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Clinical Solutions in Practice

Will Infrared Technology Render Plaster Casting Obsolete?

By Robi Garthwait, Contributing Editor
September 2005

   Considering the prevalence of orthotic therapy in podiatric care today, it only seemed like a matter of time before a technologically advanced option arrived on the scene. With the introduction of the PedAlign™ system, podiatrists may have an alternative to the traditional time-consuming and often messy method of plaster casting.    The PedAlign technology employs an infrared optical scanning device that quickly captures and digitizes a foot’s image. This image, along with a doctor’s prescription, is electronically transmitted to a laboratory where it is decoded and analyzed prior to orthotic fabrication. The result is a superior orthotic delivered in days, according to PedAlign’s manufacturer, Maxmed Technologies, Inc.    The company says the standard office setup required is relatively simple and includes the scanner, a mini tower computer, flat screen monitor and printer. Clinicians may choose from 10 orthotic base models and there are additional options including multiple extension lengths, intrinsic/extrinsic postings and biomechanical accommodations.    Michael Theodoulou, DPM, a private practitioner with three offices located throughout the District of Columbia and Maryland, is impressed with the PedAlign system.    Dr. Theodoulou, who prescribes orthotics for a variety of common structural, functional and mechanical aberrations of the lower extremities, has had outstanding results using the system.     “I have utilized the PedAlign system over the past year and have found it to be an excellent evolution in the fabrication of custom orthotics,” he says. “It provides an efficient, effective and clean means of acquiring images of the foot to produce a foot orthotic.”

Emphasizing Patient Satisfaction

   Dr. Theodoulou, whose practice produces between 30 and 40 orthotic devices per month, cites a 90 percent “immediate” satisfaction rate upon dispensing the orthotics.    In addition to easing patient symptoms, Dr. Theodoulou says PedAlign facilitates an appropriate fit without initial irritation and enhances the practitioner’s ability to fit most individual shoe needs.    Charles Young, DPM, who is affiliated with the Foot Care Institute of Michigan, is similarly impressed with the PedAlign system. “It offers a high-tech product that is clinically efficacious and technologically sound,” offers Dr. Young. In addition, he notes the orthotic products themselves are of high quality and are well received by most patients.    However, while the system is advanced, Dr. Theodoulou says it is somewhat limited when it comes to dealing with complicated multiplanar deformities of the foot and ankle. When he encounters pathology that requires supramalleolar bracing, Dr. Theodoulou uses the casting method.

Other Pertinent Points

   Drs. Theodoulou and Young both cite the ease of use of the PedAlign system.     “The software directs the user along the steps for including patient demographics, acquiring the image, prescription writing and ultimate downloading to the main database,” notes Dr. Theodoulou.    He says a high-speed Internet connection is imperative for the smooth transmission of data when using the system. For example, when downloading orders, sending messages to the lab and even receiving updates from the company, no one wants to waste time waiting for a slow computer.    Touting the device’s sophisticated state-of-the-art scanning procedure, Dr. Young also praises the PedAlign system’s user-friendliness. Dr. Young, a Clinical Instructor at the Michigan State University College of Osteopathic Medicine, also commends the company’s technical support as well. Emphasizing that the system can usually be fully operational the day of installation, Dr. Young says “the learning curve with this system is not a problem.”    However, as with all new technology, there can be a reluctance to give up tried and tested older methods, according to Dr. Theodoulou. For those who can overcome that stumbling block, he believes the results are well worth it.     “If the end is to produce a usable, durable and effective appliance, I would definitely state that PedAlign has far greater pros than plaster molding,” offers Dr. Theodoulou. Ms. Garthwait is a freelance writer who lives in Downingtown, Pa.

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