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Satisfaction Analysis of Figure 8 (Open Heel) Short Leg Casts

March 01, 2019

Contributors: Dong Yeol Kim, MD; Gisoo Lee; Jeong-Kil Lee, MD; Gangwon Seo; Chan Kang, MD; Chan Kang, MD

This video reports the results of figure 8 (open heel) short leg casts in patients with foot and ankle trauma or disease who required a short leg cast. The study included 508 patients with foot and ankle trauma or disease who were treated between November 2014 and July 2017. Of the 508 patients, 287 were men and 221 were women, with a mean age of 46.3 years (range, 18 to 86 years). The study included 236 patients with a foot and ankle fracture, 92 patients with chronic ankle instability, 48 patients with a distal tibia fracture, 35 patients with Achilles tendon rupture, 20 patients who underwent ankle and subtalar fusion, 15 patients with accessory navicular syndrome, 13 patients with an osteochondral lesion of the talus, 12 patients with lateral malleolar bursitis, 10 patients with an ankle sprain, 10 patients with a foot deformity, 9 patients who underwent extensor tendon repair, 5 patients with peroneal tendon subluxation, and 3 patients who underwent total ankle arthroplasty. The bottom portion of the figure 8 cast covered from the metatarsal head to the midportion of the medial longitudinal arch, and the leg portion of the figure 8 cast covered from the prominence of the malleoli to halfway up the lower leg, resulting in complete exposure of the heel and the distal portion of the Achilles tendon. After application of the figure 8 cast, changes in active ankle dorsiflexion/plantarflexion, passive foot inversion/eversion, and foot internal/external rotation were measured. Patient satisfaction with the figure 8 cast was investigated using a visual analog scale discomfort score ranging from 1 to 10, with 10 representing discomfort comparable to that of a postoperative short leg splint. In addition, patient selection for future use of a figure 8 cast was noted. In all of the patients, active ankle dorsiflexion/plantarflexion was less than 5°, passive foot inversion/eversion was less than 5°, foot internal/external rotation was less than 0°, and the foot and ankle were held stable without skin or soft-tissue injury until cast removal. Of the 236 patients with a foot and ankle fracture, bone union and stabilization occurred in 22 patients who underwent nonsurgical treatment with the use of a figure 8 short leg cast. The mean visual analog scale discomfort score of the figure 8 short leg cast was 2.6 (range, 0 to 5), and a figure 8 short leg cast was used in all of the patients who required a short leg cast. The use of a figure 8 short leg cast in patients with foot and ankle trauma or disease who require a short leg cast is safe, prevents skin necrosis and pressure sores, and is associated with high patient satisfaction in daily activities, such as heel-touch weight-bearing. We believe that the figure 8 short leg cast can replace the traditional short leg cast if the safety of the figure 8 cast is proven in long-term follow-up studies that include a variety of patients.

Results for "Foot & Ankle"

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