Foot & Ankle Products with Clinical Data

Transcription

1 Foot & Ankle Products with Clinical Data

2 Podalux post-op shoe

3 Podalux Developers Dr Determe Toulouse Dr Cermolacci - Marseille Dr Coillard Lyon Dr Laffenetre - Bordeaux

4 Podalux Indications Post-operative foot surgery Post traumatic injury Bunionectomy, hammer toe, claw toe Metatarsal injury Soft tissue procedures Maintains correct position during rehabilitation Secures and protects the operated joint whilst healing

5 Podalux Features Adaptable to swelling/oedema Insole with 2 levels of rigidity (patented) Offloads the forefoot Rocker sole for easy gait Two adjustable contact closure straps Breathable micro-mesh lining Wide, solid, skid resistant sole Anterior toe protection piece Raised frontal edge

6 Podalux Benefits Gives foot & ankle stability during gait Reduces load to the forefoot Allows for limited MTP joint movement Soft & comfortable to wear Accommodates bulky dressings Reduces forces during gait cycle Allows for normal gait Frontal edge gives extra toe protection

7 Gait Cycle & Analysis

8 Gait Cycle & Analysis MTPJ flexion/dorsiflexion evaluated under 5 different conditions Barefoot Post-op shoe (solid base) Darco orthowedge Podalux (with insert) Podalux (without insert) Markers positioned as per diagram

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10 Movement of the MTPJ Stance Phase Barefoot Heel strike MTPJ dorsiflexed at 12º Mid stance MTPJ neutral Heel off MTPJ s rapid dorsiflexion to 30º Toe off - MTPJ extension Swing Phase MTPJ s slight dorsiflexion to aid floor clearance

11 Post-op Shoe (Solid Base) - Results Complete restriction of MTPJ s (no movement) No off-loading of the forefoot Increases ankle dorsiflexion Adversely effects movement of body over stance limb Adversely effects gait cycle

12 Darco Ortho Wedge Guarantees a pressure distribution to the metatarsus and/or hindfoot Claims Does not load the forefoot at all Indicated for hallux valgus, hammer/claw toe and forefoot ulcerations Assists healing of forefoot ulcerations

13 Darco Wedge - Results Partial restriction of MTPJ s 70% unloading of forefoot Increased ankle dorsiflexion with little movement to plantar flexion Adversely effects knee movement Significantly disturbs gait pattern Increases quad activity Adds tension to calf muscles

14 Podalux with Insert - Results Partial restriction of MTPJ s (8º dorsiflexion) Gives 40% offload of the forefoot Ankle movement normal Knee movement - normal

15 Podalux without insert - Results Some restriction of MTPJ s (10-12º dorsiflexion) Gives a 40% offload of forefoot Ankle movement normal Knee movement - normal

16 Podalux v s Darco Wedge Podalux low profile sole reduces the risk of ankle sprains Normal shoe design avoids back pain Total contact under toes avoids grasping a problem in shoes with only heel contact and open ( grasping contraindicated for osteotomy) Contact under toes VERY IMPORTANT gives patient good balance

17 Conclusion Podalux with insert Podalux without insert Darco Wedge Post-op shoe Barefoot Allows for natural gait MTPJ movement within safe ROM Reduces load to the forefoot High level patient comfort & compliance Low cost

18 Podalux Summary Keeps MTPJ movement within safe limits Reduces load to forefoot Maintains normal gait pattern Adjustable through rehab process (insert) Accommodates dressings Acceptable to wear (increased compliance)

19 Ankle Bracing

20 Air-Stirrup Family Air-Stirrup The gold standard and market reference for functional management of ankle sprains Patented Duplex aircells producing graduated compression during ambulation Anatomically designed semi-rigid shells Pre-inflated aircells for easy application 4 sizes for a custom fit to the patient Superior support of the ankle

21 Aircast Air-Stirrup: Duplex Aircell The patented Duplex aircell system with preinflated distal and overlapping proximal aircell reduces swelling and enhances circulation. Patented Duplex aircells The pulsating, graduated compression when walking milks the oedema away.

22 Clinical Data Conservative Therapy for Acute Lateral Ligament Lesions - Single Chamber vs. Two-Chamber Orthosis Systems Schmidt, Mainers, Reintges, Lipke, Benesch, Gerngross 1999 Objective To compare the effectiveness of a dual aircell orthosis with a single aircell brace system in reducing swelling of the injured ankle Study design & methods Prospective, randomised study 56 male patients with acute unilateral fibular ankle sprain were randomized into 2 groups 31 patients were treated with a single aircell brace 25 patients were fitted with a dual aircell brace The patients were advised to wear the prescribed brace for a total of six weeks, day and night Results The dual aircell brace achieves a greater and faster reduction of swelling while providing the same level of comfort in wear. The reduction in swelling with the dual aircell brace was significantly higher than with the single aircell brace Conclusion The results indicate a clear superiority of the dual aircell brace system in reducing swelling after acute fibular ankle sprain, which leads to alleviation of symptoms and allows the injured extremity to be loaded earlier Key message Reduction of edema was clearly superior with the dual aircell design compared to the single aircell design

23 AirSport The AirSport is indicated for: Prophylactic protection Chronic instability of the ankle The AirSport incorporates the following features: Semi-rigid shell and aircells, to provide comfort and support. ATF (anterior talofibular) cross strap and integral forefoot and shin wraps for additional compression and stabilization The unique "step-in" design (toes first inserted into the back of the brace) and automatic heel adjustment make the AirSport extremely fast and easy to put on: Step In, Strap Up, And Go!

24 Clinical Data Taping vs. Bracing Prophylactic Bracing Versus Taping for the Prevention of Ankle Sprains in High School Athletes : A Prospective Randomized Trial Mickel, Bottoni, Tsuji, Chang, Baum, Tokushige 2006 Taping must be applied by experienced physical therapist/trainer Taping has been shown to loosen with physical activity Cost of taping - $1.75 per ankle - $400 per athlete per season Equipment required tape, pre-tape, skin protection spray, wrap Application time (by experienced trainer) - 67 seconds per ankle Skin irritation risk No significant difference in effectiveness between taping AirSport brace

25 A60 Ankle Brace 60 angle gives optimum protection against ankle roll over Patented breathable fabric keeps the A60 cool and comfortable Soft brace Sleek design fits easily into sports shoe Chronic instability, prophylaxis

26 A60 Design Rationale Peter Vaes, PT MT PhD Professor In Physiotherapy and Manual Therapy Faculties Physiotherapy and Medicine Brussels BELGIUM Unstable ankles show significantly less pathologic talar tilt during stress X-ray testing, when taped adding a 60 strap compared to straps that were applied at 40, 50, 70 or 80 Ankles were tested in plantar flexed position of 40, position most often described when people sprain their ankle 10 to 20 of talar tilt in unstable ankles

27 Walkers

28 Aircast Walking Braces The Aircast Walking Braces combine pulsating, graduated compression to help reduce edema, semi-rigid shells to provide protection, custominflated aircells that maintain limb contact for stability, and a rocker sole to reduce plantar pressure. The Aircast walking Braces are easy to apply in A&E, doctor s office and home.

29 Duplex Aircell Technology Overlapping back aircell provides duplex technology and help reduce edema Front aircell to secure leg in the brace Distal aircell to secure ankle and provide higher distal pressure

30 XP Walker Features/Benefits Low rocker sole for enhanced comfort & natural ambulation Overlapping semi-rigid shells give maximum support & protection Four aircells give graduated compression offering superior oedema reduction Hand held pump allows for adjustability of aircells for secure support and protection Wider foot bed offers room for dressings

31 Aircast Walker Clinical Data Functional outcome of surgery for fractures of the ankle. A prospective, randomised comparison of management in a cast or a functional brace K.A.Egol, R.Dolan, K.J.Koval, Journal of Bone & Joint Surgery 2000 Background - The aim of operative treatment for fractures of the ankle is to allow early movement after stable internal fixation Objective - To assess the functional outcome of the operative treatment of ankle fractures in two postoperative treatment conditions : functional bracing allowing early movement and cast immobilisation Design & Methods - 60 consecutive patients who were undergoing internal fixation of a closed, isolated fracture of the ankle, were randomly assigned into 2 treatment groups 1) one group was treated by immobilisation in a below-knee cast 2) the other group was treated by a functional brace with early movement Conclusion - The use of a functional brace and early movement after surgery is beneficial for patients with ankle fracture Key Message - Functional bracing after ankle fracture surgery results in higher functional outcome scores, earlier return to work, and potential cost savings without any complications.

32 Aircast XP Walker with Heel Wedges For post-op TA repair or conservative treatment Designed to be used with XP walker 5 heel supports 3 to be used for treatment 3 heels: 22 degrees 2 heels: 16 degrees 1 heel: 10 degrees