Custom Orthotics and Personalized Footwear

20200238626 ยท 2020-07-30

    Inventors

    Cpc classification

    International classification

    Abstract

    A system, process, manufacturing technique and platform are herein provided for designing and/or manufacturing orthopedic devices, custom orthotics or personalized footwear based on computerized design software adapted to adjust the scanned information into a 3D model of the device substantially ready to production, wherein the system comprises an imaging module which uses image recognition to identify different anatomic parts of the foot to allow the design of the orthotics, and a human interface that allows showing the original scan of the foot at an opaque or semitransparent manner to allow visualization of the way the foot is going to fit and be supported by the designed custom orthotic.

    Claims

    1. A system for designing orthopedic devices, custom orthotics or personalized footwear based on computerized design software adapted to adjust the scanned information into a 3D model of the device substantially ready to production, the system comprising an imaging module which uses image recognition to identify different anatomic parts of the foot to allow the design of the orthotics, and a human interface that allows showing the original scan of the foot at an opaque or semitransparent manner to allow visualization of the way the foot is going to fit and be supported by the designed custom orthotic.

    2. The system of claim 1, further adapted to designing 3D models or objects which are specifically adjusted to fit a certain portion of the human body.

    3. The system of claim 1, further comprising a marker system used for marking segments on the skin of a patient which are recognized using the system and are used for the identification of the specific organ parts as well as required posture, the marker system comprising stickers which are easily recognized using the 3D scanner according to color information, specified geometry, and/or light absorption properties.

    4. A manufacturing technique for building custom orthotic insoles or personalized sandals or footwear soles using injection of a foamed or soft material into a mold, the technique comprising heating circles and/or cooling tubes; and receiving inserts to a fixed flat side and cavity built to receive inserts according to the geometry of a specific orthotic.

    5. The manufacturing technique of claim 4, wherein the personalized sandals or footwear soles comprise custom orthotic insoles designed to treat foot wounds and ulcerations by correct distribution of the weight of a patient along the plantar surface of the foot and by including strain release depressed areas/holes in the orthotic, the insoles comprising: a plurality of materials of different hardness levels, wherein the soft materials are located under the wounds allowing load reduction from these points.

    6. The manufacturing technique of claim 4, wherein the personalized sandals or footwear soles comprise a custom orthotic flip-flop built according to specific mapping of a person's foot geometry in order to fit the plantar surface and supply arch support, the flip flop comprising a patient's foot scan was performed at a subtalar joint neutral position to correct the posture on a patient's foot.

    7. The manufacturing technique of claim 4, wherein the personalized sandals or footwear soles comprise custom orthotic clogs are built according to specific mapping of a person's foot geometry in order to fit the plantar surface and supply arch support, the clogs comprising a patient's foot scan was performed at a subtalar joint neutral position to correct the posture on a patient's foot.

    8. The manufacturing technique of claim 4, wherein the personalized sandals or footwear soles comprise custom orthotic sandals are built according to specific mapping of a person's foot geometry in order to fit the plantar surface and supply arch support, the sandals comprising a patient's foot scan that was performed at a subtalar joint neutral position to correct the posture on a patient's foot.

    9. The manufacturing technique of claim 4, wherein the personalized sandals or footwear soles comprise custom footwear designed and manufacturing specifically according to a customer's body geometry, the shoes comprising a sole made from an insert mold specific to a patient's geometry, and wherein the sole is combined with the sole molds to allow multiple colors, material properties and geometrical patterns.

    10. A process for creating customized orthotics, the process comprising: receiving a 3D file of a foot, said 3D file comprising the metatarsal region, the arch region, and the heel region; detecting and assigning position data in said 3D file for said metatarsal region, said arch region, and said heel region; generating a base orthotic model, where said orthotic base model represents a surface for mating to the corresponding mapped plantar surface, said base orthotic model conforming to the mapped plantar surface.

    11. The process of claim 10 further comprising providing a body position device, operable to facilitate a constant foot position during 3D image data capture.

    12. The process of claim 10 further comprising providing a marker pen and marking the metatarsal region, the arch region, and the heel region.

    13. The process of claim 10 further comprising providing paint and marking the metatarsal region, the arch region, and the heel region.

    14. The process of claim 10 further comprising providing label and marking the metatarsal region, the arch region, and the heel region.

    15. The process of claim 10 further comprising providing a 3D scanner comprising a depth and color camera.

    16. (canceled)

    17. The process of claim 10 further comprising detecting and assigning position data in said 3D file for wounds on said foot.

    18. The process of claim 17 further comprising detecting using one or more of hotspot detection and color differentiation.

    19. The process of claim 17 further comprising: modifying said base orthotic position to provide recesses corresponding to the position of said wounds; applying a healing agent as a substrate in said recesses; and providing an exit channel in fluid communication with said recess and a remote reservoir.

    20. The process of claim 10 further comprising: presenting an interface for manipulation or verification of said base orthotic model, wherein said interface is adapted to enable one or more functionalities including inflation or deflation operation, a smoothing operation, a stretch or compress operation, and a rotation operation.

    21. The process of claim 10 further comprising generating the negative impression of the orthotic model and transforming into a model for a mold.

    Description

    BRIEF DESCRIPTION OF THE DRAWINGS

    [0124] FIG. 1 illustrates a flowchart of embodiments of processes according to the current invention;

    [0125] FIG. 2 illustrates a pictorial chart of embodiments of a process according to the current invention;

    [0126] FIGS. 3a and 3b illustrate feet having wounds and anatomical markers;

    [0127] FIG. 4 illustrates an embodiment of an orthotic of the current invention;

    [0128] FIGS. 5a and 5b illustrates example orthotic amendments of a subprocess of the current invention;

    [0129] FIGS. 6a and 6b illustrates alternate example orthotic amendments of a subprocess of the current invention;

    [0130] FIG. 7a illustrates another example foot model amendment of a subprocess of the current invention;

    [0131] FIG. 7b illustrates an example subset of a repository of available insoles;

    [0132] FIGS. 8a and 8b illustrate an embodiment of an orthotic of the current invention in an alternate state;

    [0133] FIG. 9 illustrates a foot having wounds;

    [0134] FIG. 10 illustrates an embodiment of an orthotic of the current invention having a recess;

    [0135] FIG. 11 illustrates an embodiment of an orthotic of the current invention having a recess;

    [0136] FIG. 12a illustrates an embodiment of an orthotic of the current invention having a recess;

    [0137] FIG. 12b illustrates a plurality of inserts for the orthotic embodiment of FIG. 12a;

    [0138] FIGS. 13a and 13b illustrate alternate configurations of the orthotic embodiment of FIG. 11;

    [0139] FIG. 14 illustrates an embodiment of a mold of the current invention;

    [0140] FIG. 15a illustrates an alternate embodiment of a mold of the current invention;

    [0141] FIG. 15b illustrates another alternate embodiment of a mold of the current invention;

    [0142] FIGS. 16a-c illustrate embodiments of open footwear having orthotics of the current invention;

    [0143] FIGS. 17a-c illustrate alternate embodiments of open footwear having orthotics of the current invention;

    [0144] FIG. 18 illustrates an example 3D scanner subsystem of the current invention;

    [0145] FIG. 19 illustrates an example 3D scanner subsystem of the current invention as it may exist in operation;

    [0146] FIG. 20 illustrates a combined block and flow diagram of a molding process of the current invention;

    [0147] FIG. 21 illustrates the mold of FIG. 15a as it may exist in operation; and

    [0148] FIG. 22 illustrates an overview of a processes of the current invention.

    DETAILED DESCRIPTION

    [0149] The invention is herein described, by way of example only, with reference to the accompanying drawings. With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of the preferred embodiments of the present invention only, and are presented in the cause of providing what is believed to be the most useful and readily understood description of the principles and conceptual aspects of the invention. The description taken with the drawings making apparent to those skilled in the art how the several forms of the invention may be embodied in practice.

    [0150] FIG. 22 illustrates an overview of certain embodiments of the invention. At step 200, the system receives 3D image data of a body part. At step 300, the system processes the received 3D image body for anatomical mapping. At step 400, the anatomically mapped image data is amended and optimized. At step 500, orthotics are manufactured based on the amended and optimized anatomically mapped image data. At step 600, the personalized manufactured orthotics are applied to footwear. More consideration will be given to each of these steps below.

    [0151] FIG. 1 shows a flow chart of embodiments of systems and processes of the current invention, while FIG. 2 depicts a pictoral view of a system and process of the current invention.

    [0152] At step 200, the system receives 3D image data for a body part. The selected body part for image data capture in this description is the foot, although it is within the scope of this invention to apply the systems and processes of the invention to other body parts. In one embodiment, the system receives 3D image data. In other embodiments, the system includes a 3D mapping system, which includes a 3D scanner 191 for image data capture.

    [0153] FIG. 19 illustrates aspects of preparation of the body part, a foot here, for the image data capture. In order to correct the posture of some patients, a designated foot holding apparatus is used for placing and fixing the foot at the neutral position or any other position in which the caregiver deems the foot should be during gait. In exemplary process, the foot is maintained in that position during image data capture, more specifically a constant height y and distance x from the 3D scanner 191. One embodiment of a system provides a body positioning device 193 to facilitate constant body part position. An exemplary body positioning device 193 provides a rest or containing surface and provides a full field of view of the body part. The depicted body positioning device 193 is a platform, where the foot 192 is placed on its upper surface.

    [0154] In some embodiments, the process and system uses solely the existing geometry and color information of the body image data to identify the different regions of the foot, such as the toe, metatarsal, arch, and heel regions. FIG. 3a shows a foot with identified anatomical landmarks of the metatarsal joint 31 and the bottom part of the heel 32 on a scanned model of a foot 33. In other configurations of the system and processes, anatomical landmark detection is facilitated by use of markers 35 placed on the foot. Such a configuration is shown in FIG. 3b. A series of anatomical markers 35 is deployed by which are distinguishable by the image data processing subsystem. Exemplary anatomical markers include labels with a glue on one side and color on the other, a marker pen with colored ink, or paint. The color of the pigment should contrast the skin of the body part. Anatomical markers 35 are attached to one or more of the following: left/right/upper/lower toes, left/right/upper/lower metatarsal region, left/right/upper/lower arch, left/right/upper/lower heel region, or other landmarks. FIG. 3b shows the heel mark using an anatomical marker 35 which was placed on the plantar surface of a patients foot 34 to describe the bottom most part of the heel portion.

    [0155] The image data is captured with a 3D scanner 191. A suitable 3D scanner is one or more depth sensing and red green blue (RGB) cameras. For example, the camera may be a Microsoft Kinect, Primesense, David Laser or other depth sensing cameras. Common depth sensor cameras includes technologies such as laser or IR emitter/receiver pairs. The image data is captured, with the 3D scanner rotating about the foot in exemplary configuration. Representative image data output formats include Standard Tessellation Language (STL), the open geometry definition format (OBJ), or the polygon file format (PLY).

    [0156] After the system receives the image data file 200, the system maps the landmark anatomical features as well as other features of the foot are mapped 300. In regards to the anatomical features, the anatomical markers 35 are associated with points, typically vertices, of the image data. A representative subsystem for this step is a Blender 3D engine based tool.

    [0157] As mentioned, the system also maps other features of the foot 300. Clinical conditions of the foot such as diabetic foot, foot ulceration, wounds, infections, osteonecrosis or others may exist in the subject foot. In order to treat the pathologies, the system needs to identify the problematic zones and areas on a patient's foot. All of the information is gathered in the 3D map of dots which represents the patient's foot. As previously mentioned, the 3D scanner 191 may use one or more of the following technologies including projected structured light, projected IR or NIR speckle, laser scanning, triangulation based image analysis, or other 3D mapping technology. To analyze the center points and areas requiring load discharging, the data is analyzed using the geometrical map, the spectral images, and the IR and NIR filtered data for determining hot spots or combinations of the above. Additionally, color filtration and differentiation may be employed to aid in detection of such conditions. The zones having identified clinical conditions are marked in the image data. A representative subsystem for this step is a Blender 3D engine based tool.

    [0158] An orthotic base model is generated, where the orthotic base represents a surface for mating to the corresponding mapped plantar surface, conforming to the generated corresponding mapped plantar surface.

    [0159] At step 400, the orthotic base model is amended and optimized. The system runs a series of automated amendments as well as receiving manual amendments in order for optimum fit to the required posture and position. In one configuration, the orthotic base model is divided into multiple sections as seen in FIG. 4, where one section 43 of a first angular orientation is continuously joined to a transition section 42 of a second orientation, which in turn is joined to a third section 43 of a third orientation, while the combined sections 41 42 43 remain rigidly joined. The rate of gradient transition of the middle section 42 is proportional to the orientation of the first section 41 and third section 43.

    [0160] The system automatic performs some amendments and facilitates user manipulation of the orthotic base model. Representative operations include inflation/deflation, smoothing, gradual pulling/pushing operations, stretching, compressing, rotating the representative orthotic base model or sections 41 42 43 thereof. FIGS. 5a and 5b illustrate some of the amendments or transformation which may be applied to the orthotic base model. FIG. 5a shows a longitude stretch 52 operation which is performed on part of a scanned surface 51. FIG. 5b shows a twisting manipulation which is typically used for fixing posture related angular deformations in patients. The twisting can be performed on the heel end 53, the toe end 54 or combination of the two. The deformations as well as stretching may be performed manually by the technician, clinical or operator or automatically by the system in order to enable the subtalar neutral position. In addition to these operators, the system allows flattening of specific portions of the foot, to allow a comfortable fit of the system in a standard shoe.

    [0161] In image 6A, the scanned object 61 has been flattened in the Z axis direction 63 to allow a flat surface at the distal portion of the orthotic. This action can also be performed according to the gradient principal as shown in FIG. 4.

    [0162] Some additional features the system includes, allow digitalization of typically manual sculpting like actions. FIG. 7a shows an example of such activity, where a specific area on the surface 72 of the scanned body 71 is inflated. Additional operators include pulling/pushing, smoothing, flattening and additional sculpting operators. By allowing the operator these digital sculpting tools, he can manipulate the scanned object just as he would do to the cast or insoles using real physical sculpting tools.

    [0163] Once the 3D geometry of the desired orthotic is determined, the insole contour is used to cut the orthotic in the correct shape for a given shoe. One configuration of the includes a repository of insoles for shoes varied by toe region relative width and height, metatarsal region relative width and height, arch region relative width and height, heel region width and height. FIG. 7b shows a subset of of many contour shapes which are contain therein and fit different kinds of feet, length and widths. The system can use existing contours such as the ones shown in image 73a, 73b and 73c and amend via scaling these to the correct show size for a particular patient. In addition, the system scanner can also scan the specific contour of a patient's existing insole and create new contours fitting specifically to the application.

    [0164] Once the surface has been defined as well as the contour, the orthotic will receive volume and thickness values as shown FIG. 8a. The thickness as well as hardness level of the material can be entered manually or calculated automatically according to the patient's detail and condition as they were input into the system.

    [0165] The system contains additional overlay interfaces which for comparison which limit errors and further optimize the fit of the orthotics. In exemplary display, the overlays are presented in an opaque or semitransparent manner. FIG. 6b shows an example of such tool, where a copy of the original foot scan 65 is projected on top of the amended surface of the orthotic 64. This tool allows comparison and evaluation of the amendments made on the original surface and the way they affect the fit to the patient's original scan. Additional overlay interfaces included in the system include a cross section view. As seen in FIG. 8b the section view cuts along one of the main axes through the designed orthotic 82 as well as through the original scan copy 83. This allows local evaluation of the design as well the fit of the design to the plantar surface.

    [0166] At step 400, the orthotic base model is optimized. Optimizations include load offset from affected sites and drug delivery to affected sites. FIG. 9 depicts an example of a diabetic foot of a patient which includes ulcers and wounds at locations 91A, 91B and 91C. By analyzing this data employing the steps previously disclosed, the location of the ulcerations and wounds were mapped. In this configuration, corresponding holes 102 are placed in the body of the orthotic as shown in an example in FIG. 10. A hole 102 can protrude fully or partially into the body of the insole 101 to allow the wounds and ulcer segments to remain load free and promote healing. The hole 102 can also be seen in cross section in FIG. 11.

    [0167] In some embodiments of the present invention, the surface of the orthotic may be fully or partially coated with anti-bacterial, anti-fungal or controlled drug release coating. An example for this embodiment can be seen in FIG. 13a. A recess 132 is disposed in the body of the orthotic 131 corresponding to a wound site 91a 91b 91c. Substrate 133 represents a layer of drug coating, anti-bacterial coating, or other coating which can be locally positioned to treat the wounds and improve the healing process. An additional configuration of the current embodiment, shown in FIG. 13b, includes a plurality of exit channels 135 in fluid communication with a remote reservoir 134, presenting a fluid exit from the wound site to the reservoir, allowing the healing surface to remain dry and thus promoting healing.

    [0168] As healing of the wound sites commences, the width of the wound site 91a 91b 91c decreases. FIG. 12a illustrates an example orthotic built with the system which includes two recesses 102 dimensioned to accommodate ulcers and wounds. A plurality of concentrically disposed, successively smaller plugs 121 are inserted in the recess 102. Each plug 121 has an outer width sized to the fit in the adjacent plug (or the recess 102 in the case of the outer plug 121). Each plug 121 has an inner opening sized for receipt of a successively smaller plug 121. The shown plugs 121 are toroidal having successive outer widths of e and f and successive inner widths off and g, which can be seen in separate in FIG. 12b, plugs 122b and 123. In use, the plugs 122b 123 are inserted into each other and into the depression zones and allow gradual shrinking of the depression diameter and support for the wound as it heals and shrinks. These elements can be formed from the same materials as the orthotic or from different material of various hardness levels such as silicone or ethylene vinyl acetate (EVA).

    [0169] Once the system has finalized the design of the specific orthotic, the negative impression of the orthotic is transformed into a model of a mold. An example for such mold can be seen in FIG. 14. The mold may contain a lip 141 formed around the perimeter of the cavity which protrudes to a height 0.1 to 5 mm over the surface of the mold. This lip will contact the flat surface of the mold during injection molding and ensure a tight closure is achieved for injection. The molds may be milled on two sides of a single block as shown in FIG. 15a to save material and volume. In this case, a single patient's two orthotics can be milled and saved on a single block. Additional details which may be included in the molded blocks include an air box cavity 152 located behind the heel of the orthotic as shown in FIG. 15a. This air box is aligned to the material inlet in the injection process and therefor prevents from the deformations and discolorations associated with the material inlet from being present on the surface of the orthotic while injected. Detail 151 in FIG. 15B describes the details of a patient which may also be milled on the surface of the mold. These details can contain some of the following, but not limited to these: the patient name, initials, right or left foot, the volume of the cavity for injection, the required hardness level, the weight or any additional information relevant to the orthotic or the injection process.

    [0170] Open toe footwear present additional manufacturing and use problem compared to closed toe footwear. FIGS. 16a, 16b and 16c depict an example of an embodiment of the current invention which describes the design and manufacture of a personalized custom flip flop. In the current embodiment the orthotic is designed according to the flow chart described in FIG. 1. The curve used to cut the surface to the correct contour is designed according to a shape as depicted in FIG. 16b but not limited to this shape. This shape fits exactly into a cavity of the same shape which is located in the body of the flip-flop in detail 163 of FIG. 16c. the cut to shape orthotic is inserted and adhered or chemically or heat bonded into the cavity forming a flip-flop with a personalized orthotic surface. The flip-flop may include a strap which can be connected or disconnected from the heel portion of the flip flop and creates better support and gait to the users.

    [0171] FIGS. 17a, 17b, and 17c relate to another part of the current invention, related specifically to personalized clogs and slippers of various configurations, such as Crocs. FIG. 17a shows an example clog design which includes a cavity formed specifically to include the orthotic designed according to the flow chart described in FIG. 1. The orthotic, which example can be seen in detail 172 of FIG. 17b fits to the contour of the clog 171 and can be adhered into place or chemically or heat bonded. Alternatively, the clog 171 can host more than one orthotic sole 172 and these can be replaced according to different colors, materials, form factors or according to any other consideration that may require alternative orthotics. An additional embodiment of this invention includes the forming a personalized clog using a single molding process as seen in FIG. 17c. The one part clog injection 173 can be formed by replacing a piece of the core part of the injection mold to allow the exact fit to a patient's foot. The embodiments described in FIGS. 16a-16c as well as 17a-c describe a process of the invention for creating different personalized footwear. These are not limited to flip-flops or clogs which are described herein but are also relevant to customized sandals, slippers and soles for closed shoes personalized for each consumer.

    [0172] It should be appreciated that the disclosed 3D scanning, amending, and manufacturing processes can be applied to other product such as but not limited to personalized intra-ear earphones, off loading braces, orthopedic support braces for the knee, ankle, elbow, back, neck or any other body ligament including braces with mobility, semi mobile or fully stabilizing braces, and the earphone piece.

    [0173] FIG. 2 represents a typical yet not limiting flow chart of the current invention. The process starts with the scanning of the patients foot using a 3D mapping unit 21. The data is uploaded via the internet to the laboratories or alternatively processed locally taking into consideration the mapping factors as well as personal details from the customer. The negative impression of the design orthotic is then carved on a block or made using additive manufacturing technologies 24 into a mold 25 used for injection molding of one of the final products, including personalized orthotics 26, flip flops 27, clogs 28, or shoe soles, slippers or application non-related to the feet such as fixation aids for head, hand, legs or other part of the body as well as custom apparatus such as chairs, handles and more.

    [0174] Another part of the invention related to the controlled process of injection molding of the orthotic insoles, soles or personalized shoes. FIG. 20 describes a flow chart of all the controlled parameters which can affect the final product produced in the injection molding process. While in some preferred embodiments two components or more are mixed together during the injection, the user can control the injection volume, the pigment affecting the color of the product as well as the mix ratio which controls the hardness level of the product. These parameters may be picked manually by the technician or operator or be automatically calculated according to the system inputs. The parameters may be milled on the surface of the mold block to facilitate the insertion into the injection system by the end user. FIG. 21 describes an example injection molding tool according to one embodiment of the current invention. In this setup the mold housing includes a base block 212 which includes a cavity according to the dimensions of the blocks. These blocks 211 are interchangeable according to the specific mold for each client. The housing block 212 includes a heating system 213 which could be electric or using warmed fluids as well as a cooling system 214. The second part of the molding system includes a pneumatically or mechanically moving plate 215. This plate includes the material inlet as well as a mechanical or pneumatically controlled closure system 215.

    [0175] Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many subsystems, subprocesses, alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such subsystems, subprocesses, alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims.

    EXAMPLES

    [0176] Aspects of the present teachings may be further understood in light of the following examples, which should not be construed as limiting the scope of the present teachings in any way.

    Example 1: Producing a Custom Orthotic Using the System Described Herein

    [0177] Healthy patient, 34 years of age, 190 cm of height, 85 Kg weight. Engages in sports 1-3 times a week including running and basket-ball. Patients complaints and appears to be in discomfort. Diagnosed with plantar fasciitis, Functional hallux limitus.

    [0178] After physical examination the patient was seated in a chair and the feet were positioned in the subtalar neutral position. The position of the foot was fixated using the designated holder described in FIG. 19. Once the foot was positioned the 3D mapping was performed, resulting with a 3D scan of the plantar surface of the foot in the subtalar joint neutral (STJN) position. This was repeated for the second foot. All of the patient's information including personal, clinical and diagnosis was uploaded through the system's portal together with the patient's scans. Additionally the existing inserts from the sports shoes which are used by the patient normally were mapped and uploaded to the portal as well. The 3d orientation and modifications were performed by the system and the orthotic contour was cut according to the scanned insole in order to best fit into the sports shoes. The parameters inserted about this patient suggested a medium hardness level for this patient, referred to by the system as B. After the orthotic 3D model was created and the volume was calculated, the mold model was fabricated including these parameters written on the mold, as seen is FIG. 15B detail 151. This file was sent to the automated CNC milling machine which fabricated a two sided mold block specific to the patient's geometry. The block was inserted into the mold housing similar to the one described in FIG. 21 where each side was injected with two component foamed polyurethane material. The mass of each component as well as ratio were determined according to the parameters calculated and written on the body of each side of the mold, in this example 80 grams of component A and 50 of component B. After the injection molding process was completed, the orthotics were tested to the correct hardness level, in this case 15 Shore A which is within the B hardness level limits which are 14 to 16 Shore A.

    Example 2: Producing a Custom Orthotic for Diabetic Foot Using the System Described Herein

    [0179] Diabetic Patient, 37 years of age, 185 cm of height, 105 Kg of weight. Suffers from severe diabetic related neuropathy in both feet, has multiple wounds and ulcers on each of his feet. Suffers from Charcot foot. Has a history of wound infection which have put his feet in danger of amputation. Uses diabetic's footwear.

    [0180] After diagnosis of the patient, his feet were placed in the foot holding unit and scanned at the STJN position. The scan included spectral information as well as 3 axis geometrical information for each vertex on the surface of the patient's foot. The scans and patient information were sent via the internet to the systems portal for diagnostics. While analyzing the scanned surface, three ulcer location were diagnosed on the plantar surface of the patient's foot, as seen in FIG. 9 details 91A, 91B and 91C. The insole design was built to support the foot around the wounds while allowing zero weight bearing at the wounded and ulcer regions of the foot. The patient received a treatment in which he had to return for follow up on the wound conditions once a month. Each time he came, as the treatment improved the condition of his wounds and reduced the size of these, he had received a new pair of orthotics with the same geometry only with smaller diameter strain release portions, as seen in an example on FIGS. 12a and 12b. The hardness level of this patient's insoles was determined as according to the system and therefor injection molding parameters were set to 11 Shore A, inside the A range which is 10-12 Shore A.

    Example 3: Producing Custom Clogs Using the System Described Herein

    [0181] Healthy patient, male 55 years of age, 175 cm of height, 75 Kg weight. Works as surgeon at a hospital, requiring up to 12 hour of standing every day. Patients uses orthotic insoles while engaging in sports but wares clogs while in the operating room. Generally healthy, has a pes cavus foot condition, history of plantar fasciitis.

    [0182] The patient was scanned using the system at the STJN position using the equipment and setting as described in example 1 above. The scans were aligned and manipulated using the system software after being uploaded to the portal. The contour used for trimming the boundary line was a specific contour line which fits the cavity of the custom clog's design, such as the once described in detail 172 of image 17B. After being manufactured using the process described in the above examples the orthotic was adhered to a pair of size 11 orthotic clogs, forming a water tight, one piece like clog. The orthotic clog was injected with a two component polyurethane foam which included silver particles in order to reduce the chance for infection while using the clogs. In addition, the same orthotic was also trimmed a second time using the software, this time according to the contour which best fits the flip flop orthotics, such as the one described in detail 162 of FIG. 16B. This orthotic was manufactured the same way and integrated into a custom flip-flop pair which was also supplied to the patient.

    [0183] Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims. All publications, patents and patent applications mentioned in this specification are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by reference. In addition, citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention.