Biomechanical assessment of gait in below-knee walking casts

The introduction of modern synthetic casting bandages for splinting of frac tures and soft tissue injuries has allowed the development of new casting t echniques. Casts can be constructed with a greater degree of function so th at controlled motion and stabilisation can be provided within the same cast . This study has shown that a very efficient gait can be achieved with mode rn synthetic bandages, if they are correctly applied. The authors have comp ared the gait of volunteer subjects fitted respectively with below-knee wal king casts constructed from a rigid glass fibre bandage and a flexible glas s fibre bandage which is reinforced. These casts were wrapped so that minim al amounts of bandage were used whilst appropriate strength and stiffness w as provided. The temporal and spatial factors of cast gait were not statist ically different from normal gait. The cast gait was found to be slightly m ore asymmetrical (dominant versus non-dominant leg) when a cast was worn an d there was also a greater Physiological Cost Index (PCI). The flexible ban dage has some advantages compared with the rigid bandage as normal footwear can be worn, the casts are more comfortable and they could be removed with shears, obviating the need for a power saw.