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SHELL MODIFICATIONS

Modification suggestions and diagrams listed by possible patient conditions.


TO CORRECT FOR IN-TOE The shell extends laterally to the middle of the 5th digit changing the gait pattern for in-toeing patients under 10 years of age.	TO CORRECT FOR OUT -TOE The shell extends medially to the middle of the 1st digit changing the gait pattern for out-toeing patients under 10 years of age.	SHORTEN or LENGTHEN DEVICE Standard orthotic length is made to the bi-section of the 1st and 5th met heads. Standard shortening or lengthening is 1/8" from normal.	NARROW or WIDEN DEVICE Standard orthotic width is made to the bi-section of the 1st and 5th met heads. Standard widening or narrowing is 1/8" from the normal.


CLIP IST MET HEAD The medial distal corner of the orthotic shell is removed just proximal to the 1st metatarsal head, used for hallux limitus.	EXTRINSIC FOREFOOT & REARFOOT POSTING An external piece of EVA materal is added to the forefoot or rearfoot of the orthotic to provide varus, valgus, or neutral correction.	INTRINSIC REARFOOT POSTING Varus,Valgus or neutral posting is ground into the shell of the orthotic device.	INTRINSIC FOREFOOT POSTING The casting of the foot is poured to rearfoot neutral and the forefoot variance is filled in with plaster to intrinsically post the forefoot of the orthotic.


COMPRESSIBLE FF POST TO SULCUS An EVA forefoot posting is applied to the orthotic extending to the sulcus creating greater forefoot control on contact.	MEDIAL and LATERAL FLANGES The medial or lateral border of the orthotic shell extends higher around the sides of the foot providing greater control.	REDUCE BULK Additional arch filler material is removed and the rearfoot posting is undercut an additional 10 degrees achieving a better shoe fit.	LATERAL WEDGE An EVA wedge is applied to the lateral plantar surface of the orthotic helping to evert the foot.


PLANTAR FASCIAL GROOVE A depression in the shell of the orthotic is created providing relief for the plantar fascia.	NAVICULAR SHELL ACCOMMODATION An indentation in the shell of the orthotic is created to provide a "well" for a misplaced navicular.	HEEL SPUR CUTOUT The shell is cut away from the center of the heel and replaced with a gel padding.	HEEL CUP DEPTH 3/8" Standard, ¼" shallow 5/8" deep, ¾" very deep.