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Foot of the Week – Episode 23 – Post Tib Brace Evolution

In this “Foot of the Week” episode, we talk about the evolution of the medial malleolar window in our custom brace design for post tib or posterior tibial tendonitis (PTTD or PTD). The Blaze MI brace includes a relief for the medial malleolus called a window, and since its origination, the shapes have changed. Now the brace even includes a relief or window for the navicular or any other prominent bone of the foot. This provides the required support while also providing the needed space and “give” when pressures and pain are high.

Video Transcript:
Welcome back to Foot of the Week. Today we’re going to talk about the medial malleolar window and the evolution of the window and where it stands at this date. As you can see this is one of our first designs. We made the malleolar window to provide the support and provide the relief at the apex of that malleolus as it drives into the medial upright. But then we had this problem with the navicular. So, in an attempt to rectify that we ended up with a longer window. The problem with this design is twofold, one is we ended up with not so much support and the other is we ended up with the interior frame of that window cutting into the throat of the shoe. So, we then moved to a design that had both a medial malleolar window and a navicular window. And here you can see we have a jog and what this jog does, it allows for the anterior frame of that window to come right behind the throat of the shoe but in front of the medial malleolus. Here what happens is sometimes when that becomes very narrow, that is the windows become too close together, this band creates a high-pressure area which is hard for the patient to tolerate. So, in order to rectify that we occasionally use the split and what that does that cut basically creates a yield so when the patients are in moments of high impact, they’re not experiencing that intolerable pressure band. So being a custom shop we sometimes make windows that provide relief here at the head of the first. That is there are feet that end up having a big bony prominence right here in this spot and this is an example; this one isn’t done yet as you can see, but this is an example where we would make a relief there for the head of the first and for the medial malleolus. So obviously we wouldn’t have that cut for this specific design. So, thanks for joining us for Foot of the Week and we’ll see you next week.

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