Saying ‘PTTD’ is misleading: It’s time for a new lexicon to distinguish pathologies

Kathy Fisher In the News

Lower Extremity Review (LER) Magazine Excerpt.
By Ian Engelman, MS, CPO.

Ian Engelman, MS, CPO, developer of the patented Blaze MI AFO for medial column breakdown, is owner and President of Insightful Products, LLC.  He also developed the Step-Smart Brace for drop foot and the Funnel shoe horn.

Have you read Outliers: The Story of Success by Malcolm Gladwell? In the book, he observes that expertise is developed through tenacity and repeated observation and presents examples of what he calls the “10,000-hour rule” for mastering a craft or field of inquiry.

I mention this because, over the past 15 years, I have designed more than 15,000 ankle–foot orthoses by working with 3-dimensional plaster models. Each model takes, on average, 1 hour to make—causing some practitioners to burn out. I have remained in the plaster room, however, and, although I don’t pretend to compare myself to the leaders described in Outliers, I have put in my time and therefore have insights to share.

In this article, I present a perspective on, and a theory of, medial column breakdown (ie, ligamentous failure), based on observation and experience, in the hope that data and statistical analysis will follow. Using CubeVue software to process imaging acquired by the pedCAT ultra-low dose computed tomography system (both products of Curvebeam, Warrington, Penn.), I believe that scientific analysis of these injuries is possible through repeatable quantification—perhaps for the first time.

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Want to learn more about the Blaze MI AFO for medial column breakdown?

Visit the Blaze MI for Medial Instability information page for Clinicians or  or give us a call at (207) 885-0414