“The orthosis gives patients the security they need”

No day goes by without joint injuries – not even Sunday. To help patients combat pain immediately and ensure they get home safely, Dr. med. Klaus Fischer reaches for the MalleoLoc L3 in his emergency reserves.

Bauerfeind life: How do you proceed when treating ankle joint injuries?

Dr. Fischer: I generally take an X-ray. Diagnosis by exclusion is extremely important for sprains and supination trauma, for instance to keep from overlooking a syndesmosis injury or fracture at the base of metatarsal V. I get a feel for the tenderness and mobility, which is difficult. Of course, the patients are afraid. The same applies when checking for displacement of the talus and performing the talar tilt test. They become very tense during these tests, which makes it difficult to estimate the exact extent of the injury.

How do you help them?

Dr. Fischer: If heavy swelling is present , an air-cushioned splint is beneficial at first. But such swelling usually goes away within a few days and exchanging the splint for an orthosis that stabilizes well should be considered. If the swelling is kept in check, all patients with supination trauma are candidates for the MalleoLoc L3, in principle. I think the orthosis is ideal for emergency care – it keeps many options open and provides sufficient protection from the very start. For emergency aid, it is crucial to prevent the tendency to supinate at first , which requires support. The L-shell does exactly that and reduces the tendency to supinate, as do the figure-8 straps. The shell follows the anatomy of the foot , ensuring a good fit.

What else is required for emergency care 1after a sprain?

Dr. Fischer: Functional follow-up treatment always focuses on safety while stepping. I almost never give patients crutches. That wouldn’t be doing them any favors. The goal is for them is to stand on their own two feet – they should be walking! MalleoLoc L3 provides stability in the shoe and supports mobilization.

A compression support is also integrated in the MalleoLoc L3

Dr. Fischer: Yes, and you can definitely rely on the knitted fabric, which demonstrates proprioceptive effects as well as providing compression to reduce swelling. That offers additional stability. The shell and straps are removable, so the degree of stabilization can be adjusted as needed, and the patients have freedom to adapt. This is sensible and well thought out. Ultimately, early functional treatment is what really helps.

Do you have a philosophy for urgent care when it comes to products?

Dr. Fischer: If a patient comes into my office with a fresh ankle joint sprain, it is generally clear that they will not be able to walk far to obtain a product. They need to be given a product right here, that will prevent the risk of further injuries. With MalleoLoc L3, we are on the safe side in most cases.

Do you believe there is a risk of excessive treatment?

Dr. Fischer: We don’t want to over-treat patients, nor do we want to use unnecessary initial treatment such as an air-cushioned splint that would just be replaced later on by the MalleoLoc L3 or an ankle joint support anyway. If we have excluded the possibility of any red flags with a proper diagnosis, an orthosis will give the patient the security they want and need in order to combat their injury. Patients should wear orthoses as long as they are helpful. This is the best kind of early functional treatment.

Images: Udo Schönewald