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DOES THE USE OF AN AIRCAST WALKER BOOT FOLLOWING OPERATIVE FIXATION OF ANKLE FRACTURES ALLOW FOR EARLY PATIENT DISCHARGE?

Sandwell and City NHS Trust, Sandwell General Hospital, Birmingham, UK

Introduction: The use of an Aircast walking boot following operative fixation of ankle fractures has been shown to significantly improve early patient comfort, post-fracture swelling and time to full rehabilitation. However, the practical implications and in particular the financial impact of this orthosis has not been assessed. The current study, therefore, aims to determine whether use of the removable splint following operative fixation provides an economically viable alternative to the standard below knee cast.

Materials and methods: Between May 2006 and January 2007 those patients who underwent operative ankle fixation and who were treated postoperatively with the use of an Aircast walker were identified. A group of age-matched controls were used for comparison. Demographic details and postoperative outcomes including postoperative stay were obtained from the hospital notes and computer records.

Results: 12 patients were treated with an Aircast boot during the study period. The mean age of the study group was 43.6 years compared to 43.3 years in the control group. Operative fixation was carried out within 0.83 days and 0.92 days respectively. Patients in the Aircast group were discharged within a mean period of 2.92 days following surgery compared to 3.58 days in the control group.

Conclusions: The current study demonstrates that the use of an Aircast walker boot in the postoperative period is clinically comparable to the standard below knee cast. In particular, the orthosis also enables patients to be discharged home earlier, which has positive implications both for patient recovery and the overall cost of treatment.

Correspondence should be addressed to Mr Bimal Singh, c/o BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE