CN104699908B - The preparation method of 3D orthopedic insoles - Google Patents

The preparation method of 3D orthopedic insoles Download PDF

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CN104699908B
CN104699908B CN201510130971.2A CN201510130971A CN104699908B CN 104699908 B CN104699908 B CN 104699908B CN 201510130971 A CN201510130971 A CN 201510130971A CN 104699908 B CN104699908 B CN 104699908B
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shoe
pad
foot
bone
curved surface
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CN104699908A (en
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唐力
邓毅
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Chongqing Liangdao Medical Equipment Co ltd
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Abstract

The present invention relates to a kind of preparation method of 3D orthopedic insoles, including:Imageological examination is carried out to the ankle of Weight carrying position, or imageological examination is carried out to the non-weight bearing position of the ankle after correction;To the image of scanning is imported into three-dimensional modeling software, the threedimensional model of sufficient bone and foot is generated;Shoe-pad curved surface for fitting vola is derived according to the threedimensional model of foot;According to the particular type of the threedimensional model of sufficient bone and sufficient bone to shoe-pad curved surface carry out it is orthopedic, obtain it is orthopedic after shoe-pad curved surface;By 3D printer print with it is orthopedic after shoe-pad curved surface corresponding to shoe-pad.The present invention can realize personalized customization shoe-pad, and targetedly orthopedic insoles are made according to the change of patients feet.

Description

The preparation method of 3D orthopedic insoles
Technical field
The present invention relates to a kind of preparation method of 3D orthopedic insoles, the production field applied to shoe-pad.
Background technology
Orthopedic insoles are widely used in the clinic of orthopaedics and orthopaedic srugery and rehabilitation department.Flat foot, talipes cavus, vola Fascitis, hyperosteogeny, diabetic keratopathy ulcer of sole, intoe, gout, subtalar joint subluxation, lower limb rotation deformity, Gonitis, meniscus injury, cruciate ligament etc. can improve symptom by orthopedic insoles, delay disease to send out Exhibition, correct the line of force or as postoperative rehabilitation.
Because plantar arch collapse flattens, metapedes shortens flat foot patient after arch of foot is lost, and makes the forward and backward muscular relaxation of shin, reduces to foot The maintenance ability of bow, aggravates the formation of flat foot.Chop and brevis loses the antagonism of flesh before and after shin bone and excessively drawing, tension force occurs It is hyperfunction, there is front foot supination abduction and the rear strephexopodia.Supporting role of the plantar aponeurosis to longitudinal arch of foot in sagittal plane accounts for whole foots The 1/3 of bottom ligament, and the abduction of limitation foot bones and outward turning in other two planes.So when plantar aponeurosis relaxation loses admittedly During some restraints, abduction, outward turning and the rear strephexopodia of front foot have been aggravated.The average weight distribution in vola is about normally metapedes 60%th, mesopodium 8%, front foot 28%, toe 4%, wherein fifth metatarsal bone load-bearing reach the 11% of gross weight, and the 1st astragalus load-bearing is up to always The 12% of weight.Research shows that because the rear strephexopodia causes fifth metatarsal bone load-bearing to be reduced to 1%, the 1st metatarsal load-bearing increases sarapus 22% is added to, power revolved after plantar arch collapse to caused by first metatarsal bone, big toe in addition before, easily causes Hallux valgus.Flat foot Disease patient substantially changes to tibial astragaloid joint forced belt because of flatfoot deformity, makes the total contact zone of articular surface of ankle outside, be moved back, connect Contacting surface product reduces 35%, and average pressure increases by 14%, is moved outside pressure peak distributed area, adds the lesion risk of ankle-joint, more Because of the change of the lower limb line of force, cause knee, hip joint occurs the line of force and changes and cause arthritis, the later stage because of faulty posture and The lopsided line of force can also result in back pain.Flatfoot patient causes ankle and foot because of the internal laxity of ligament of foot, sufficient bone arrangement change The functional disturbances such as pain, posterior tibial muscle tendon cause ankle muscular strength to decline, and then locomitivity reduces, it is impossible to pleasure trip on foot walking.Ligament and The further damage of muscle deforms the further dislocation for causing each bone of foot and joint.A large amount of scholars are it is experimentally confirmed that foot is rectified Shape shoe-pad should be used as the intervention means of the first step, by the arch of foot collapsed on the inside of being supported on shoe-pad, padded inner side heel correction Valgus calcaneus, can reduction of patient pain, rebuild the shape of inside of the foot, improve the quality of living.
Orthopedic insoles are divided into Prefabricated orthopedic insoles and customization orthopedic insoles.
Prefabricated shoe-pad is according to foot fixed size, such as 39,40 yards, using mould batch making, orthopedic mode Arch of foot is raised for level altitude, and fixed position is pressurizeed to articulatio talonavicularis, and fixed angle correction turns up calcaneum;Due to this skill Art is not high for shoe-pad producer knowledge technology, working environment and equipment requirement, in Asia and Some European area using more Extensively.The method is produced using mould, it is impossible to and made according to patients feet's concrete shape and problem and targetedly handled, but with It is partially general complete.It is flooded with substantial amounts of product of orthopedic shoes pad currently on the market, is that uniform data increases medial arch and heel portion, Declare rectifiable various lower limb malformations.It can not 1, consider each patients feet's degree of deformity, for example be soft type or stiff Type flat foot, therefore can not be by the different material of categorizing selection.And lot of documents proves, soft type flat foot applies harder material Arch support, and stiff type flat foot improves symptom using more soft relatively comfortable material.2nd, individual can not be considered The arrangement of sufficient bone, for example whether there is articulatio talonavicularis dislocation and dislocation degree, whether there is valgus calcaneus deformity and degree of turning up, therefore can not be right Maleformation makes accurately correction design.This be all non-medical staff designer to the splayfooted pathologic, physiologic acquisition of knowledge not Enough cause.And it is simple raise arch of foot, after patient's use of different pathogeny, often can not only solve foot problems, it is right on the contrary The state of an illness has deterioration effect, the lower limb line of force or foot deformity is further made a variation.
Customized insole often podiatrist instruct under complete, compared to the former, more targetedly.First, conventional cast Type shoe-pad preparation method is common method, need to take female, gypsum sun shape repairing type and using modeling with plaster bandage to patients feet Flitch material carries out high-temperature molding or metal material beats the shoe-pad of personalization is made by hand.The characteristics of this manufacturing technology is footwear Pad makes long processing time, general a pair of shoe-pad makes the two day time of palpus, while requires special to making teacher's technology and clinical experience Not high, need to pass through the study of long-time professional knowledge and clinical speciality practical training could be competent at.In the U.S., due to by traditional-handwork Shoe-pad pattern, foot straightening technique educational mode, national economy more affluence and people are made to the foot disease degree of awareness Higher influence, the method that gypsum takes type to make also are used extensively.Problems be present in it:1, moulding basis is patient's foot Contouring, rather than the Imageology of patients feet's bone structure.The measurement of deformity and the design of shoe-pad osteotomy site can not reach Unified precision.2, insole design is completed by the technician of brace company, and non-physician, i.e. diagnosis and shoe-pad are made by different portions Door completion, generates disconnection, lacks the technician of theory of medicine knowledge and orthopedic insoles can not be designed perfection with reference to clinical.3, take Mould and production are completed for multistep, it is difficult to ensure the accuracy of product.4, orthopedic patient is a long process, it may be necessary to Different height and the orthopedic insoles of position are how long changed, the modulus of corresponding number is needed with original method for customizing, to manpower, material resources It is significant wastage.2nd, the mode of sole pressure test instrument carries out computer for analysis and dynamic chek finds lacking present in foot Fall into, the information of obtained extraction is passed through the special design software of shoe-pad, progress shoe-pad specific design by computer system.Finally by Number processing lathe produces personalized shoe-pad.Problems be present in it:1st, sole pressure test, which is only capable of analyzing arch of foot, collapses Sunken position and degree, computer can not judge the specific change of sufficient bone arrangement, for example whether there is articulatio talonavicularis dislocation, valgus calcaneus journey Degree, is soft type or stiff type flat foot etc..Because each case is required for targetedly orthopedic, this is sole pressure test Instrument is unanalyzable, and it is only capable of the shoe-pad for making correction medial arch height.2nd, the making of shoe-pad is that computer software coordinates footwear The participation of designer is padded, without detailed understanding and guidance of the doctor to conditions of patients, therefore can not possibly be reached with a definite target in view.3rd, numerical control Lathe is time-consuming big to the complex surface machining of shoe-pad, and cost is high, and the requirement to machine operation person is also very high.Other Digit Control Machine Tool Flexible material can not almost be processed, just limited to very much, it is necessary to the processing of later stage complexity in the selection of material.Process is numerous Trivial, cost is higher.4th, CAD/CAM shoe-pads, which make, needs plantar pressure analyzer, external Special shoe pad Software for producing, and lathe etc. is set Standby, investment is huge, and fundamentally not from the bone sex deviation analysis design shoe-pad of patient.
The content of the invention
, can the invention provides a kind of preparation method of 3D orthopedic insoles in order to solve the problems, such as that prior art is present Personalized customization shoe-pad is realized, targetedly orthopedic insoles are made according to the change of patients feet.
The technical solution adopted in the present invention is:
A kind of preparation method of 3D orthopedic insoles, including:
(1) imageological examination is carried out to the ankle of Weight carrying position, or image is carried out to the non-weight bearing position of the ankle after correction Learn and check;
(2) to the image of scanning is imported into three-dimensional modeling software, the threedimensional model of sufficient bone and foot is generated;
(3) manual analysis foot bone type, and confirm that sufficient bone type is pure plantar arch collapse, plantar arch collapse is with valgus calcaneus With plantar arch collapse with one kind in valgus calcaneus and middle abduction of foot, articulatio talonavicularis dislocation;
(4) the shoe-pad curved surface for fitting vola is derived according to the threedimensional model of foot;
(5) according to the particular type of the threedimensional model of sufficient bone and sufficient bone to shoe-pad curved surface carry out it is orthopedic, obtain it is orthopedic after Shoe-pad curved surface;
(6) by 3D printer print with it is orthopedic after shoe-pad curved surface corresponding to shoe-pad.
In step 1, the imageological examination includes being checked using X-ray machine, CT machines or magnetic resonance examination machine.
In step 2, the three-dimensional modeling software is MIMICS.
Preferably, in steps of 5, specific straightening method is:
(5.1) by obtaining three-dimensional model arch of foot length and the nut bone height of sufficient bone, and nut bone index is calculated, according to The nut bone index of normal person, reckoning, which obtains nut bone, should go up the height of lift, and the height of lift should be gone up by further obtaining arch of foot, so as to calculate Obtain degree of raising on the corresponding curved surface of shoe-pad.
Further, the nut bone should go up the height of lift and arch of foot should go up the height and the corresponding curved surface of the shoe-pad of lift The height of upper lift is equal.
Preferably, for judging that sufficient bone type for plantar arch collapse companion's valgus calcaneus, also has in steps of 5 in step 3,
(5.2) 15-20mm back walls are set in the corresponding heel portion of shoe-pad curved surface.
For judging that sufficient bone type is that plantar arch collapse is dislocated with valgus calcaneus and middle abduction of foot, articulatio talonavicularis in step 3 , also have in steps of 5,
(5.3) inboard wing is extended upward by heel back wall in the inner side of shoe-pad curved surface, the height of the inboard wing reaches Lower 1/3 in astragalus;Raised laterally, inboard wing extends forward and gradually decreased down in the middle part of first metatarsal bone;
(5.4) ala lateralis extending upward by heel back wall in the outside of shoe-pad curved surface, edge is located at tuberosity of cuboid bone thereon, The ala lateralis is summit to inner bulge closely with epiphysis using cuboid, and the ala lateralis extends forward and gradually decreases down the 5th plantar In the middle part of bone.
The 3D printer is used in nylon, EVA plastic materials, polyurethane foam, thermoplastic elastomer (TPE) and ABS plastic Any one is as raw material.
Beneficial effects of the present invention:
1st, completed with reference to clinical medicine and digitizing technique, medical diagnosis on disease and insole design by the doctor in charge of patient, The imaging data of patient and the design data of shoe-pad are stored in database, are adapted to long term follow-up, according to disease Feelings improve, and detect conditions of patients variation tendency and are proposed that and further suggest.Patient needs to change footwear because of damage or disease progression During pad, without modulus again, produced after directly being adjusted again according to the initial data in database.
2nd, personalized customization is really realized, imageological examination and 3D modelings can more accurately reflect patient's leg bone and soft group The exception knitted, can be abnormal come analyzing anatomical by accurate DATA REASONING, and accurate customization can be given on insole design. Arch of foot peak, and nut bone near-end lower edge, arch of foot is accurately raised from there, recover arch of foot to anatomical position.It is abnormal in preceding abduction of foot During shape, it may customize and accurately pressurize from head of talus position and pressurizeed at cuboid.Sufficient inward turning, can be in heel when valgus calcaneus is serious Cup ground design inclined-plane, further corrects valgus calcaneus.These are all that conventional art can not accurately be accomplished!Because flat foot is divided into Variety classes, such as simple plantar arch collapse, merge valgus calcaneus, merge articulatio talonavicularis dislocation etc..Can be according to patients feet's Change and make targetedly orthopedic insoles.
3rd, orthopedic insoles are designed into production, completed by digitizing technique, greatly reduced in links from modulus Error.3D printing also can preferably improve accuracy and the compactness of shoe-pad by control errors in nanometer range.
Brief description of the drawings
The structural representation of Fig. 1 orthopedic insoles;
Fig. 2 is foot bones structural representation;
Fig. 3 is the schematic diagram after foot coordinates with orthopedic insoles;
Fig. 4 is Fig. 3 perspective view.
Wherein:1st, inboard wing;2nd, heel back wall;3rd, ala lateralis;4th, cuboid.
Embodiment
Referring to Fig. 1-Fig. 4,
Embodiment 1:
The invention provides a kind of preparation method of 3D orthopedic insoles, comprise the following steps:
(1) imageological examination is carried out to the ankle of Weight carrying position, or image is carried out to the non-weight bearing position of the ankle after correction Learn and check;
(2) to the image of scanning is imported into three-dimensional modeling software, the threedimensional model of sufficient bone and foot is generated;
(3) the shoe-pad curved surface for fitting vola is derived according to the threedimensional model of foot;
(4) according to the particular type of the threedimensional model of sufficient bone and sufficient bone to shoe-pad curved surface carry out it is orthopedic, obtain it is orthopedic after Shoe-pad curved surface;
(5) by 3D printer print with it is orthopedic after shoe-pad curved surface corresponding to shoe-pad.
Exactly by scanning the threedimensional model of user's foot, then the shoe-pad curved surface in fitting vola is derived, then pass through 3D Printer prints shoe-pad so that when in use, shoe-pad is bonded completely with the vola of user completely, is used so as to strengthen The level of comfort of person.
Full fitting foot pad can be avoided vola local accumulation strain, protected plantar manadesma, prevented with mean allocation plantar pressure It is pulled repeatedly causes plantar fascitis and calcaneal spur etc. to occur.Full fitting shoe-pad can also reduce the probability of Falls in Old People.
Certain above procedure can omit step 4.
The nut bone index (belonging to prior art) of normal person is between 5.4-6.5 (a/b in Fig. 2), and the nut bone of some people Index is greater than 6.5, and normal life is affected.
By the threedimensional model of the sufficient bone obtained in step 2, the nut bone index of user is calculated, such as nut bone index More than 6.5, then explanation is needed to shoe-pad just orthopedic (step 4).
Specifically straightening method is:
By obtaining three-dimensional model arch of foot length and the nut bone height of sufficient bone, and nut bone index is calculated, according to normal The nut bone index of people, reckoning, which obtains nut bone, should go up the height of lift, and the height of lift should be gone up by further obtaining arch of foot, so as to calculate to obtain Degree of raising on the corresponding curved surface of shoe-pad.
User using the shoe-pad when, the curved surface of arch of foot corresponding to shoe-pad due to upwards on lifted certain height, from And make it that the arch of foot of user is also lifted upwards, the further nut bone for causing user moves up, so as to reduce user Nut bone index, be at as defined within the scope of.
It is explanation to need, the nut bone should go up the height of lift and arch of foot should go up lift height and the shoe-pad it is corresponding Curved surface on the height lifted it is equal.
That is, the distance of shoe-pad correction is equal using the height lifted on nut bone during the shoe-pad with user.
Pass through such setting so that the orthopedic insoles obtained by this method possess certain health-care effect.
The orthopedic insoles that above method obtains may also be used for carrying out foot's shaping to the patient of flatfoot.
In step 1, the imageological examination includes being checked using X-ray machine, CT machines or magnetic resonance examination machine.
In step 2, the three-dimensional modeling software is MIMICS.
Foregoing MIMICS softwares are existing software, and its purposes and function just repeat no more herein.
The 3D printer is used in nylon, EVA plastic materials, polyurethane foam, thermoplastic elastomer (TPE) and ABS plastic Any one is as raw material.
Embodiment 2:
A kind of preparation method of 3D orthopedic insoles, including:
(1) imageological examination is carried out to the ankle of Weight carrying position, or image is carried out to the non-weight bearing position of the ankle after correction Learn and check;
(2) to the image of scanning is imported into three-dimensional modeling software, the threedimensional model of sufficient bone and foot is generated;
(3) manual analysis foot bone type, and confirm that sufficient bone type is pure plantar arch collapse, plantar arch collapse is with valgus calcaneus With plantar arch collapse with one kind in valgus calcaneus and middle abduction of foot, articulatio talonavicularis dislocation;
(4) the shoe-pad curved surface for fitting vola is derived according to the threedimensional model of foot;
(5) according to the particular type of the threedimensional model of sufficient bone and sufficient bone to shoe-pad curved surface carry out it is orthopedic, obtain it is orthopedic after Shoe-pad curved surface;In arch of foot peak, and nut bone near-end lower edge, arch of foot is accurately raised from there, recovers arch of foot to anatomical position.
(5.1) by obtaining three-dimensional model arch of foot length and the nut bone height of sufficient bone, and nut bone index is calculated, according to The nut bone index of normal person, reckoning, which obtains nut bone, should go up the height of lift, and the height of lift should be gone up by further obtaining arch of foot, so as to calculate Obtain degree of raising on the corresponding curved surface of shoe-pad;
(5.2) 15-20mm heels back wall 2 is set in the corresponding heel portion of shoe-pad curved surface;
Heel portion insole design is level,, can be in heel cups bottom water plane when valgus calcaneus is serious for foot inward turning Upper design inclined-plane, strengthens the orthopedic of valgus calcaneus.
(5.3) inboard wing 1 is extended upward by heel back wall in the inner side of shoe-pad curved surface, the height of the inboard wing reaches Lower 1/3 in astragalus;Raised laterally, inboard wing extends forward and gradually decreased down in the middle part of first metatarsal bone;
(5.4) ala lateralis 3 is extended upward by heel back wall in the outside of shoe-pad curved surface, edge is located at the tuberosity of cuboid 4 thereon Place, the ala lateralis are summit to inner bulge closely with epiphysis using cuboid, and the ala lateralis extends forward and gradually decreases down the In the middle part of five metatarsals;
(6) by 3D printer print with it is orthopedic after shoe-pad curved surface corresponding to shoe-pad.
It should be noted that being pure plantar arch collapse for sufficient bone type, step only need to be proceeded in its step 5 5.1.
It is plantar arch collapse companion's valgus calcaneus for sufficient bone type, its step 5 need to proceed to step 5.2, that is to say, that Step 5 Chinese medicine carries out step 5.1 and step 5.2 (plantar arch collapse is inevitable with pure plantar arch collapse with valgus calcaneus).
Heel portion designs back wall, and reinforcement prevents valgus calcaneus during walking and gives calcaneum to the pressure in front of Inner.Away from boat During abarticulation, inboard wing is designed, the height of the wing is defined in the middle part of astragalus, raised laterally, and it is outside upwards to give head of talus Thrust, correct articulatio talonavicularis dislocation.
The thickness of back wall is arranged on 15-20mm, is mainly typically not more than 20mm in view of the thickness of spring heel, because And need to be by the thickness control of back wall within 20mm.
And the specific selection of thickness, then need to be determined according to the actual conditions of user.
For plantar arch collapse with valgus calcaneus and middle abduction of foot, articulatio talonavicularis dislocation, need to proceed to step in steps of 5 5.4。
When articulatio talonavicularis is dislocated, inboard wing is designed, the height of the wing is defined in the middle part of astragalus, raised laterally, gives astragalus The upward outside thrust of head, corrects articulatio talonavicularis dislocation.
Orthopedic insoles can be fabricated to hard orthopedic insoles, semihard orthopedic insoles or soft orthopedic insoles as needed.
Hard orthopedic insoles:Directly with hard material, such as PP, nylon adds glass etc. to print 3/4 shoe-pad, without being answered on surface Close flexible material.
Semihard orthopedic insoles:The distal end of shoe-pad (bottom shoe-pad) is printed in articulationes metatarsophalangeae near-end about 2cm positions, as 3/4 Shoe-pad, printed with relatively hard materials, such as PP, nylon adds glass, hard EVA etc..Thick in the compound one layer of about 2mm of bottom shoe insole surface The pressure that flexible material, such as EVA, RUBBER, silica gel, ox-hide, buffering and absorption foot are subject to.
Soft orthopedic insoles:Directly printed with soft nylon, rubber etc., print full length insole, it is not necessary to which surface is multiple Compound matter.

Claims (4)

  1. A kind of 1. preparation method of 3D orthopedic insoles, it is characterised in that including:
    (1) imageological examination is carried out to the ankle of Weight carrying position, or iconography inspection is carried out to the non-weight bearing position of the ankle after correction Look into;
    (2) image of scanning is imported into three-dimensional modeling software, generates the threedimensional model of sufficient bone and foot;
    (3) the shoe-pad curved surface in fitting vola is derived according to the threedimensional model of foot;
    (4) according to the particular type of the threedimensional model of sufficient bone and sufficient bone to shoe-pad curved surface carry out it is orthopedic, obtain it is orthopedic after shoe-pad Curved surface;Specifically straightening method is:
    By obtaining three-dimensional model arch of foot length and the nut bone height of sufficient bone, and nut bone index is calculated, according to normal person's Nut bone index, reckoning, which obtains nut bone, should go up the height of lift, and the height of lift should be gone up by further obtaining arch of foot, so as to calculate to obtain shoe-pad Degree of raising on corresponding curved surface;
    The nut bone should go up the height of lift and arch of foot should go up the height phase lifted in the height and the corresponding curved surface of the shoe-pad of lift Deng;
    For judging that sufficient bone type is plantar arch collapse companion's valgus calcaneus in step (3), in the corresponding heel of shoe-pad curved surface Portion sets 15-20mm back walls;
    For judging that sufficient bone type is dislocated for plantar arch collapse with valgus calcaneus and middle abduction of foot, articulatio talonavicularis in step (3), Inboard wing is extended upward by heel back wall in the inner side of shoe-pad curved surface, the height of the inboard wing reaches lower 1/3 in astragalus Portion;Raised laterally, inboard wing extends forward and gradually decreased down in the middle part of first metatarsal bone;After the outside of shoe-pad curved surface is by heel Enclose and extend upward ala lateralis, thereon along at the tuberosity of cuboid bone, the ala lateralis is summit to inner side closely with epiphysis using cuboid Projection, the ala lateralis extend forward and gradually decreased down in the middle part of fifth metatarsal bone;
    (5) by 3D printer print with it is orthopedic after shoe-pad curved surface corresponding to shoe-pad.
  2. 2. the preparation method of 3D orthopedic insoles according to claim 1, it is characterised in that:In step (1), the iconography Checking includes being checked using X-ray machine, CT machines or magnetic resonance examination machine.
  3. 3. the preparation method of 3D orthopedic insoles according to claim 1, it is characterised in that:In step (2), the three-dimensional is made Mould software is MIMICS.
  4. 4. the preparation method of 3D orthopedic insoles according to claim 1, it is characterised in that:The 3D printer uses Buddhist nun Any one in dragon, EVA plastic materials, polyurethane foam, thermoplastic elastomer (TPE) and ABS plastic is as raw material.
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