Young Darryl, Stone N Craig, Molgaard John, Durford Diane
Division of Orthopaedics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Nfld.
Can J Surg. 2003 Jun;46(3):183-6.
To compare the effectiveness of 3 common models of walking boots (Walkabout, Samson Walker and Equalizer Premium Walker) to that of a fibreglass cast in protecting an arthrodesis of the first metatarsophalangeal (MTP) joint in the early postoperative period, we carried out a biomechanical study in cadavers in the bioengineering laboratory at Memorial University of Newfoundland.
Two cadaver models of a first MTP joint arthrodesis were prepared by placing a strain gauge at the joint. This provided a measure of the bending moment across the fusion site. Walking was simulated by applying a force to the sole of the cadaver foot at multiple positions from heel to toe, representing the stages of gait from heel strike to toe off.
For both cadaver specimens, the Walkabout boot had the lowest mean moment. The Walkabout and Sampson Walker boots were better than the Equalizer Premium Walker boot and the fibreglass cast (p < 0.05), but the Walkabout boot was the best (p < 0.05). Also, for both specimens, the Walkabout boot had the smallest absolute maximum moment (p < 0.05).
On a first MTP joint arthrodesis site, removable cast boots provide the same, if not more, reduction of force as a traditional cast.
为比较3种常见步行靴（Walkabout、Samson Walker和Equalizer Premium Walker）与玻璃纤维石膏在术后早期保护第一跖趾（MTP）关节融合方面的有效性，我们在纽芬兰纪念大学生物工程实验室对尸体进行了一项生物力学研究。
通过在关节处放置应变仪，制备了两个第一MTP关节融合的尸体模型。这提供了融合部位弯矩的测量值。通过在尸体脚底从脚跟到脚趾的多个位置施加力来模拟行走，代表从脚跟触地到脚趾离地的步态阶段。
对于两个尸体标本，Walkabout步行靴的平均弯矩最低。Walkabout和Sampson Walker步行靴优于Equalizer Premium Walker步行靴和玻璃纤维石膏（p < 0.05），但Walkabout步行靴最佳（p < 0.05）。此外，对于两个标本，Walkabout步行靴的绝对最大弯矩最小（p < 0.05）。
在第一MTP关节融合部位，可移除的石膏靴即使不能提供更多的力的减少，也能提供与传统石膏相同的效果。
