Satisfaction analysis of Figure 8 (open heel) short leg cast

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Lindsay Mathews
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1 Chan Kang, MD, PhD Dong-Hun Kang, MD Jae-Hwang Song, MD Min-Gu Jang, MD Ki-Jun Ahn, MD Ki-Soo, Lee, MD Department of Orthopedic Surgery, Chungnam National University School of Medicine. Daejeon, Republic of Korea

2 Disclosure No conflict to disclosure Satisfaction analysis of Chan Kang, MD, PhD Dong-Hun Kang, MD Jae-Hwang Song, MD Min-Gu Jang, MD Ki-Jun Ahn, MD Ki-Soo, Lee, MD Out disclosures are in the Final AOFAS Mobile App. We have no potential conflicts with this presentation.

3 Cast Circumferential immobilizer Superior immobilization than splint However, more complication than splint Pressure sore M/C cause : poor cast application Nerve damage Signs of nerve damage» Loss of power, tingling and numbness

4 Complication of plaster cast, as pressure sore, and discomfort can be reduced by heel opening To evaluate The results of Figure 8 cast (Heel open short leg cast) in foot & ankle disease and trauma

5 508 cases of ankle disease & trauma Nov ~ Jan Male 287, Female 221 Mean age : 39.9 (8~88) Retrospective study Foot & ankle fracture 236 Chronic ankle instability 92 Distal tibia fracture 48 Ankle & subtalar fusion 20 Ankle sprain 10 Osteochondral lesion of talus 13 Accessory navicular syndrome Recurrent peroneus subluxation 15 5 Achilles tendon rupture 35 Lateral malleolus bursitis 12 Foot deformity 10 Total ankle arthroplasty 3 Extensor tendon repair 9

6 Technique C-type Satisfaction analysis of Foot surface Cover from mid portion of medial longitudinal arch to metatarsal head Calf portion Cover from medial & lateral malleolus protrusion area to half of the lower leg Expose heel and distal portion of achilles tendon

$Technique K-type Indication Pilon fracture, Lateral malleolar fracture, Posterior malleolar fracture Calf$

7 Technique K-type Indication Pilon fracture, Lateral malleolar fracture, Posterior malleolar fracture Calf portion Satisfaction analysis of Cover from distal portion of achilles tendon to half of the lower leg Expose heel

8 Methods Stability evaluation Active ankle dorsiflexion & plantarflexion Passive foot inversion & eversion Passive foot internal & external rotation Clinical evaluation VAS discomfort score Compared with short leg splint (10) Reselection of heel open cast

9 Results Stability evaluation Active ankle dorsiflexion Active ankle plantarflexion Passive foot inversion & eversion Passive foot internal & external rotation Within 5 degrees Within 5 degrees Within 5 degrees 0 degrees Especially, 44 cases of foot & ankle fractures Conservative therapy in heel open cast Maintained the stability and achieved bone union in radiology

10 Results Clinical evaluation VAS discomfort score 2.9 (0~6) Reselection of heel open cast All cases All of the cases maintain the stability No complication including skin & soft tissue damage

11 Discussion Figure 8 cast(heel open short leg cast) Less discomfort than conventional short leg cast Less complication rates than conventional short leg cast Accomplishment of ankle stability Early weight bearing with heel stroke In further long-term comparative studies with a larger sample size The usefulness of the heel open short leg cast may be confirmed

12 References 1. Ahl T, Dalen N, Holmberg S, Selvik G. Early weight bearing of malleolar fractures. Acta Orthop Scand, 1986;57: Ahl T, Dalen N, Lundberg A, Bylund C. Early mobilization of operated on ankle fractures. Prospective, controlled study of 40 bimalleolar cases. Acta Orthop Scand, 1993;64: Finsen V, Saetermo R, Kibsgaard L, Farran K, Engebretsen L, Bolz KD, Benum P. Early postoperative weight-bearing and muscle activity in patients who have a fracture of the ankle. J Bone Joint Surg Am, 1989;71: Tropp H, Norlin R. Ankle performance after ankle fracture: a randomized study of early mobilization. Foot Ankle Int, 1995;16: Ahl T, Dalen N, Selvik G. Early weight bearing of displaced ankle fractures. Acta Orthop Scand, 1987;58: Ahl T, Dalen N, Selvik G. Mobilization after operation of ankle fractures. Good results of early motion and weight bearing. Acta Orthop Scand, 1988;59: Cimino W, Ichtertz D, Slabaugh P. Early mobilization of ankle fractures after open reduction and internal fixation. Clin Orthop, 1991;267: Dale PA, Bronk JT, O'Sullivan ME, Chao EY, Kelly PJ. A new concept in fracture immobilization. The application of a pressurized brace. Clin Orthop, 1993;295: Dogra AS, Rangan A. Early mobilisation versus immobilisation of surgically treated ankle fractures. Prospective randomised control trial. Injury, 1999;30: Egol KA, Dolan R, Koval KJ. Functional outcome of surgery for fractures of the ankle. A prospective, randomised comparison of management in a cast or a functional brace. J Bone Joint Surg Br, 2000;82: Godsiff SP, Trakru S, Kefer G, Maniar RN, Flanagan JP, Tuite JD. A comparative study of early motion and immediate plaster splintage after internal fixation of unstable fractures of the ankle. Injury, 1993;24: Hedstrom M, Ahl T, Dalen N. Early postoperative ankle exercise. A study of postoperative lateral malleolar fractures. Clin Orthop, 1994;300:

Surgery-Ortho. Fractures of the tibia and fibula. Management. Treatment of low energy fractures. Fifth stage. Lec-6 د.

$Surgery-Ortho. Fractures of the tibia and fibula. Management. Treatment of low energy fractures. Fifth stage. Lec-6 د.$ Fifth stage Lec-6 د. مثنى Surgery-Ortho 28/4/2016 Indirect force: (low energy) Fractures of the tibia and fibula Twisting: spiral fractures of both bones Angulatory: oblique fractures with butterfly segment.