A prospective study comparing attempted weight bearing in fiberglass below-knee casts and prefabricated pneumatic...

Partial weight bearing is commonly advised after fracture of the lower extremity. Research has determined this to be inaccurate both in its instruction and its reproducibility. Many trauma departments are commonly using alternatives to plaster in the splintage of fractures, such as fiberglass and the prefabricated pneumatic braces. This study's null hypothesis is that there is no difference between partial weight bearing through a fiberglass cast as compared with a pneumatic walker. A prospective study was conducted in our department including all patients who had metatarsal or ankle fractures and could partially weight bear. Patients were excluded if they were not allowed to bear weight, had received operative fixation of their fracture, or were younger than age 16 years. The patients' total weight was measured first, and then they were trained to place 50% of their weight through the splinted limb. Three measurements were taken of their attempted weight bearing at 50%, and they were blinded to the results. Over a 16-month period, 117 patients were enrolled for this study: 72 in the pneumatic walker group and 45 in the fiberglass group. There was no significant difference in sex, age, or fracture type. There was a significant difference in percentage of weight placed through the splinted limb, with the pneumatic brace group placing much greater force than the fiberglass group. This may have been caused by altered proprioception from the walker. It is important to realize this when prescribing partial weight bearing in a particular splint as this may result in avoidable complications.