“Mobilization is the key aim”

Bauerfeind life introduced the MalleoLoc L and MalleoLoc L3 to Dr. med. Jörn Kühle at the Metropol Medical Center in the German city of Nuremberg. After some brief instructions, the orthopedic specialist intuitively positioned the shell in front of his lateral malleolus and fastened it in place with the straps. He then immediately slipped his foot into his shoe and he was off…

Bauerfeind life: What is your first impression of the MalleoLoc L?
Dr. Kühle: I got my foot into my shoe without needing to use a shoehorn and without the orthosis being pushed up by the edge of the shoe. I can hardly feel the shell when I’m walking.

And how about the sense of stability?
Dr. Kühle: I feel supported – it’s a good feeling. I can’t really say any more than that after just five steps. There are orthoses which provide a greater degree of stabilization after an acute injury. But as I see it , the main function of the MalleoLoc L and MalleoLoc L3 is to support mobilization in patients with ankle instability. It might also be a way of avoiding ligament reconstruction.

And what do you think of the MalleoLoc L3?
Dr. Kühle: The fact that it can be adapted by removing elements is a good idea. Its modular design means that the orthosis can be used by patients with typical lateral ligament injuries until they reach the end of the road of therapy. Obviously that means that it needs to be a durable product too. With many other orthoses, Velcro straps are a breaking point. If, after putting it on four or five times, I can no longer get a good pull on the straps, then they’re useless. That problem seems to have been solved well in this case. I also like the fact that the compression of the support helps to reduce swelling. The shape of the shell also helps with this.

…the shell that provides lateral stabilization only.
Dr. Kühle: That’s not actually new. A splint called the MHH splint was developed in the 1990s and it also had an L-shaped shell. That was then followed by the wider U-shaped shells. But now the unilateral orthosis therapeutic concept is gaining ground once more and offers certain benefits because of its light weight. What’s new about this L-shaped shell is its attractive anatomical shaping. It follows a ventral course from the front , bypasses the line of swelling at the lateral malleolus, and can offer resistance against talar shift , which is a common problem with ankle instability.

What does an ankle orthosis need to be able to do for you to recommend it to patients in your private practice?
Dr. Kühle: It must be successful. The patient must want to wear it. If patients feel , right from the outset , that it isn’t pressing too tightly and isn’t restrictive, that’s already one big obstacle overcome. If, in addition to that , the swelling goes down, the orthosis provides adequate stabilization, and it can be used by the patient throughout the rehabilitation phase, then it’s safe to say that it’s a good one. I recommend a particular type of orthosis to my patients depending on the indication in question. They then go to the medical supply retailer where they seek advice and generally choose between two models. I see the outcome at the next appointment. The score so far is: 70:30 to Bauerfeind.

Image: Conny Kurz