Orthopedic boot

This article is about the orthopedic device. For the outdoor activity footwear, see Hiking boot.

A variety of orthopedic boots are 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.^[1][2]

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

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

A controlled ankle motion walking boot, also referred to as a controlled ankle movement walking boot, below knee walking boot, CAM boot, CAM walker, or moon boot, is an orthopedic device prescribed for the treatment and stabilization of severe sprains,^[3] 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.^[4]

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.^[5]

Comparison to casting

While CAM walkers do not provide the same degree of immobility that an orthopedic cast offers, they have some advantages.^[6] 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;^[7] 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

1. "Achilles tendon rupture - aftercare". National Institutes of Health. 2012-06-28. Retrieved 2012-11-25.
2. "Lisfranc (Midfoot) Injury". American Academy of Orthopaedic Surgeons. December 2011. Retrieved 2012-11-25.
3. Christopher W. DiGiovanni; Justin Greisberg (2007). Foot and Ankle: Core Knowledge in Orthopaedics. Elsevier Health Sciences. pp. 229–. ISBN 978-0-323-03735-8.
4. John H. Bowker; Michael A. Pfeifer (2008). Levin and O'Neal's the Diabetic Foot. Elsevier Health Sciences. pp. 535–. ISBN 978-0-323-04145-4.
5. How Does a CAM Walker Work? | LIVESTRONG.COM
6. Pollo, Fabian E; Gowling, Tracy L; Jackson, Robert W (May 1999). "Walking boot design: a gait analysis study". Orthopedics. 22 (5): 503–507. PMID 10348111.
7. Sigvard T. Hansen (2000). Functional Reconstruction of the Foot and Ankle. Lippincott Williams & Wilkins. pp. 294–. ISBN 978-0-397-51752-7.

Further reading

• Lamer, Stéphanie; Hébert-Davies, Jonah; Dubé, Vincent; Leduc, Stéphane; Sandman, Émilie; Ménard, Jérémie; Nault, Marie-Lyne (August 2019). "Effect of a Controlled Ankle Motion Walking Boot on Syndesmotic Instability During Weightbearing: A Cadaveric Study". Orthopaedic Journal of Sports Medicine. 7 (8). doi:10.1177/2325967119864018. PMC 6702776. PMID 31457067.
• McHenry, Benjamin D.; Exten, Emily L.; Cross, Janelle A.; Kruger, Karen M.; Law, Brian; Fritz, Jessica M.; Harris, Gerald (November 2017). "Sagittal Subtalar and Talocrural Joint Assessment During Ambulation With Controlled Ankle Movement (CAM) Boots". Foot & Ankle International. 38 (11): 1260–1266. doi:10.1177/1071100717723129. PMID 28800714. S2CID 30986747.
• Lamer, Stéphanie; Dube, Vincent; Hebert-Davies, Jonah; Stephane, Leduc; Menard, Jeremie; Nault, Marie-Lyne (1 July 2018). "Effect of CAM boot immobilization on weightbearing stability in syndesmotic injuries: a cadaveric study". Foot & Ankle Orthopaedics. 3 (3). doi:10.1177/2473011418S00302. S2CID 81279843.
• Brashears, Jennifer; Klusky, Sarah; Meese, Morgan; Mun, Kyle (12 April 2018). Cam Boot vs Sneaker: How Do Lower Extremity Joint Angles and Ground Reaction Force Magnitudes Change During Ambulation?. James J. Whalen Academic Symposium.
• Smyth, Niall A.; Abbasi, Pooyan; de Cesar Netto, Cesar; Michnick, Stuart M.; Casscells, Nicholas; Parks, Brent; Schon, Lew C. (1 April 2020). "The Effect of CAM Boots on Contact Pressures of the Ankle and Hindfoot Joints". Foot & Ankle Orthopaedics. 5 (2): 2473011420S0001. doi:10.1177/2473011420S00014. PMC 8697274. S2CID 225957292.