Ready Lauren V, Fisk Erica G, Ciurylo William, Chiodo Christopher P, Bluman Eric M, Smith Jeremy T
Department of Orthopaedic Surgery (Ms. Ready), Brigham and Women's Hospital, Brown University; the Department of Orthopaedic Surgery (Dr. Fisk), Brigham and Women's Hospital, OrthoNorCal; the Department of Orthopaedic Surgery (Mr. Ciurylo), Brigham and Women's Hospital, University of New England; and the Department of Orthopaedic Surgery (Dr. Chiodo, Dr. Bluman, and Dr. Smith), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
J Am Acad Orthop Surg Glob Res Rev. 2018 Nov 27;2(12):e044. doi: 10.5435/JAAOSGlobal-D-18-00044. eCollection 2018 Dec.
Controlled ankle movement (CAM) walker boots may cause gait alterations and leg-length discrepancy. This study evaluates secondary site pain relating to immobilization in a CAM walker boot.
Patients wearing a CAM walker boot were prospectively enrolled and evaluated for new or worsened secondary site pain. Surveys at four time points were completed to evaluate secondary site pain severity and its effect on function.
The study included 46 patients (mean age, 49 years). At transition out of the boot (mean, 4.2 weeks), 31 patients (67%) reported pain which was new or worse than at baseline. The sites most susceptible to pain were lower back, contralateral hip, and ipsilateral knee. Most pains (84%) began within the first 2 weeks of boot wear. Secondary site pain was less common after transition out of the boot: 18 patients (39%) at 1 month and 15 patients (33%) at 3 months.
Secondary site pain after CAM walker boot wear is common. The frequency and severity of pain lessened after transition out of the boot. Yet, one-third of patients still had new or worsened secondary site pain 3 months after cessation of boot wear.
可控踝关节活动（CAM）步行靴可能会导致步态改变和腿长差异。本研究评估与CAM步行靴固定相关的继发部位疼痛。
前瞻性纳入穿着CAM步行靴的患者，并评估新出现的或加重的继发部位疼痛。在四个时间点完成调查，以评估继发部位疼痛的严重程度及其对功能的影响。
该研究纳入了46例患者（平均年龄49岁）。在脱靴时（平均4.2周），31例患者（67%）报告有新出现的疼痛或比基线时更严重的疼痛。最易出现疼痛的部位是下背部、对侧髋部和同侧膝盖。大多数疼痛（84%）在穿着步行靴的前2周内开始出现。脱靴后继发部位疼痛不太常见：1个月时为18例患者（39%），3个月时为15例患者（33%）。
穿着CAM步行靴后继发部位疼痛很常见。脱靴后疼痛的频率和严重程度有所减轻。然而，三分之一的患者在停止穿靴3个月后仍有新出现的或加重的继发部位疼痛。
