orthopedic boot
{{Short description|Medical device}}
{{This|the orthopedic device|the outdoor activity footwear|Hiking boot}}
{{Infobox medical intervention
| name = Walking boot
| image = Aircast walking boot1.JPG
| caption = A walking boot being used to aid weight bearing after an ankle fracture.
| alt =
| pronounce =
| synonyms =
| ICD10 =
| ICD9 =
| ICD9unlinked =
| CPT =
| MeshID =
| LOINC =
| other_codes =
| MedlinePlus =
| eMedicine =
}}
{{multiple image
| width = 200
| image1 = Fracture_boot.jpg
| image2 = Fracture_boot_side_view.jpg
| footer = A walking boot being worn in place of a cast to treat a broken ankle. The air pump system can be seen on the side of the boot to inflate the boot to provide added support
}}
An orthopedic boot is used for the treatment of injuries of the foot or ankle. Along with orthopedic casts, leg braces, splints and orthotics, they can immobilize and shift weight bearing to help treat injuries to the foot area.{{cite web|url=https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000546.htm|title=Achilles tendon rupture - aftercare|accessdate=2012-11-25|date=2012-06-28|publisher=National Institutes of Health}}{{cite web|url=http://orthoinfo.aaos.org/topic.cfm?topic=A00162|title=Lisfranc (Midfoot) Injury|accessdate=2012-11-25|date=December 2011|publisher=American Academy of Orthopaedic Surgeons}} Varieties include the controlled ankle motion walking boot (or controlled ankle movement walking boot, below knee walking boot, CAM boot, CAM walker, or moon boot), an orthopedic device prescribed for the treatment and stabilization of severe sprains,{{cite book|author1=Christopher W. DiGiovanni|author2=Justin Greisberg|title=Foot and Ankle: Core Knowledge in Orthopaedics|url=https://books.google.com/books?id=OcHq05vQGDwC&pg=PA229|year=2007|publisher=Elsevier Health Sciences|isbn=978-0-323-03735-8|pages=229–}} fractures, and tendon or ligament tears in the ankle or foot. In situations where ankle motion but not weight is to be limited, it may be used in place of a cast.{{cite book|author1=John H. Bowker|author2=Michael A. Pfeifer|title=Levin and O'Neal's the Diabetic Foot|url=https://books.google.com/books?id=M7ENEwXCTYwC&pg=PA535|year=2008|publisher=Elsevier Health Sciences|isbn=978-0-323-04145-4|pages=535–}}
Description
A walking boot consists of:
- An inner lining, usually fabric, with hook and loop fasteners which encloses and cushions the patient's foot and ankle
- A rigid frame to restrict motion in the lower leg
- A hard plastic shell that provides rigidity and protection to the leg
- Adjustable closure system that allows for proper fitting to various leg sizes
Variations
CAM walkers may range in height from mid-calf to nearly knee-length, depending on the condition they are meant to treat. Some contain inflatable compartments that can be adjusted by the patient for maximum support and comfort. For further protection of the injured ankle and leg, CAM walkers may also utilize a more extensive plastic shell that also encloses the back and sides of the walker, with detachable plastic plates for the front.[http://www.livestrong.com/article/22337-cam-walker-work/ How Does a CAM Walker Work? | LIVESTRONG.COM]
Comparison to casting
While CAM walkers do not provide the same degree of immobility that an orthopedic cast offers, they have some advantages.{{cite journal |last1=Pollo |first1=Fabian E |last2=Gowling |first2=Tracy L |last3=Jackson |first3=Robert W |title=Walking boot design: a gait analysis study |journal=Orthopedics |date=May 1999 |volume=22 |issue=5 |pages=503–507 |pmid=10348111 |url=https://www.proquest.com/openview/372c4e9c02e9f422634777c8617924b1/1 }} Unlike casts, they are adjustable and reusable, and fully removable, permitting the patient to bathe the foot and ankle and remove the walker at night, if they so desire;{{cite book|author=Sigvard T. Hansen|title=Functional Reconstruction of the Foot and Ankle|url=https://books.google.com/books?id=ASSCGDRC-KsC&pg=PA294|year=2000|publisher=Lippincott Williams & Wilkins|isbn=978-0-397-51752-7|pages=294–}} and a CAM walker requires no special modifications for the patient to bear weight and walk. With some fractures, however, removal may result in worse outcomes and thus this may be a negative; also, with some fractures, the person should be non-weight bearing. Additionally, there is greater cost.
For more severe fractures, a traditional cast may still be preferable.
References
{{Reflist}}
Further reading
- {{cite journal |last1=Lamer |first1=Stéphanie |last2=Hébert-Davies |first2=Jonah |last3=Dubé |first3=Vincent |last4=Leduc |first4=Stéphane |last5=Sandman |first5=Émilie |last6=Ménard |first6=Jérémie |last7=Nault |first7=Marie-Lyne |title=Effect of a Controlled Ankle Motion Walking Boot on Syndesmotic Instability During Weightbearing: A Cadaveric Study |journal=Orthopaedic Journal of Sports Medicine |date=August 2019 |volume=7 |issue=8 |doi=10.1177/2325967119864018 |pmid=31457067 |pmc=6702776 }}
- {{cite journal |last1=McHenry |first1=Benjamin D. |last2=Exten |first2=Emily L. |last3=Cross |first3=Janelle A. |last4=Kruger |first4=Karen M. |last5=Law |first5=Brian |last6=Fritz |first6=Jessica M. |last7=Harris |first7=Gerald |title=Sagittal Subtalar and Talocrural Joint Assessment During Ambulation With Controlled Ankle Movement (CAM) Boots |journal=Foot & Ankle International |date=November 2017 |volume=38 |issue=11 |pages=1260–1266 |doi=10.1177/1071100717723129 |pmid=28800714 |s2cid=30986747 |url=https://epublications.marquette.edu/bioengin_fac/541 }}
- {{cite journal |last1=Lamer |first1=Stéphanie |last2=Dube |first2=Vincent |last3=Hebert-Davies |first3=Jonah |last4=Stephane |first4=Leduc |last5=Menard |first5=Jeremie |last6=Nault |first6=Marie-Lyne |title=Effect of CAM boot immobilization on weightbearing stability in syndesmotic injuries: a cadaveric study |journal=Foot & Ankle Orthopaedics |date=1 July 2018 |volume=3 |issue=3 |doi=10.1177/2473011418S00302 |s2cid=81279843 |doi-access=free }}
- {{cite conference |last1=Brashears |first1=Jennifer |last2=Klusky |first2=Sarah |last3=Meese |first3=Morgan |last4=Mun |first4=Kyle |title=Cam Boot vs Sneaker: How Do Lower Extremity Joint Angles and Ground Reaction Force Magnitudes Change During Ambulation? |conference=James J. Whalen Academic Symposium |date=12 April 2018 |url=https://digitalcommons.ithaca.edu/whalen/2018/presentations/75/ }}
- {{cite journal |last1=Smyth |first1=Niall A. |last2=Abbasi |first2=Pooyan |last3=de Cesar Netto |first3=Cesar |last4=Michnick |first4=Stuart M. |last5=Casscells |first5=Nicholas |last6=Parks |first6=Brent |last7=Schon |first7=Lew C. |title=The Effect of CAM Boots on Contact Pressures of the Ankle and Hindfoot Joints |journal=Foot & Ankle Orthopaedics |date=1 April 2020 |volume=5 |issue=2 |pages=2473011420S0001 |doi=10.1177/2473011420S00014 |s2cid=225957292 |doi-access=free |pmc=8697274 }}