Abstract
Conservative “functional” management of acute Achilles tendon ruptures has become
increasingly popular. Critical to this is the use of the walking orthosis, which positions
the ankle in equinus to allow for early weightbearing. Our aim was to test whether
2 common orthoses achieved a satisfactory equinus position. A total of 11 sequentially
treated Achilles tendon ruptures were assigned to either a fixed angle walking boot
with wedges (FAWW) or an adjustable external equinus-corrected brace (EEB). The lateral
radiographs of the cast immobilized tendons showed a mean tibiotalar angle (TTA) of
56° (range 54° to 57°) and a mean tibio-first metatarsal angle (1MTA) of 74° (range
62° to 85°). The FAWW resulted in a mean TTA of 28° (range 15° to 35°) and 1MTA of
37° (range 30° to 45°). The EEB resulted in a TTA of 48° (range 43° to 45°) and 1MTA
of 54° (range 47° to 57°). Ankle equinus was significantly greater with the EEB than
with the FAWW (p < .05) and similar to that with an equinus cast. The use of wedges produced an equinus
appearance through the midfoot but not at the ankle. We express caution in the use
of the FAWW because it is unlikely to achieve sufficient ankle equinus to shorten
the Achilles tendon.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
