DRAFT Custom Design Process
Custom Design Processes
The posting techniques, cast modification and design principles we use, determine the shape of the finished orthotic shell. Different shell materials require different design principles to ensure a comfortable fit and ensure the device is as functional or accommodative as required. Our “Tissue Stress” Close Contact functional devices are PPL’s most popular devices, being suitable for most patients. Total Contact Accommodative offloading devices are chosen for patients with more complex foot shapes, and used extensively in the Woundcare area.
Tissue Stress Design - Close contact & functional orthoses
Tissue Stress devices are made using materials which have strength, yet some degree of flexibility. This allows us to design devices to fi t closely to the shape of the foot. More flexible materials facilitate normal dynamic movements of the foot, and provide high levels of comfort, control and shock attention. Tissue Stress orthotic shells are ¾ length, but can be extended to full length using cushioning materials.
When to Use
These types of devices should be selected when stability and correction in excess of 8° is required. Custom casted Tissue Stress orthoses are the optimal choice for conditions such as the supinated Pes Cavus foot, the mobile hyper-pronated flat foot with Tib Post Dysfunction and unusual foot shapes with orthopaedic presentations.
Root Functional Design - Rigid & semi-rigid orthoses
Root functional design devices are made using materials which have strength, but less flexibility and shock attenuation. Less flexible materials require more cast modifications to ensure comfort and device toleration. While these devices are harder and resist more force, they do not fit closely to the shape of the arch and midfoot. Root devices are slimmer in design and are accommodated more easily in dress footwear. Root orthotic shells are ¾ length but can be extended to full length using cushioning materials.
When to Use
These types of devices should be selected when stability and correction is required in slim fitting footwear. Root functional orthoses are the optimal choice when stiffness and durability are essential, however they provide less shock attenuation and cushioning than Tissue Stress devices.
Total Contact Design - Accommodating & offloading orthoses
Total Contact devices are designed to accommodate deformity, limit motion and offload high pressure areas. Total Contact shells are all Full Length, made of flexible shock attenuation materials and manufactured using CAD CAM processes.
When to Use
Total Contact devices are used widely in the at risk and diabetic foot, and where there is gross orthopaedic deformity. They offload peak pressure areas by redistributing load over the full plantar surface of the foot. They immobilise the foot, rather than promoting function, and therefore minimal cast corrections and postings are used.