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Abstract
Three-dimensional laser scanning has been used for patient measurement for cranial helmets and spinal braces. Ankle-foot orthoses are commonly prescribed for children with orthopaedic conditions. This trial sought to compare ankle-foot orthoses produced by laser scanning or traditional plaster casting. Assessment of the effectiveness and efficiency of using laser scanning to produce ankle-foot orthoses. Randomised controlled trial with blinding of orthotists and patients to the construction technique used. A randomised double-blind trial comparing fabrication of ankle-foot orthoses from casts or laser scans. The time spent in the rectification and moulding of scanned ankle-foot orthoses was around 50% less than for cast ankle-foot orthoses. A non-significant increase of 9 days was seen in the time to delivery to the patient for laser scanning with computer-aided design and computer-aided manufacturing. There was a higher incidence of problems with the scan-based ankle-foot orthoses at delivery of the device, but no difference in how long the ankle-foot orthoses lasted. Costs associated with laser scanning were not significantly different from traditional methods of ankle-foot orthosis manufacture. Compared with conventional casting techniques, laser scan-based ankle-foot orthosis manufacture did not significantly improve either the quality of the final product or the time to delivery. Ankle-foot orthoses (AFOs) are a common requirement for chronic neurological conditions during childhood. Improved efficiency of provision of AFOs would benefit children and families by reducing the delay in provision of devices and would benefit the health service by making best use of valuable orthotist time.
Highlights
Three-dimensional laser scanning has been used for patient measurement for cranial helmets and spinal braces
This method can be replaced by laser scanning with computer-aided design and computer-aided manufacturing (LSCAD/CAM), where a positive of the limb is milled in foam directly from the digital image
New study orthotists were less experienced in laser scanning and had less time to devote to the study, so the ability to recruit patients into the trial became more difficult
Summary
Three-dimensional laser scanning has been used for patient measurement for cranial helmets and spinal braces. Ankle–foot orthoses are commonly prescribed for children with orthopaedic conditions This trial sought to compare ankle–foot orthoses produced by laser scanning or traditional plaster casting. The orthosis is formed by moulding polypropylene sheets over the positive cast This method can be replaced by laser scanning with computer-aided design and computer-aided manufacturing (LSCAD/CAM), where a positive of the limb is milled in foam directly from the digital image. A recent systematic review suggests that foot orthotics designed from 3D scans are at least comparable with those made through traditional methods, none of the studies reviewed were randomised controlled trials and further research is required to confirm this.[3] One study suggested that plaster casting may be preferable to laser scanning when it is important to capture the forefoot-to-rearfoot relationship.[4]
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