Custom Products
Custom Functional Orthoses
Custom functional orthoses are designed to the unique specifications of the patient’s foot and are built with specific functional objectives to address biomechanical issues within the foot. Ordering Functional Orthoses can be confusing, so Dr. Comfort® has created standard designs within four product collections to simplify the many options available when ordering functional foot orthoses. Building your own design from scratch is an option, however our standard designs are available as a quick and simple solution.
The Comfort Scan Mobile™ App makes ordering easy by taking a 3D scan of the foot, selecting options and submitting the order via the App. Traditional casting methods such as plaster casts or foam impression boxes are still available to submit with paper order forms that can be obtained through Customer Service.
The following four product collections encompass our standard designs prior to any alterations.
Standard Functional Orthoses
Casual
Polypropylene shell with/or without heel post
Topped with 1/8” medium density EVA top. +/- heel post
Consider for:
Casual Shoes, Walkers
Material:
- Top cover – medium density EVA – full length
- Shell – Polypro – ball length
- Bottom – Pseudo suede
Standard Modifications/ Accommodations Available:
Met pads, 1st ray cut out, heel skives and forefoot post
Sport
Polypropylene shell with/or without heel post
Topped with 1/8” antimicrobial neoprene fabric top. +/- heel post
Consider for:
Better shock absorption, Athletic Shoes, Runners and Walkers, Weekend Warriors
Material:
- Top cover – antimicrobial neoprene fabric top – full length
- Shell – Polypro – ball length
- Bottom – Pseudo suede
Standard Modifications/ Accommodations Available:
Met pads, 1st ray cut out, heel skives and forefoot post
Dress
Polypropylene shell without heel post.
Topped with leather to the sulcus and 1/16” soft midlayer. +/- heel post
Consider for:
Dress Shoes, Support with Thinner Profile
Material:
- Top cover – Leather top with soft 1/16” midlayer – sulcus length
- Shell – Polypro – ball length
- Bottom – Pseudo suede
Standard Modifications/ Accommodations Available:
Met pads, 1st ray cut out, heel skives and forefoot post
Comfort
EVA shell topped with 1/16” soft midlayer and pseudo suede top
Consider for:
Casual Shoes or Depth Shoes, Walkers, Less Control
Material:
- Top cover – 1/16” Soft midlayer / pseudo suede
- Shell – EVA – full length
- Bottom – Pseudo suede
Standard Modifications/ Accommodations Available:
Met pads, 1st ray cut out, heel skives
EXOS® Functional Orthoses
All styles in the Standard Functional Orthoses Collection are also available with the reformable EXOS® nano-tube shell which allows for easier reformability than the traditional Polypro shell. This gives you the same support platform with the adjustability of more flexible materials.
Dr. Comfort® EXOS functional inserts technology with the use of an exothermix heat patch:
Specialty Functional Orthoses
Marathoner
Semi flexible Polypropylene shell, soft arch fill, dual density heel post, and antimicrobial neoprene top
Consider for:
Heel toe runners, Long distance runners, Greater dynamic response than standard functional orthotic
Material:
- Top cover – 1/8” antimicrobial neoprene Fabric
- Arch fill – Soft EVA
- Posting – Dual Density EVA
- Shell – Polypro 2mm – ball length
- Bottom – Sole Cap + Pseudo suede
Field Sport
Rigid Polypropylene shell with plantar-flexed 1st ray and morton’s extension, firm heel post, and antimicrobial neoprene top with soft forefoot extension
Consider for:
Soccer and football, Sport specific pathologies
Material:
- Top cover – 1/8” antimicrobial neoprene Fabric
- Forefoot extension – Soft EVA
- Posting – Firm Density EVA
- Shell – Rigid EXOS – ball length
- Bottom – Sole Cap + Pseudo suede
Trilam Embedded Shell
55 durometer EVA shell + plus Polypropylene shell for added stiffness, bilam top and pseudo suede bottom cover
Consider for:
Comfort and control combination, Larger patients with sensitive feet, Higher durability than traditional accommodative style
Material:
- Top cover – Soft Bilam
- Shell – Polypro 2mm – ball length
- Base – 55 durometer EVA
- Bottom – Pseudo suede
Cobra
Polypropylene shell with narrow width, minimal heel cup and traditional Cobra trim lines. Cover with 1/16” soft midlayer and leather top to sulcus
Consider for:
Dress shoes and slip-ons, Dance shoes, Thinnest profile
Material:
- Top cover – Leather to sulcus
- Midlayer – Soft EVA
- Shell – Polypro – ball length
- Bottom – Pseudo suede
Total Contact Orthoses
If you are looking for less rigidity, then a Total Contact design might better fit your patient’s needs. The Dr. Comfort® TCO line of Functional Orthoses allow for greater flexibility in comparison to a traditional functional orthoses while using more semi-rigid types of materials. Molded Total Contact orthoses are also available when a very high heel cup or added reinforcements are needed. These styles of Custom Functional Orthoses are designed with a fuller, more intimate fit which may result in the need for a depth-style shoe to accommodate the finished product. The TCO line is customizable to specific biomechanical and or accommodative needs. See the Special Accommodations and Modifications for Inserts/Orthoses chart for further detail.
Standard Total Contact Orthoses
Consider for:
Casual shoes or some athletic shoes, Walkers and runners, General comfort or foot fatigue
Top Cover Materials
Choose from a variety of EVAs to fit specific needs. Dr. Comfort® utilizes different durometers of EVAs in this style of orthosis
- 1/8” Soft EVA
- 1/8” Sport EVA (medium density)
- Soft Bilam – Soft EVA with a soft midlayer
Base Materials
Choose from a semi-rigid EVA or a more dense cork material
- White 55 durometer EVA full length
- 70 durometer Cork full length
Molded Total Contact Orthoses
Consider for:
Depth shoes, Added medial and lateral control
Top Cover Materials
Choose from a variety of EVAs to fit specific needs. Dr. Comfort® utilizes different durometers of EVAs in this style of orthosis
- 3/16” EVA
- Sport Trilam
- Soft Trilam
Reinforcement Materials can be added to strengthen the device
Base Materials
Choose from a semi rigid EVA or a more dense cork material
- 55 durometer EVA
- 70 durometer Cork
Custom Orthoses
Custom inserts are a sure way to guarantee total contact — particularly for patients with needs more complex than can be addressed with our heat-moldable or Gel Plus inserts.
Our lab can make custom inserts with off-loading areas, metatarsal pads, and more.
Custom Toe Fillers – L5000
Toe fillers provide proper biomechanical balance, support and protection for patients who have had partial foot amputations.4,5 Each toe filler device is designed specifically for the patient and to fit into your patient’s footwear in an aesthetically pleasing manner. Toe fillers provide medial and lateral stability with distal stump protection and biomechanical balance to help provide the most natural ambulation. They are constructed of durable materials and have a semi-rigid prosthetic filler that maintains a soft accommodative surface for the foot.
Coding for Toe Fillers
Two separate benefit categories exist for shoe inserts used to accommodate missing digits (toes) for beneficiaries with and without diabetes. The codes L5000 and A5513 of the Healthcare Common Procedure Coding System (HCPCS) are used for these categories.
Please refer to: https://med.noridianmedicare.com/web/jadme/article-detail/-/view/2230703/toe-fillers-and-diabetic-shoe-inserts-coding-clarification for full clarification of this coding.
L5000 for Hallux Amputation
Provides medial and lateral stability with an EVA* fill in the hallux position to provide natural spring and biomechanical support. Designed to fit virtually any style of your patient’s footwear.
L5000 for Trans Metatarsal Amputation
Provides medial and lateral stability with distal stump protection and biomechanical support and natural toe spring with an EVA* fill in forefoot. Designed to fit virtually any style of your patient’s footwear.
Consider for:
Partial foot amputations such as toe and ray amputations and transmetatarsal amputations.4
Materials Used:
- Soft trilament top cover with PU midlayer
- Cork post for hindfoot and midfoot stability
- Semi rigid EVA for toe filler portion
Custom Diabetic Inserts
As one of the world’s leading pedorthic laboratories, the Dr. Comfort® Custom Lab specializes in making high quality diabetic inserts. These types of inserts are often recommended to offer additional protection and accommodation of the diabetic foot from pressure, friction and skin trauma. Dr. Comfort inserts provide good arch fit and foot accommodation with a standard 15mm heel cup, minimum base thickness of 3/16” and a minimum of 35 durometer base with soft top covers. Special accommodations can be added per our accommodations and modifications chart.
Coding for Diabetic Inserts
Two separate codes exist for custom made diabetic inserts. The coding is now determined by the fabrication method of the inserts. Dr. Comfort Diabetic Inserts are primarily direct milled or carved, but we also reserve a molded technique for feet with severe deformities such as charcot joint.
Please refer to https://www.cgsmedicare.com/jc/pubs/news/2018/0218/cope6148.html for clarification of this coding.
PDAC Approved
The Pricing, Data Analysis and Coding (PDAC) contractor maintains the Durable Medical Equipment Coding System (DMECS). For more information on coding for Custom Diabetic Inserts, visit www.dmepdac.com
Custom Diabetic Inserts - Standard
Total contact accommodative insert with good arch control and a standard 15mm deep heel cup* for medial and lateral support.
Consider for:
Diabetes with callus formation, history of ulcerations, peripheral neuropathy and foot deformity
Material:
- Top cover: Blue Soft top (standard), Pink/Blue bilam top
- Base: Yellow 40 durometer , White 55 durometer (recommended for patient’s over 200lbs)
Custom Diabetic Inserts - With Special Accommodations
An intrinsic metatarsal pad and/or metatarsal offloading helps to reduce pressure on plantar abnormalities. The met pad helps by raising the area just proximal to the metatarsal heads to transfer the load and offloading helps by creating a depression in the insert for additional offloading.
Consider for:
Diabetes with callus formation, history of ulcerations, peripheral neuropathy and foot deformity
Material:
- Top cover: Blue Soft top (standard), Pink/Blue bilam top
- Base: Yellow 40 durometer , White 55 durometer (recommended for patient’s over 200lbs)
Shoe Modifications
The Dr. Comfort Laboratory can modify most models of our shoes to accommodate a patient's gait or other unique need, as determined by the prescribing medical professional or another qualified expert. We can also modify shoes from other brands, including children’s shoes.
Shoes that have been modified cannot be returned to Dr. Comfort for a refund, so please confirm style and size before submitting your order.
Heel & Sole Lift
Heel-and-sole lift modifications are recommended for patients with a leg length discrepancy.
The Dr. Comfort Laboratory can accommodate any height. Heights greater than 3/4 of an inch will have an automatic heel and sole rocker for heel shock absorbency and toe-off.
Shoes that have been modified cannot be returned to Dr. Comfort for a refund, so please confirm style and size before submitting your order.
Medial Arch Fill
Medial arch fill modifications provide medial stability and can be used for severe pes planus, tibial tendon deficiency and other diagnoses that may require additional medial stability.
Shoes that have been modified cannot be returned to Dr. Comfort for a refund, so please confirm style and size before submitting your order.
Rocker Soles
Rocker soles are an addition to the sole of the shoe that creates a stiff forward rocking motion.
Significant research has been done that supports the need and use of rocker soles.
To create the rocker sole, the appropriate amount of material will be chosen based on the size of the shoe and type of rocker sole. A specific amount of material can be requested. Because this modification will add height to the shoes, it is strongly advised that rocker soles are ordered on both shoes to prevent an uneven stance.
Lateral Flare
Lateral flare (or lateral heel wedge) modifications are commonly used for lateral ankle instability, severe calcaneal varus and other diagnoses that require additional lateral stability.
Shoes that have been modified cannot be returned to Dr. Comfort for a refund, so please confirm style and size before submitting your order.
Strap Extension/Reduction
Closure strap length modifications can help patients obtain a better fit. Strap length can be changed on any style with a Velcro closure, as recommended by a physician or practitioner.
Extensions are often beneficial for patients with severe edema.
Shoes that have been modified cannot be returned to Dr. Comfort for a refund, so please confirm style and size before submitting your order.
Heel Lift
Heel lift modifications accommodate leg length discrepancies and ankle equinus deformities.
Shoes that have been modified cannot be returned to Dr. Comfort for a refund, so please confirm style and size before submitting your order.
Toe Skater
Toe skater modifications allow the patient’s toe to slide over various surface conditions, preventing tripping and toe catching on uneven surfaces. Recommended for patients with drop foot, shoes with toe skater modifications should be worn with or without an A.F.O.
Shoes that have been modified cannot be returned to Dr. Comfort for a refund, so please confirm style and size before submitting your order.
Leg Brace Prep
Dr. Comfort’s leg brace prep modification includes the addition of a full-length or a 3/4-length spring steel shank and a 1/8-inch mid-sole.
Orthotic, prosthetic and pedorthic labs can request shoe prepping for stirrup attachment.
Shoes that have been modified cannot be returned to Dr. Comfort for a refund, so please confirm style and size before submitting your order.
