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Less load measured through foot when subjects wore walking cast frame
A walking cast frame reduced mean peak force by 73.1% through the fifth metatarsal head, as well as overall mean peak force.
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A walking cast frame used for lower limb immobilization helped substantially reduce transmission of force through the foot during weight-bearing compared to a Sarmiento cast above the knee and a standard below-the-knee cast, based on study results presented here.
A walking cast frame significantly reduced the mean peak force through the first metatarsal head, through the fifth metatarsal head and through the calcaneum when compared to a standard below-knee cast, James T. Berwin, MBBS, and colleagues noted in their study.
“We think this will probably reduce the incidence of morbidity, and hopefully improve what it is like for the patients to wear their casts,” compared to the current gold standard of patella tendon-bearing or Sarmiento cast, James T. Berwin, MBBS, said at the British Orthopaedic Association Annual Meeting.
Not previously evaluated
The load on the foot from casts has not previously been evaluated, Berwin said. He and his colleagues devised a measurement system that used force sensors applied to the first and fifth metatarsal head and the plantar surface of the calcaneus to obtain baseline force readings. They used the system in seven men and seven women who were healthy volunteers. Force measurements were taken first without a cast applied, according to the abstract, and then with three separate casts.
Each volunteer was fitted with each style of cast and walked a distance wearing each type of cast to obtain the in-use readings. The types of casts studied were a Sarmiento cast, a below-knee cast and a Böhler Walker cast frame (Beagle Orthopaedic Ltd.). The cast frame was designed to achieve a reduction in force across the foot and ankle, according to the study abstract.
“Compared to the standard below-knee cast, the Böhler Walker reduced the mean peak force through the first metatarsal head by 58.9%,” Berwin said.
Significant reduction in mean peak force
The Böhler Walker significantly reduced the mean peak force by 73.1% through the fifth metatarsal head. The Böhler Walker also significantly reduced the mean peak force by 32.2%, he noted.
The mean forces were higher across the calcaneal tuberosity with the Sarmiento cast. The Sarmiento cast effectively demonstrated mean percentage reduction in peak force of 8.6% and 4.4% through the first and fifth metatarsal heads, but it also increased the mean peak forced by 5.9% through the calcaneum, the investigators noted.
According to the abstract, the implications of these findings may mean walking is safer and better tolerated by patients who are casted due to various foot and ankle conditions. – by Susan M. Rapp
- Reference:
- Berwin JT, et al. Paper #24. Presented at: British Orthopaedic Association Annual Congress; Sept. 15-18, 2015; Liverpool, United Kingdom.
- For more information:
- James T. Berwin, MBBS, can be reached at Department of Trauma and Orthopaedics, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, United Kingdom; email: james.berwin@nhs.net.
Disclosure: Berwin reports no relevant financial disclosures.