Orthotic Walking Boots for Patients with Fractures or Ligament Injuries: A Review of Clinical Effectiveness and Cost-Effectiveness [Internet]

Excerpt

Ankle injuries are one of the most common orthopedic injuries in the general population. In a Swedish study it was reported that the annual incidence of ankle fractures in the adult population was 179 per 100,000 persons. In the US, over five million ankle injuries occur annually. In Canadians aged 12 years or older, it was estimated that there were 942,000 activity-limiting ankle or foot injuries per year.

Ankle injuries include sprains and fractures. In ankle fractures, one or more of the bones that make up the ankle joint are broken. The ankle joint is made up of three bones: tibia (shinbone), fibula (smaller bone of the lower leg) and talus (a small bone located between the heel bone [calcaneus] and the tibia and fibula). The ankle bones and joint are held in position by the ligaments. Toddler’s fractures were first defined in 1964 by Dunbar et al. as oblique, non-displaced fractures of the distal one-third of the tibia occurring in children aged between nine months and three years; subsequently the term has also been used to include fractures of the proximal and mid-tibia.

Treatments for ankle fractures include surgical and non-surgical options, depending on the type of fracture. Generally, in case of fractures that are stable and undisplaced, nonsurgical options are used to immobilize the affected leg with regular radiographic follow-up. Immobilization methods include use of cast (made of plaster of Paris, or other synthetic material), braces, splints, or orthotic walking boots. There appears to be uncertainty around the optimal non-surgical immobilization method for treating fractures.

The purpose of this report is to review the clinical effectiveness and cost-effectiveness of orthotic walking boots for patients with ankle fractures or ligament injuries.