Walking boot

A walking boot being used to aid weight bearing after an ankle fracture.

A controlled ankle motion walking boot, or CAM boot, also sometimes called a below knee walking boot, is an orthopedic device prescribed for the treatment and stabilization of severe sprains,^[1] 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 an cast.^[2]

Description

A walking boot consists of:

• A soft, front-opening, Velcro-closure foam liner which encloses and cushions the patient's foot and ankle
• A frame (usually aluminum) consisting of two vertical bars, one on each side of the walker, with a joint at the ankle allowing for adjustable range of motion^[3]
• A hard plastic shell that forms the sole of the walker and holds the aluminum frame in place
• Adjustable Velcro straps to secure the components of the walker to each other and the patient's leg^[4]

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.^[4]

Comparison to casting

While CAM walkers do not provide the same degree of immobility that an orthopedic cast offers, they have some advantages.^[5] 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;^[6] 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

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1. Christopher W. DiGiovanni; Justin Greisberg (2007). Foot and Ankle: Core Knowledge in Orthopaedics. Elsevier Health Sciences. pp. 229–. ISBN 0-323-03735-6.
2. John H. Bowker; Michael A. Pfeifer (2008). Levin and O'Neal's the Diabetic Foot. Elsevier Health Sciences. pp. 535–. ISBN 0-323-04145-0.
3. Fred R. T. Nelson; Carolyn Taliaferro Blauvelt (16 August 2014). A Manual of Orthopaedic Terminology. Elsevier Health Sciences. pp. 181–. ISBN 978-0-323-31567-8.
4. How Does a CAM Walker Work? | LIVESTRONG.COM
5. Pollo, Fabian E., Ph.D., Tracy L. Gowling, B.S., and Robert W. Jackson, M.D. "Walking Boot Design: A Gait Analysis Study." Gait and Posture 7 (1998): 179. ScienceDirect. Web. 24 Oct. 2012
6. Sigvard T. Hansen (2000). Functional Reconstruction of the Foot and Ankle. Lippincott Williams & Wilkins. pp. 294–. ISBN 978-0-397-51752-7.
7. Patent US4771768 - Controlled motion ankle fracture walker - Google Patents
8. Transient bone marrow edema of the foot and a... [Foot Ankle Int. 2011] - PubMed - NCBI