KevinRoot Medical offers four basic orthotic width profiles. These are labeled from narrow to wide as “Dress”, “Performance”, “Control” and “UCBL”. Diagrams of these profiles can be found on the page labeled “Root Orthotics Profiles”. The “performance” profile is generally considered the default width on most devices, should you desire a different width than this profile please make sure you denote that preference when ordering the device. How are these profiles defined? The answer is straightforward and simple.
The width of the orthotic device is generally defined by the relationship of the medial edge of the orthotic frame versus the 1st metatarsal. A similar relationship between the lateral orthotic edge and the 5th metatarsal also applies. The assumption is the 1st metatarsal and sesamoids are in anatomically correct positions with an approximate intermetatarsal angle between first and second metatarsals of 8 degrees, and the sesamoids are in their anatomical grooves under the 1st metatarsal head. Subsequently, if significant Hallux abducto valgus deformity exists the orthotic width will approximate where the metatarsal should be.
The “Dress” profile orthotic will have its medial edge bisecting the location of the Fibular sesamoid. The “Performance” profile orthotic will bisect the midline of 1st metatarsal and sesamoid apparatus (default width). The “Control” profile medial edge will bisect the Tibial sesamoid. The “UCBL” profile medial edge will be medial to the entire 1st ray and should approximate the soft tissue surface on the medial aspect of the forefoot.
Generally speaking, the wider the orthotic profile, the deeper the orthotic will be. A higher medial arch will be present in a wider orthotic than a narrower orthotic made from the same impression. A wider profile device will exert more functional control over the foot, the narrower the device, the easier it is to fit into a shoe. The clinician should be mindful of the environment the orthotic will be subject to when determining the appropriate width of the device. For example, a patient may want to have a device to wear in a dress shoe, but works long hours in retail, or performs ballroom dancing. How do you account for the added control needed in a space limited environment? Orthotic width is one variable which may be used to accomplish a successful outcome in a complex situation.
The width of the heel cup can be independent of the width of the midfoot or forefoot portion of the orthotic device. In a case of a severely splayed forefoot with a relatively narrow heel you can be specific in your order for the device. The lab may not necessarily be able to see the splaying in a non weight bearing impression. In such a case ordering a “control” profile with minimal fat pad expansion in the heel would be appropriate, possibly adding a medial flange or a medial heel skive, if needed, to attain more control of heel eversion with less width to the heel cup.
KevinRoot Medical is here to work with you. Every case is unique and every device should be customized to address your patient’s specific needs.
