baring plaster cast when making custom orthotics or footwear.
Rest assured we will continue to look at future offerings from the scientific innovators to bring further improvements and refinements to enable you to function better.
A final thought!. One sage contributor to the online debate summarized, without a good diagnosis and appropriately written orthotic prescription, the method of capturing the foot is of no importantance.
If you have any questions regarding this topic please comment below or message us and we’ll be quick to reply.