[Pa23] foot/ankle splinting/casting/boot clarification

[Gerstner, Laura R.]

HI everyone,

I understand that there is some confusion between information taught in the foot/ankle lecture and in the casting/splinting lecture & lab about when each is used.

When a posterior splint is used:  in an acute injury setting where there is swelling present - particularly with a foot or ankle fracture.  You can also place an acute ankle sprain in a posterior splint if a walking boot is not available or if significant swelling is present initially.  REMEMBER: PATIENT'S MAY NOT BEAR WEIGHT ON THESE!

When a short leg cast is used: 5-7 days after foot or ankle fracture once the swelling has gone down (and then kept on for the duration of healing).   Best in the situation where a patient will be non-weightbearing for the fracture to heal.  Casts can be made to sustain weight bearing (if allowed given the diagnosis), but they still break down quickly, even with a cast shoe.

When a walking boot is used: with a stable, nondisplaced fracture that can ultimately be weight bearing as tolerated (Weber A distal fibula fracture, dancer's fracture of the 5th metatarsal), also used with ankle sprains in patients who are initially unable to bear weight, but will be allowed to do so when pain decreases.

I hope this helps!
Mrs. G

Laura R. Gerstner, MHA, MSHS, PA-C
Associate Program Director & Associate Professor
Campbell University Physician Assistant Program
gerstnerl at campbell.edu
910-893-1252

https://apps.exxat.com/public/steps/Campbell-PA/Home

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