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For Immediate Release
Certain common foot fractures heal faster when treated with soft casts Speedier return to activity saves time and money
Treating a common foot fracture with cloth padding and elastic bandages rather than a hard fiberglass cast will significantly speed the recovery of most patients, according to a study released in the June issue of Foot and Ankle International. Fractures at the base of the little toe bone treated with a soft dressing recovered 40 percent faster than those treated with hard fiberglass casts.
"This is a common minor injury," explains Bradley D. Wiener, MD, Director of Sports Medicine, Catskill-Orange Orthopaedics, P.C., Ferndale, NY, and an author of this study. "It results from a forced inversion of the foot -- the sort of thing that happens when people step off a curb, misjudge the height of the sidewalk and roll outward over their ankle. Often, if the individual does not suffer a fall, they will not notice that they have done any significant damage to themselves until they realize that pain persists days later."
The study examined avulsion fractures of at the base of the little toe bone (metatarsal). An avulsion fracture is characterized by a tearing away of a part of a bone structure. In this instance the base of the metatarsal leading to the little toe is pulled away from the shaft of the toe bone.
Dr. Wiener and his co-authors randomly treated 89 avulsion fracture patients entering the emergency room at St. Vincent's Hospital in New York City, and followed up with the study group extensively during their recovery period. These patients either received an inflexible fiberglass cast or had their injuries immobilized with a soft dressing consisting of a binding layer of cloth padding, an ace bandage, another layer of cloth padding and finally another ace bandage.
Patients in this study receiving the soft cloth dressing returned to full, preinjury activity in an average of 33 days while hard cast patients took almost two weeks longer to return to full activity.
"The flexibility of the soft dressing allows the patient to make a natural return to weight bearing and mobility while still offering support and protection to the injury," explained Dr. Wiener.
During follow-up the two study groups rated their pain, recovery of function, maximum walking distance, and abnormality of gait (if any) into a "modified foot score" on a scale of 1 - 100. Patients receiving hard casts rated their overall recovery at an average 86 or "good," while those receiving soft dressings rated their recovery at an average 92 or "excellent." There was no significant difference in the occurrence of complications related to the fracture between the two groups.
Dr. Wiener was aided in the collection of data and the writing of this study by Jeffrey F. Linder, MD, and Joseph F. G. Giattini, MD.
Foot and Ankle International is the official scientific journal of the American Orthopaedic Foot and Ankle Society (AOFAS).
Dedicated to advancing research and educational objectives in foot and ankle care, the American Orthopaedic Foot and Ankle Society is the leading medical organization for orthopaedists with a special interest in foot and ankle problems.
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