Shorter recovery can be achieved from using walking boot after operative treatment of an ankle fracture

Abstract

Background/ObjectiveAnkle fractures, even if treated surgically, usually take a long time to heal. For all patients with ankle fracture, immobilisation is a critical part of treatment. Short-leg walking boots (WBs) have been reported to be an effective alternative to plaster casts (PCs) that could shorten this postoperative recuperative period. The aim of this study was to compare the functional recovery of a conventional PC with that of a WB after surgery for ankle fractures.MethodsForty-seven patients (mean age, 53.9 ± 12 years) who had undergone surgical operation for an unstable ankle fracture from January 2008 to October 2014 were reviewed retrospectively. Either a PC or a WB was prescribed postoperatively, with 25 patients and 22 patients, respectively. The time that it took the patient to stand unipedal on the affected side after allowing full-weight bear and to walk without crutches were used for assessment of functional recovery. The prevalence of postoperative loss of reduction and nonunion was also reviewed.ResultsBoth the time of being able to stand unipedal on the injured side and to walk without crutches were significantly shorter in patients using WBs (WB, 2.6 weeks; PC, 4.5 weeks, p = 0.01; WB, 1.4 weeks; PC, 3.1 weeks, p = 0.03). There were no patients with loss of reduction or nonunion.ConclusionPatients who used WBs showed a significantly faster recovery. WBs have an adjustable heel lift that allows users to change the ankle position slightly plantarflexed that helps walking in a postoperative swollen ankle. WBs are easy to slip on, and it is easy to adjust the ankle position in conformity with swelling so that the least painful position could be maintained during walking. WBs have good fixity to allow immediate weight-bearing postoperatively, and there were no cases with loss of reduction postoperatively. The Rocker bottom design minimises the sagittal plane motion in the specific joint of the foot, which also facilitates the course of recuperation. An ankle fracture fixed appropriately endures loading when a WB is used. The WB treatment results in faster functional recovery, allowing the patients to return to normal activity at a faster rate.

A Prospective Randomized Study Comparing Functional Outcome in Distal Fibula Fractures between Conventional AO Semitubular Plating and Minimal Invasive Intramedullary “Photodynamic Bone Stabilisation”

“…These complications include wound healing problems, redness, hyperthermia, superficial and deep infections, deep leg vein thrombosis, and loosening of the material resulting in a loss of reposition. Previous studies in elderly patients with preexisting comorbidities demonstrated that intramedullary nailing systems in distal fibula FX have a significantly lower incidence of soft tissue complications and lead to adequate FX stability compared to conventional plate osteosynthesis [ 26 , 28 , 29 , 30 ]. White et al described in their prospective randomized study on 100 patients ( n = 50 ORIF, n = 50 IM nailing) no superficial wound infections in the IM group compared to eight (16%) superficial wound infections in the ORIF group [ 22 ].…”

“…In addition to fracture healing and the complications related to the surgery itself, postoperative therapy is a prognostic factor for the patient’s satisfaction, functional outcome, and return to normal daily activities [ 28 , 29 , 30 , 31 ]. For older patients suffering from an ankle fracture, returning to their normal daily life is important in terms of their quality of life and freedom [ 32 , 33 , 34 ].…”

“…Therefore, the main goal of any post-operative therapy is to reduce time of recovery to a minimum and to achieve full physical capacity as early as possible. In the past, a few clinical trials have shown that early weight bearing and functional treatment avoiding a plaster cast may shorten the immobilization period, but it also may provoke a loss of reduction, depending on morphology and initial stability of the FX, as well as patients’ age and comorbidities [ 28 , 32 , 36 , 37 , 38 , 39 ]. A few clinical trials have demonstrated that IM ankle FX fixation might be a good method to preserve the soft tissue, but it could lead to fibula shortening and loosening of the implant [ 21 , 22 , 26 , 27 , 40 , 41 ].…”

Affordable orthotic moon boot alternative

“…Strategic placement of the open and closed cell foam layers allows for a comfortable orthotic, due to it being well-cushioned, and shock resistant. Furthermore, the device is designed to be breathable and reduce the degree of discomfort experienced by the user, like commercial moon boots (Amaha, et al, 2017). The use of Velcro straps as the primary fasteners allows for the boot to be put on or removed easily, without requiring the assistance of a third party.…”

Commonly Used Types and Recent Development of Ankle-Foot Orthosis: A Narrative Review

“…The WB is used for acute injuries such as ligament sprains/tears, postoperative stabilization or support, ulcers, or cases with fractures [29,[32][33][34][35]. Amaha et al [36] in 2016 retrospectively evaluated patients who had surgeries for unstable ankle fractures. Of the 47 patients who received follow-up observations for at least 6 months, 25 wore a plaster cast (PC) and 22 wore a WB, and recovery rates were monitored in the two groups.…”