Biomechanical assessment of gait in below-knee walking casts

The introduction of modern synthetic casting bandages for splinting of fractures and soft tissue injuries has allowed the development of new casting techniques. Casts can be constructed with a greater degree of function so that controlled motion and stabilisation can be provided within the same cast. This study has shown that a very efficient gait can be achieved with modern synthetic bandages, if they are correctly applied. The authors have compared the gait of volunteer subjects fitted respectively with below-knee walking casts constructed from a rigid glass fibre bandage and a flexible glass fibre bandage which is reinforced. These casts were wrapped so that minimal amounts of bandage were used whilst appropriate strength and stiffness was provided. The temporal and spatial factors of cast gait were not statistically different from normal gait. The cast gait was found to be slightly more asymmetrical (dominant versus non-dominant leg) when a cast was worn and there was also a greater Physiological Cost Index (PCI). The flexible bandage has some advantages compared with the rigid bandage as normal footwear can be worn, the casts are more comfortable and they could be removed with shears, obviating the need for a power saw.