Ankle fractures, even if treated surgically, usually take a long time to heal. For all patients with ankle fracture, immobilisation is a critical part of treatment. Short-leg walking boots (WBs) have been reported to be an effective alternative to plaster casts (PCs) that could shorten this postoperative recuperative period. The aim of this study was to compare the functional recovery of a conventional PC with that of a WB after surgery for ankle fractures.


Forty-seven patients (mean age, 53.9 ± 12 years) who had undergone surgical operation for an unstable ankle fracture from January 2008 to October 2014 were reviewed retrospectively. Either a PC or a WB was prescribed postoperatively, with 25 patients and 22 patients, respectively. The time that it took the patient to stand unipedal on the affected side after allowing full-weight bear and to walk without crutches were used for assessment of functional recovery. The prevalence of postoperative loss of reduction and nonunion was also reviewed.


Both the time of being able to stand unipedal on the injured side and to walk without crutches were significantly shorter in patients using WBs (WB, 2.6 weeks; PC, 4.5 weeks, p = 0.01; WB, 1.4 weeks; PC, 3.1 weeks, p = 0.03). There were no patients with loss of reduction or nonunion.


Patients who used WBs showed a significantly faster recovery. WBs have an adjustable heel lift that allows users to change the ankle position slightly plantarflexed that helps walking in a postoperative swollen ankle. WBs are easy to slip on, and it is easy to adjust the ankle position in conformity with swelling so that the least painful position could be maintained during walking. WBs have good fixity to allow immediate weight-bearing postoperatively, and there were no cases with loss of reduction postoperatively. The Rocker bottom design minimises the sagittal plane motion in the specific joint of the foot, which also facilitates the course of recuperation. An ankle fracture fixed appropriately endures loading when a WB is used. The WB treatment results in faster functional recovery, allowing the patients to return to normal activity at a faster rate.

Original article can be found at: https://www.sciencedirect.com/science/article/pii/S2214687316302679

Universal Hinged Knee Brace

Advanced Orthopedics

Anne Walmsley, National Director of Sales

HC: Tell us about what products Advanced Orthopaedics offers to the orthopedic softgoods industry.
WALMSLEY: Advanced Orthopaedics manufactures high-quality orthopedic braces, supports and other non-invasive orthotic rehabilitation products designed to meet the needs of a wide variety of customers.

HC: What upcoming trends to you see for the orthopedic softgoods/O&P industry? How is technology changing the market?
WALMSLEY: Retail sales are emerging as a front-runner of all industry sales channels, and I believe we will see that continue to grow. Changes in reimbursement, consolidation of providers and a growing consumer market seeking products and services outside of the physician’s office are resulting in a much higher demand for high quality cash and carry products, including orthopedic bracing.

HC: Do you expect to see any major changes in the market in 2016 or in the future?
WALMSLEY: Although we have seen a tremendous increase in audits, reimbursement has remained stable. I believe that will change very soon. The split codes for custom and off-the-shelf bracing have been published for over two years with no change in reimbursement between the two. It is expected that CMS will announce a fee schedule change for the off-the-shelf codes in the near future.

How does you company plan to stay competitive in 2016?
WALMSLEY: Providing alternative revenue streams such as retail sales opportunities or reducing the amount of inventory needed by expanding our universal product offering are two examples of concrete ways Advanced Orthopedics is poised to assist our customers in this highly competitive and ever-changing landscape.

How can HME providers adapt to remain competitive?
WALMSLEY: To survive these turbulent times I believe that HME providers must be willing to reinvent themselves. Changes in marketing strategy, such as working with primary care physicians to drive off-the-shelf bracing orders, diversified revenue stream via retail sales and alternative channels such as on-line sales can impact the bottom line quickly.