Research Papers

A New Method in the Design of a Dynamic Pedorthosis for Children With Residual Clubfoot

[+] Author and Article Information
Robert Rizza

Department of Mechanical Engineering, Milwaukee School of Engineering, Milwaukee, WI 53226

XueCheng Liu, John Thometz, Roger Lyon, Channing Tassone

Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI 53226

J. Med. Devices 4(2), 021004 (Aug 04, 2010) (5 pages) doi:10.1115/1.4001814 History: Received October 13, 2009; Revised April 15, 2010; Published August 04, 2010; Online August 04, 2010

Clubfoot is a common pediatric orthopaedic deformity. Despite the popularity of Ponseti’s method and night splints such as the Denis–Browne method, there is still an 11–47% rate of deformity relapse reported in the literature. The technique to make traditional orthotics is dependent on a nonweight-bearing casting or foot imprint. These splints outdate clinical treatment trends and only apply to patients who are of nonwalking age. This study shows that a new procedure utilizing computer aided design and the finite element method can be employed to develop a customized weight-bearing dynamic orthotic. In addition, the plantar pressure distribution and the trajectory of the center of this pressure distribution are used to design the orthotic. It is shown that the trajectory of the center of pressure, traditionally used in gait analysis, can be used not only to quantify the severity of the foot deformity but to design a custom orthotic as well. Also, the new procedure allows the custom orthotic to be designed and analyzed within a day. The new orthotic design is composed of soft foam interior layers and a polymer supportive exterior layer. It is proved that rapid prototyping technologies employing selective laser sintering can be used to construct these layers to produce a custom orthotic within a 24 h time frame.

Copyright © 2010 by American Society of Mechanical Engineers
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Figure 1

The new design approach

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Figure 2

(a) Posterior view of the foot model showing parallel planes used to obtain the location of key anatomic arch features; (b) geometry at the slice imported in ORTHOTICPRO .

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Figure 3

Plantar pressure distribution of a child with clubfoot. Note the deviation of this child’s COP trajectory from that of a normal child.

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Figure 4

Orthotic design with arch support, wedge, and soft and hard components

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Figure 5

Plantar pressure as predicted by FEA for a child wearing the orthotic




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