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CAD CAM Casted Orthotic Devices


At PPL we are constantly seeking ways to enhance our product portfolio and methods of production. For the past five years we have utilised the most technologically advanced CAD CAM (Computer Aided Design Computer Aided Manufacture) systems to manufacture fully customised orthoses. While many other manufacturers now offer CAD CAM products, we believe that the success of a CAD CAM device is dependent on the people who design it. We combine our vast technical experience from over twenty years of traditional custom fabrication, with high levels of ability in CAD CAM design to create unrivalled custom orthoses. All our devices are individually designed and we do not employ the use of generic design templates.

These can be ordered by sending us plaster casts, foam boxes or 3D scan files (.stl format) along with a completed prescription form. If you opt to send us plaster casts or foam boxes we will scan them and use this data to design the orthoses. The finished design is subsequently milled out using a computer numerical control (CNC) machine. Our production team assemble the finished product to the same high level of quality as our handmade products.


Shell Options

We offer a wide range of CAD CAM devices made from EVA, polyurethane or polypropylene.

The Evolve device is made from ultra-high density EVA which is both highly durable and shock attenuating. These close contact functional devices are our most popular shell type, offering excellent pronation or supination force resistance, shock attenuation and stability. We advise ultra-high density EVA shells for the supinated Pes Cavus foot, the mobile hyper-pronated flat foot with Tib Post Dysfunction and unusual foot shapes with orthopaedic presentations. Suitable for both sports and everyday use. Evolve is the equivalent of Podoflex from the handmade range.

Polyurethane (PU) offers superior impact resistance and shock attenuation making this an excellent option for patients requiring maximum contact & shock attenuation. Structural memory properties ensure these devices return to original shape following loading. Suitable for cradling the rigid flat foot and at-risk or diabetic foot. Whilst PU is the most shock attenuating shell, it is not suitable for high levels of pronation /supination force resistance or hypermobility.

Polypropylene devices are available in semi-flexible, semi-rigid and rigid shell options. These devices are highly durable and the shell is guaranteed against cracking. These functional devices offer good pronation/supination force resistance and are easily accommodated in slimmer fitting footwear. However, they are not as close contact or shock attenuating as EVA or PU shells. Glide‘s shell and heel post is 100% direct milled from polypropylene, and is our most popular and cost effective polypropylene shell. Motion & Propel are fitted with ultra-high density EVA heel posts.


Posting Procedures

We assume that all casts are taken in subtalar neutral position unless otherwise informed. The modification procedures that we employ to adapt our casts/scans are a variation on the Blake and Modified Root techniques. Our plaster modification techniques have been perfected over the course of the past twenty years and we pride ourselves on a high level of excellence in this area. These procedures are tailored to the particular type of shell that you have chosen for your patient.

Intrinsic Posting: posting that is integral to the shape of the shell itself. This is achieved by twisting and modifying the casts. The maximum amount of intrinsic posting depends on numerous factors including foot shape, forefoot inversion and patient age.

Extrinsic Posting: posting/wedging applied to the outside or machined into the underneath of the casted orthoses shell. Normally a maximum of 5-8° of extrinsic posting can be added to the shell without it becoming unstable or too bulky to accommodate in regular footwear.

We favour intrinsically posting the rearfoot as close to the desired corrected position (normally STJ neutral) as possible. This depends on the type and amount of forefoot deformity present and the patient profile. We recommend intrinsic posting as this is less bulky and increases compliance. If full correction intrinsically is not possible we may add extrinsic posting to the device. We generally intrinsically balance out soft tissue forefoot inversions to 0° if possible. Large soft tissue forefoot inversions over 5-15°, (depending on shoe size and patient profile), may require the use of a 2-5 varus metatarsal bar, as well as intrinsic forefoot balancing. Very large soft tissue forefoot inversions over 10-25°, (depending on shoe size and patient profile), may require the use of a combination of forefoot medial or total forefoot medial posting and intrinsic balancing.

We generally modify casts for flexible shells (e.g. Podoflex) with minimal arch fill to give a total contact effect in the midfoot. The more flexible material allows for the dynamic movements of the medial column to occur, thereby allowing 1st Ray plantarflexion to occur.

We generally modify casts for more rigid shells (e.g. Podofirm) with moderate arch fill. The less flexible material will not allow the dynamic movements of the medial column to occur. If arch fill is not added 1st Ray plantarflexion will be blocked and the medial slip of the plantarfascia may be irritated.


Features

  • High quality durable materials
  • Scan files are kept in storage indefinitely enabling lifelong repeat orders
  • Digital modelling enables accuracy to within 0.01mm
  • Lower cost than handmade devices
  • Direct milling ensures shells are precisely duplicated
  • Pricing structure based on the device length and number of additions requested
  • No additional cost for any combination of rearfoot and forefoot extrinsic posting
  • Non-standard additions can be requested with a sketch

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