Ankle Orthosis Malleo TriStep 50S8N Otto Bock for Three-Stage Rehabilitation

Description:

The Malleo TriStep 50S8N is a unique modular orthosis designed for staged rehabilitation after ankle injuries and surgeries. Its combination of removable modules allows for adjustable support and immobilization throughout the recovery process, ensuring optimal comfort and effectiveness at each stage.

Indications:

• Ankle injuries (subluxations, ligament sprains and ruptures)
• Chronic instability of the capsular-ligamentous apparatus
• Injuries and diseases affecting the peroneal tendons
• Inflammatory and degenerative diseases of the ankle joint, especially in the acute phase
• Post-operative conditions after reconstructive surgery on the ankle’s capsular-ligamentous apparatus

Application Stages:

Stage 1 (Exudative Phase, Days 1-3):

Treatment Goals:

Pain relief, reduction of swelling (following the PRICE protocol: Protection, Rest, Ice, Compression, Elevation).

Orthosis Application:

The Malleo TriStep is used with all modules: the plastic plantar splint is attached to the base bandage. The plantar splint, with an additional pronation strap, immobilizes the foot in a neutral position with slight pronation. This provides necessary ankle stabilization, accelerates the subsidence of inflammation, and stimulates initial repair processes. Weight-bearing on the injured foot is permitted only in the absence of significant pain; otherwise, crutches should be used. The plantar splint is worn continuously, day and night, to maintain a neutral foot position. The orthosis cannot be used with footwear. The patient can perform pain-free movements of the foot and toes.

Stage 2 (Proliferative Phase, Days 4-28):

Treatment Goals:

Gradual increase in range of motion combined with controlled weight-bearing; stimulation of the patient’s own muscle apparatus to achieve active joint stabilization; continued reduction of swelling and repair of damaged tissues.

Orthosis Application:

During the day, the orthosis is used without the plantar splint. At the beginning of Stage 2, the base bandage is used with red, reinforcing lateral inserts and an additional semi-elastic strap placed crosswise over the bandage. These inserts protect the ligaments from supination stress. As mobility increases, the red inserts can be replaced with more flexible grey inserts. At night, to prevent re-injury, the base bandage is used with the plantar splint, as the foot is normally in supination during sleep. Rehabilitation includes physical therapy under specialist supervision to restore muscle strength and endurance while wearing the orthosis. Activities like walking, swimming, and cycling may be possible towards the end of Stage 2, but consultation with a physician is essential beforehand.

Stage 3 (Reparative Phase, Days 29-42):

Treatment Goals:

Dynamic ankle stabilization through muscle activation; restoration of range of motion and proprioception (joint-muscle sense); improved coordination and balance.

Orthosis Application:

In Stage 3, only the soft base bandage is used without additional reinforcing elements. This helps restore proprioception and provides light ankle support. The semi-elastic strap and/or lateral inserts can be used if needed (e.g., during physical therapy). Nighttime use of the orthosis with the plantar splint is recommended. After Stage 3, the base bandage can be used as protective support during physical activity to prevent re-injury. The combination of modules depends on injury severity and the recovery process and is determined by the attending physician.

Features:

The orthosis comprises several combinable modules, allowing for adjustable immobilization throughout rehabilitation. It includes a plastic plantar splint for maximum stabilization during the acute phase, an ankle base bandage, lateral reinforcing inserts (two stiffness levels), and various securing straps. All modules are removable and easily combined without tools. The lateral inserts self-adapt to the patient’s leg shape. Removable Velcro straps allow for complete opening of the base bandage, facilitating application when ankle pain is severe.

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