Digitalizing manual plaster cast technology 

Digital processes have been used in orthopedics for quite some time. And they work well in combination with the skills of craftsmen. The Bodytronic measurement data are precise to the millimeter, and Orthopädie Technik Bauche in Neustadt in Holstein demonstrates the journey this data goes on to be turned into a custom-made brace.  

Unusual images appear on the monitor of the Bodytronic 610: a blue object rotates slowly around its axis, measurement lines are shown, numbers and marking points can be seen. Usually, measurement data, item sizes and product suggestions would be listed. But now, the moving physical model of a lower leg can be recognized. The monitor of the scanner does not show the usual measurement program but the interface of modeling software. Bodytronic, but with a twist: Orthopädie Technik Bauche in Neustadt uses the measurement system for manufacturing custom-made products for example.

Minimal data deviation is the foundation of making braces

“Of course, we also use the Bodytronic every day to adapt supports and compression stockings. But the system can do a lot more.” Max Bauche, expert orthotist and junior manager of the company employing 24 staff at three locations, sounds quite enthusiastic. This does not devalue
day-to-day operations, on the contrary.
This exact data is the foundation of the added value generated with the Bodytronic by the Bauche family. “We take such precise measurements,” explains Max’ father, Matthias Bauche, senior manager and expert orthotist, “that we can fully rely on the dimensional accuracy of the data when making braces and corsets.”

Much is expected of the technician during the digital process

Two years ago, the first foot lifter brace was made based on Bodytronic measurement data for a hemiparesis patient. Standard products did not have the desired outcome for this patient. Before the measurement process, the patient’s specific requirements for the brace were determined as part of discussing the patient’s medical history. During this phase, the importance of careful planning the digital treatment concept took effect. The structured proceedings were designed to eliminate errors in advance. Independent of the measurement principle, a scanner only records what is visible. An orthotist’s practiced eye can see more. It can “read” individual requirements. Do the perpendicular lines and angles of the physical model match the subsequent requirements during production? Can the measurement data still be corrected after importing it into the modeling software? Do additional markers have to be set? Insights from previous projects have shown the following: the combination of experience and measurement technology can create results that are easy to validate. This was the case with the hemiparesis patient. After the relevant preparations, a 3D scan of his lower leg was performed. The data recorded was transmitted via an STL interface to a modeling program that the medical retailer installed directly on the Bodytronic computer. Windows computers associated with Bodytronic systems are generally open to industry-specific CAD programs. Objects depicted using STL format can be enlarged, reduced, rotated or processed in third-party software without problems. It is possible, for example, to precisely address the anatomical proportions of a patient during digital modeling.

Based on a foam model, not on a plaster cast 

The foot lifter brace took shape, not following the complex plaster cast imprint procedure but by creating a positive model from foam. To do this, the Bodytronic data was sent to a partner company, the extended workbench of Orthopädie Technik Bauche. It created a hard-foam model of the lower leg milled by a multi-axis robot. This allowed Max Bauche to carry out his orthopedic craft layer by layer: a spiral-shaped carbon brace based on the foam model was created using pre-preg technology with the filament materials aramid and Dyneema. It had to be flexible, cushioning, free from edges, in different densities depending on the load, flattened for optimized heel-to-toe movements in the toe area and embedded in a foot orthosis. The foot foam imprint measurement for the foot orthosis was also taken with the Bodytronic system. This STL data was merged with that of the brace in the CAD program, too. To the delight of the patient. His typical steppage gait was significantly moderated.

Bodytronic data for Chêneau corsets

Because Bauche is so close to Schön Klinik Neustadt right by the Baltic Sea, creating customized braces is a central component of its business. Scoliosis treatment in particular benefits from torso braces and Chêneau corsets that are often produced in cooperation with spine surgeons. Bodytronic is used for this process as well. “The measurement system is perfect for the torso,” says Matthias Bauche. When producing a Chêneau corset, named after the recently deceased physician and inventor, intersections of pressure pads, load and pressure relief zones as well as breathing space must be borne in mind. This is highly complex design work, but is the perfect fit when completed – provided that the original data is reliable. Bodytronic 610 is able to measure more than just compression stockings and supports. Here, too, the basis for digital processing is STL data from the measurement with the body scanner. At Orthopädie Technik Bauche, about a third of all scans is for the production of braces and corsets. Monsieur Chêneau would have been pleased. 

Images: Stefan Volk