Over the last few decades, clinicians have debated the merits of traditional plaster casting versus modern 3D scanning in orthotic capture. Amid continuing discourse, 1 principle holds: the clinician’s grasp of anatomical data and its impact on device design is critical to success. Equally as vital is the orthotic lab’s role in translating clinical intent into design. As modern techniques introduce greater variability, the shared responsibility between clinician and lab becomes paramount to achieving successful clinical outcomes.
Today’s capture methods span plaster casting, foam boxes, flatbed laser scanning, and increasingly, mobile devices like iPads and iPhones using TrueDepth infrared arrays, structured light, and photogrammetry. Each scanning modality offers unique biomechanical implications. Some clinicians use fully corrected scans via glass/acrylic frames or weight-bearing flatbed techniques to balance forefoot-rearfoot alignment. These approaches often differ from traditional neutral position casting, reflecting a broader shift in clinical philosophy. We’re seeing a deliberate evolution in technique–clinicians now over- or under-correct based on individual patient needs, rather than defaulting to neutral.
As with any transformative technology, the adoption of 3D scanning in clinical practice brings both opportunity and complexity. At the forefront is the imperative for clinicians to not only understand the mechanics of scanning but to master their techniques ensuring precision, consistency, and excellent patient outcomes.
This theme will be explored in the remaining two articles of this series, which will delve into the current hardware landscape, present findings from a recent comparative study on scan accuracy and offer practical strategies for refining scanning protocols in clinical settings.
By Dr. Dean Hartley (Podiatrist & Adjunct Engineering Fellow–University of Queensland)
