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Clinical Solutions in Practice

Inventive Brace May Improve Stability While Reducing Pain

Robi Garthwait, Contributing Editor
November 2017

Physicians seeking to provide stability and pain relief to patients suffering from a variety of foot and ankle issues may want to consider an innovative type of brace.

The TriLok External Ligament System is designed to mimic the function of healthy ligaments and tendons, explains the manufacturer BioSkin. According to the company, TriLok controls each motion of the ankle, arch and heel, allowing for increased function and decreased pain. Clinical indications for the brace include ankle sprains, peroneal tendonitis, chronic ankle instability, posterior tibial tendon dysfunction, plantar fasciitis, Achilles tendinitis and pes planus.

David J. Neese, DPM, FACFAS, FABFAS, has been using the TriLok brace since the product’s introduction several years ago.

“I was looking for a foot/ankle brace that could be worn as an ‘everyday’ device for my patients, not just a situational brace,” says Dr. Neese, the Director of the Podiatric Surgery Residency Program at Mercy Hospital in Coon Rapids, Minn. “This brace has several layers that can be adjusted for control as well as comfort, all with Velcro rather than plastic or laces.”

Dr. Neese says the brace is easy to apply, even for patients who have arthritis in their hands.

Howard Stone, DPM, FACFAS, has been using TriLok for about four years and cites the product’s design and well-made materials as key benefits.

“I use the TriLok brace following ankle sprains, ankle tendon repairs and ankle fractures. The TriLok is dispensed at the same time I prescribe physical therapy,” notes Dr. Stone, who is in private practice in Illinois and on the faculty at Northwestern University’s Feinberg School of Medicine.

A key feature of the product is the FootLok Strap, which the manufacturer describes as “an external ligament” that provides suspension and support to injured tendons and ligaments.

“Taken as a whole, this brace is a compression device, which is desired for acute injuries,” says Dr. Neese. “[It also] offers frontal plane control of the hindfoot and ankle in chronic as well as acute situations.”

Dr. Neese cites a recent case in which a patient presented with dysfunction of the posterior tibial tendon on the right foot and ankle. Magnetic resonance imaging (MRI) revealed lateral talar dome chondromalacia with subfibular impingement syndrome. The patient was unable to take time off work for surgical reconstruction. Furthermore, his job required him to drive heavy machinery for his occupation, making a solid brace, such as a gauntlet, impractical for use while the patient was at work, points out Dr. Neese.

“I placed him in a TriLok brace, which helped control the medial ankle, and had him return to the clinic the following week,” says Dr. Neese. “He was nearly completely asymptomatic [and] appreciated that the brace fit in a work boot, and that he could adjust the fit as needed throughout the day.”

Both Drs. Stone and Neese would recommend the TriLok brace to other practitioners.

“It really is universal in reference to controlling medial as well as lateral hindfoot and ankle pathology,” states Dr. Neese.

Ms. Garthwait is a freelance writer who lives in Downingtown, Pa.

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