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Handmade Casted Orthotic Devices


At PPL we manufacture a wide range of truly handmade custom orthoses using plaster modification techniques. We allow total flexibility in the customisation of your devices whilst also offering our expert advice. We create a plaster mould from a cast or foam box which our client sends to us along with their prescription form. All devices are individually designed and hand finished to your requirements. For further information on the services we offer with respect to custom devices click on the button below.

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. 


Shell Options

We offer devices made from ultra-high density EVA (Podoflex), semi-rigid thermoplastics (Podofirm) and a blend of both materials together (Flexifirm). Each device is subject to strict quality control protocols throughout the entire manufacture process. 

Podoflex 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. Podoflex is the equivalent of Evolve from the CAD CAM range.

Podofirm is a semi-rigid thermoplastic shell (Supralene) with an ultra-high density EVA heel post. 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. Not suitable for instability or gross foot deformities.

Flexifirm is a highly corrective functional orthoses made from a combination of very high density EVA and a thin Supralene thermoplastic shell. This device is ideal for providing very high levels of pronation/supination force resistance for heavier patients requiring maximum support. The EVA fill ensures excellent shock attenuation and enhances durability.


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

  • Truly custom made orthoses
  • Individually handmade and designed from a plaster cast or deep foam box impression of the foot
  • High quality durable materials
  • Multiple top cover and shell colour variations available
  • 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

Services

*extra charge applies

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