“Keeping pace with technological developments“

With the Bodytronic ID:CAM system solution from Bauerfeind, orthotists can individually model orthoses and then have them milled at Bauerfeind – since recently for sensitive diabetic feet as well. This is a good thing, according to the German Bauerfeind quality partner Jan Fritzsch.

“Treatment for diabetics is an issue in and of itself,” says Jan Fritzsch, the 38-year-old Managing Director of the Andreas Fritzsch GmbH medical supply retailer, which operates outlets in Attendorn and Lennestadt-Altenhundem. “Actually, one should start using indication-appropriate orthotic care measures as soon as a diagnosis of diabetes is made.” The problem is that people often aren’t aware of this: “Even today, I still get diabetes patients coming in with prescriptions for cork/leather foot orthoses.”

Awareness is important

Patients themselves also aren’t always aware of how serious their situation is. Many patients therefore develop polyneuropathy at an early stage of their illness. Because of the nerve damage this causes, those affected don’t notice when pressure points form on their feet. Many patients also have an attitude that can be summed up as: “Why should I treat something that doesn’t hurt?” Jan Fritzsch is therefore firmly convinced that “physicians not only need to prepare patients for appropriate medications but also make them aware of the dramatic consequences diabetes can have for their feet.”
The reduced pain perception in particular makes early pressure relief with foot orthoses an essential component of a holistic therapeutic approach. “There’s also another aspect ,” says Jan Fritzsch. “Like the rest of the population, diabetics sometimes have foot misalignments. If a slight foot misalignment is left untreated, it might develop into a severe misalignment. This will make treatment more difficult later on because orthopedically speaking, a crooked foot can only be corrected with pressure, and pressure is counterproductive with diabetics.”

“Actually, one should start using indication-appropriate orthotic care measures as soon as a diagnosis of diabetes is made.”Jan Fritzsch

Premium care provided with milled orthoses in most cases

The Bauerfeind quality partner is happy about the fact that with ErgoPad ID:Diabetes, Bauerfeind now has a milled orthosis that serves as the basis for diabetes-adapted foot cushioning – and Fritzsch can individually model it using Bodytronic ID:CAM. “Milled orthoses already account for around 70 percent of our high-quality foot orthoses,” he explains. “The depth of detail here is greater than anything the traditional sandwich design can offer. For example, if I say lower the fifth MTP joint by 1.5 millimeters, then Bodytronic ID:CAM will do exactly that. It’s almost impossible to depict something like that with your hands, or at least you can’t do it that quickly.”

Good experiences with the Bauerfeind system solution

Fritzsch’s staff in the Sauerland region of Germany have been working with the Bodytronic ID:CAM web application since the system was introduced in 2015. “Before that , we used an external milling solution, but the Bauerfeind web application won me over,” Jan Fritzsch explains. “The depth of detail , the various configuration possibilities, the exact reproducibility, and the simple and intuitive way the software works were truly impressive.” Four of Fritzsch’s 15 employees manage the foot orthoses orders – and all four also work with Bodytronic ID:CAM, usually with the “Advanced” profile. It’s important to Jan Fritzsch that those who advise customers and examine and measure their feet also shape the foot orthosis.

“Milled orthoses already account for around 70 percent of our high-quality foot orthoses.”Jan Fritzsch

Extensive measurement data for treating diabetics

Fritzsch’s outlets all have computers installed directly in the foot orthosis measurement rooms. Measurement data is uploaded to these computers, after which the orthoses are modeled using Bodytronic ID:CAM – in the shortest time possible after the customer’s appointment. Whereas a foot scan is usually conducted for the modeling of a standard foot orthosis, the team at the medical supply retailer employs the complete repertoire when foot orthoses are modeled for diabetics. Here, a foot scan is performed, a measurement of foot pressure distribution and pressure peaks is taken, and a foam imprint is made. “The foam imprint is digitized by the Bodytronic 600 measurement system,” Jan Fritzsch explains. “Bodytronic ID:CAM then uses the 3D model generated as a result to create an electronic cast , so to speak. This is where some people have problems because many orthosis specialists prefer a physical cast that they can hold, which means they can see and feel the model of the orthosis they will produce. In the end, however, we do the same work with Bodytronic ID:CAM, only we do it on a screen. In this sense, only one part of the process for supplying a foot orthosis has been modernized here.”

Special “diabetes algorithm”

A specially developed algorithm that provides for optimal pressure distribution is used to create the topography for the new ErgoPad ID:Diabetes soft cushioning orthosis. Here, the orthotist can individually combine the required thicknesses of soft padding on the computer. “For example, if I want to attach a cushion layer that’s three millimeters thick, Bodytronic ID:CAM will make the foot orthosis three millimeters lower in order to ensure the final product is the right height ,” Jan Fritzsch explains.
When configuring the orthosis, the orthotist can use layers with different degrees of firmness to guide the foot , support the foot arches, and correct foot misalignments. Special pressure relief zones and functional elements can also be incorporated as required. Once the foot orthosis has been fully modeled, the orthotist sends the data to Bauerfeind, where the base layer of the cushioning is milled to fit the foot of the wearer exactly. “Normally, we receive the milled orthoses within two business days. After that , we cover them and make sure they fit perfectly in the patient’s shoes.”

“In the end, however, we do the same work with Bodytronic ID:CAM, only we do it on a screen.”Jan Fritzsch

Long-lasting soft cushioning with Vepur special foam

Jan Fritzsch is pleased that Bauerfeind has developed a soft foam known as Vepur that offers a particularly high degree of shape retention. “It’s absolutely essential in our business as well that we keep pace with technological developments in terms of both manufacturing technology and materials,” he says. He is impressed by the Vepur viscoelastic soft foam: “A high level of pressure and shock absorption and long-lasting shape retention offer benefits to diabetics in particular. Even if patients don’t think about their health as much as they should, the foot orthosis stays in their shoe for two years.” Whether or not the shape retention of ErgoPad ID:Diabetes is maintained over the same period remains to be seen however, Jan Fritzsch points out with a wink. If customers then want to obtain another foot orthosis, Bodytronic ID:CAM makes it possible to supply them with the exact same product. They just need to be measured again to make sure nothing has changed. This offers benefits in terms of stock-keeping as well , as the “electronic casts” can be stored digitally in unlimited numbers without taking up any space whatsoever. “The individual modeling of milled orthoses using Bodytronic ID:CAM is a logical and extremely helpful piece of the puzzle when it comes to the overall provision of care,” says Jan Fritzsch. “Nevertheless, the most important factor is still a good orthotist who can draw up an accurate and holistic case history and who also has the knowledge and the craftsmanship skills needed to produce a high-quality product. Theoretically, ID:CAM can be used to mill just about anything. Ultimately, however, it is the experience and expertise of a technician that determines whether or not a pad is in the proper position, whether the arch support fits, or whether a foot orthosis offers a soft cushioning that is truly adapted to the needs of diabetics.”

Images: Michael Bause, Bauerfeind