Frequently Asked Questions
What does TAG stand for?
TAG stands for the "Toad Anti-Gravity" Brace.
What is the TAG Brace used for?
The TAG Brace can be used for any indication where complete or partial unloading of the foot or ankle complex is required for healing. The two main indications are diabetes, fractures and sprains.
Can the TAG Brace really offload the entire lower foot and ankle?
Yes. The design of the brace enables it to suspend the body's entire weight through the calf section which completely unloads the foot and ankle complex. While complete unloading is easily obtainable, partial unloading of specified regions of the foot is also an option using our modular foot plate designs.
How does the suspension work?
The TAG Brace uses patented and proprietary prosthetic suspension technology, similar to how a below knee prosthesis works for an amputee. This enables the TAG Brace to completely offload the lower extremity while providing comfortable, confident suspension.
Will the TAG Brace damage the already compromised skin of a diabetic patient?
No. The TAG Brace uses patented prosthetic suspension technology which includes a 3mm silicone liner designed for the protection of fragile or damaged skin. These design elements ensure that further complications or skin break-down does not occur.
Does the brace constrict vascular supply to the lower extremity?
No. The TAG Brace has been doppler tested and proven to not cause vascular constriction. The brace allows wound patients to remain ambulatory, and their wounds will benefit from the normalised circulation effect which occurs during walking. This increased blood flow leads to improved granulation tissue formation in the wound healing process. A study to quantify this effect has not yet been undertaken.
Does the TAG Brace create a leg length discrepancy?
Of course. Every brace on the market creates an LLD. The TAG Brace creates an LLD similar to a cam walker. We are generally not concerned when the healing period is short (4-6 weeks), but recommend a contralateral lift if the healing time goes longer than 6 to 8 weeks. For longer wear time, use of an “Evenup” Balancer is common. As well, we offer fabrication services which can add a lift to the contralateral shoe as long as it is sent in with the initial cast during fabrication.
Have there been any clinical studies performed on the TAG Brace?
Clinical trials are currently underway at University Hospitals, Case Medical Center, Cleveland and other medical schools in Ohio.
What types of fractures have been treated with the TAG Brace?
Some of the fractures treated include metatarsal fractures, calcaneal fractures, distal pilon fractures, and mid-foot fractures. The brace has also been used for Charcot's ankle and foot deformities, severely arthritic ankles and lower extremity pain, gracilis muscle transfers, bunionectomies, achilles tendon tears and a variety of other lower extremity complications.
Why is the TAG Brace the best choice for diabetic plantar ulcers?
The two issues that complicate bracing success in healing plantar ulcers are pressure and sheer. Braces such as a CROW (Charcot Relief Orthotic Walker) have been mildly successful by removing some pressure under the ulcer area. This reduces pressure, but sheer forces, increased humidity and pooling of perspiration and the inability to completely unweight the wound make the CROW a poor choice for success. The TAG Brace reduces both pressure and sheer and enables the patient to be ambulatory without the need for a wheelchair or crutches.
Why is the TAG Brace the best choice for fractures and sprains?
Today, cam walkers or walking casts are the standard choice for fractures. The patient is fit in the brace, but must remain non-weight bearing for healing to occur. This means they must use a walker or crutches and only one leg, or have to remain in a wheelchair if they cannot ambulate safely. The TAG Brace allows normal ambulation while unweighting the fractured area. Through the modular design, we can slowly begin to increase pressure, as directed by the physician, throughout the healing cycle to ensure the strongest ossification and healing of the fractured site. No other brace on the market offers this to the fracture patient.
Is the TAG Brace heavy?
No. Since the TAG Brace is fabricated out of carbon fiber and fiberglass, the entire brace weighs less than a common cam walker.
Is the TAG Brace a good final option before opting for amputation?
Absolutely. Amputation of a limb has severe implications both emotionally and physically and should be avoided when possible. The TAG Brace has been fit on a number of patients where the wound care team had exhausted other options for healing the ulceration. Many patients that were scheduled for amputation surgery were healed completely in the TAG Brace. The TAG Brace is the premier choice for limb salvage.
Can the TAG Brace be utilised on both limbs at the same time?
Yes. We have had great success with patients requiring bilateral braces with both the fracture and ulceration indications. The patients adjust to them very quickly and are confident in both balance and gait.
Can the TAG Brace adjust for fluctuating edema or volume changes?
Yes. The dual overlapping shells enable the brace to allow for approximately 3” volume fluctuations while still ensuring proper fit and suspension.
Is the TAG Brace easy to fit?
Because the TAG Brace is custom fabricated to a cast, the fitting process is generally easy for even those not trained in the Orthotics field.
Could you explain the fitting procedure?
When you receive your custom TAG Brace, these are the steps for a proper fitting. First, read the enclosed fitting brochure entirely. It will help to avoid any fitting problems. Cut the very bottom off the silicone liner; there is a line or seam around the very bottom to be used as a guide. Next, roll the liner onto the calf section of the leg ensuring that the liner will protect the entire area under the shell of the brace. Place the pad in the proper location so that it will not put pressure on the ulcer or fracture.
Place the patient's leg in the shell and suspend the foot approximately 2-2.5" above the pad to allow for some settling when the brace is applied. Close the anterior shell around the leg and tighten the 3 velcro straps with moderate pressure to lightly squeeze the calf section. Review liner position to make sure that the skin is protected under the brace.
Have the patient stand in the brace and review the foot height in the brace. Settling will occur upon standing and the foot should be suspended approximately 3/4" above the carbon bottom. This will ensure that the foot will not contact the carbon strut.
Is the TAG Brace comfortable?
Much like any Orthopaedic device, the TAG Brace will be comfortable as long as a proper "break-in" schedule is followed. It is common to feel some discomfort upon initial wear as the calf section is not accustom to having the body weight transmitted through it. By simply following the suggested break-in period described on the fitting brochure, a patient will find that the leg will accept the brace and feel comfortable by the second or third day. Much like any orthopaedic device, it is important to follow the break-in process to desensitise the nerves in the lower extremity, and to allow for both acceptance and compliance of the brace.
What if the TAG Brace slides on the leg and the foot touches the carbon strut?
This is a very rare occurrence. First, it is important that the patient does not use lotions on their skin as it can act as a lubricant against the liner. This can cause slippage in the liner. Second, is improper donning height as some settling or distal migration of the limb will occur (usually about ½”) when fitting the TAG Brace so it is important to follow the proper fitting height.
How long should the TAG Brace be worn?
After the proper break-in procedure is followed, the TAG brace can be worn all day. It is important to remove the brace during sleep to enable a resting period from the brace.
When can a patient discontinue use?
The TAG Brace is part of the treatment protocol prescribed by the physician. It is important that the physician follows the fracture or ulceration to determine proper healing and ultimately decide when the patient can discontinue use.
Does the TAG Brace have a warranty?
Yes. The TAG brace carries the industry standard warranty of 6 months covering any manufacturing defects.
What if the patient has a problem with the fit or function of the brace?
Please get in contact with us if you or your patients have any problems with the state or use of the brace.