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Alignment Maintenance: A Closer Look at Controlled Ankle Motion (CAM) Boots

by Calvin J. Rushing, DPM

Early weightbearing and accelerated postoperative rehabilitation programs often rely on CAM walking boots to prevent excessive motion and early complications.

The stability afforded, however, is unclear.

Original research

In their recent study “Physiologic Motion in the Intact and Unstable Syndesmosis During Plantigrade Weightbearing in Controlled Ankle Motion Boots,” Matz et. al. finally sought to shed some light on the topic.

Their cadaveric study is limited by the lack of rotational forces applied, and deltoid ligament sectioning, which has become almost standard for invitro studies involving syndesmotic disruption.

The takeaways:

  • Axial loading of the specimens did not produce excessive motion ­– even in specimens with both syndesmotic sectioning and fibular osteotomy

  • Antero-posterior motion after loading was the greatest (~3mm)

  • Medial-lateral motion after loading was the least

  • Recorded motion dropped as injury states progressed

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