Updated: Apr 11
When you’re working on your own, trying to take a scan you’ll find that a sulcus stick will really help to control the forefoot and get the patient involved in helping you to achieve a great result.
It’s a really simple piece of equipment and easy to make if you’ve got the passion for it.
You need a piece of tube 6mm to 10mm outside diameter, or a piece of 10mm diameter acrylic rod, about 1M length, with a right angle bend at 150mm to 200mm from one end. (the top of a drip stand or something similar will be a great start if you can get one).
To use the sulcus stick the patient needs to help you. This length is great if your patient is sitting on an exam couch but you might find it a little long if your patient is kneeling on a chair.
Place the sulcus stick under the patient’s toes, distal to the met heads and ask your patient to hold the long arm of the stick. Position the foot where you want it to be, neutral calcaneus with some tension on the plantar fascia and the forefoot in as neutral a position as you can maintain. Depending on the foot architecture, you’ll probably see forefoot pronation or supination. This is OK as long as the mid foot is locked. The algorithm will create a shell with an intrinsic post to accommodate the forefoot positioning.
Take your scan and you’ll see that the software will clean up the imaging from the stick.
You’ll find that a stick really helps if you’ve got a patient who can’t maintain positioning or the TA is tight and causes internal forefoot rotation.