Total views : 268
Design and Fabrication of Mechanically Controlled Pedorthosis to Treat Congenital Talipes Equino Varus (CTEV)
Objectives: Clubfoot scientifically coined as Congenital Talipes Equino Varus (CTEV) is a deformity in which the afflicted foot appears to be rotated internally at the ankle and shape the subject to walk on the sides of their foot. To diagnose clubfoot deformity non-surgical technique such as serial casting and implementing an Ankle Foot Orthosis (AFO) is preferred over surgical method. This paper aims at developing a mechanically governed non-surgical corrective mechanism that rectifies clubfoot deformity in infants. Methodology: To design the supportive device, following three parameters, are to be considered: Foot Bi-Malleolar angle (FBM), Angle of Plantar Flexion (PF), Angle of Dorsi Flexion (DF). The FBM, PF and DF angle for a healthy infant ranges from 85 - 90˚, 0 - 40˚ and 0 - 22˚ but for a child with clubfoot it is constrained within 50 - 65˚, 0 - 22˚, 0 - 12˚. This deformation can be corrected with the help of mechanically controlled hinge joint and sliding pair mechanism. The orthosis predominantly consists of two main parts sole and cylindrical pair joint. The sole part which is connected to the lower link using a hexagonal nut and bolt creates a hinge joint and thus providing movement along PF. The bottom link in-turn is connected with the cylindrical pair joint and thus allowing 360˚ movement along FBM. Thus hinge joint provides the counter force on the forefoot. Similarly, cylindrical pair joint provides the counter force on mid and hind foot thus directing the bone growth to its pristine. Findings: The initial wearable prototype of the pedorthosis has been proposed, designed and fabricated using thermoforming process. Applications: This wearable orthosis can be fitted to a subject and the growth pattern can be studied. Feasibility of the concept can be understood by virtually evaluating using finite element analysis.
Clubfoot, Orthosis, Thermoforming Process.
- Susan JH. Basic Biomechanics. 6th edition, McGraw-Hill. 2011 Jun.
- Herd F, Ramanathan AK, Cochrane LA, Macnicol M, Abboud RJ. Foot pressure in clubfoot – The development of an objective assessment tool. The Foot. 2008 Jun; 18(2):99-105.
- Dimeglio A, Bensahel H, Souchet P, Mazeau P, Bonnet F. Classification of clubfoot. Journal of Pediatric Orthopedics Part B.1995; 4(2):129-36.
- David C, Simon B, Nicola M. Subjective and objective outcome in congenital clubfoot; a comparative study of 204 children. BMC Musculoskeletal Disorders. 2007 Jun; 8(53):1-7.
- Vijayaragavan E, Leya MK, Sulayman H, Gopal TV. Application of Rapid Prototyping in the treatment of clubfoot in children. Procedia Engineering. 2014 Dec; 97:2298-305.
- Chesney D, Barker S, Macnicol MF, Porter RW, Maffulli N. Management of congenital TalipesEquinovarus in Scotland: a nationwide audit. Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland. 2004; 2:47-51.
- Historical overview of clubfoot treatment - Journey to the Ponseti method.http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.535.3184&rep=rep1&type=pdf. Date accessed 02/07/2016.
- Matthew AH, Jan ED, Jen-Chen H, Cameron GW, Stewart JW, Haemish AC. Ponseti method compared with surgical treatment of clubfoot - A prospective comparison. The Journal of Bone and Joint Surgery (American). 2010 Feb; 92(2):270-78.
- Richards BS, Faulks S, Rathjen KE, Karol LA, Johnston CE, Jones SA. A comparison of two no operative methods of idiopathic clubfoot correction: The Ponseti method and the French functional (Physiotherapy) method, The Journal of Bone and Joint Surgery (American). 2008 Nov; 90(11):2313-21.
- Ponseti IV, Smoley EN. The classic: congenital clubfoot: the results of treatment. Clinical Orthopedics and Related Research. 2009 May; 467(5):1133-45.
- Kite JH. Principals involved in the treatment of congenital clubfoot. Journal of Bone and Joint Surgery.1939 Jul; 21(3):595-606.
- Ranjitha RJ, Vijayaragavan E, Angeline K. 3dimensional modeling of an ankle foot orthosis for Clubfoot deformity. International Journal of Biomedical Research. 2011; 2(3):171‐80.
- Manikandan K, Logesh K, Sivaraman J, Padmapriya P, Vijayalakshmi C. Design and Development of a Foot Pressure Scanner for Diabetic Patients. Indian Journal of Science and Technology. 2016 Jan; 9(2):1-6.
- Jain ML, Sanjay GD, Nalinaksh SV. Virtual modeling of an ankle foot orthosis for correction of foot abnormality. Robotics and Computer-Integrated Manufacturing. 2011 Apr; 27(2):257-60.
- Xue CL, Channing T, Robert R, Eric L, John GT, Roger L, Sergey T. A newly designed foot orthosis for children with residual clubfoot after Ponseti casting. Journal of Prosthetics and Orthotic. 2014 Jan; 26(1):38-42.
- Robert R, Xue CL, John T, Gerald FH. Effectiveness of a New Dynamic Pedorthosis with Wedge on the Clubfoot. Foot and Ankle International. 2010 Jan; 31(9):849.
- Dobbs MB, Rudzki JR, Derek BP, Walton T, Kristina RP, Christina AG. Factors Predictive of Outcome after Use of the Ponseti Method for the Treatment of Idiopathic Clubfeet. The Journal of Bone and Joint Surgery. 2004 Jan; 86(1):22-27.
- Downey DJ, Drennan JC, Garcia JF. Magnetic resonance image findings in congenital talipes equino varus. Journal of Pediatric and Orthopedics. 1992 Apr; 12:220-24.
- James NA, Justina SC, John MR. Impression techniques and model modification of a custom-molded ankle-foot orthosis for the idiopathic clubfoot. Journal of Pediatrics and Orthopedics. 1995 Jan; 7(3):99-124.
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 3.0 License.