Mobile cast vs Rigid below-knee cast

I’ve been doing some research on the internet and came across some information of different types of casts that can be used with and Achilles Rupture. Has anyone used the Mobile cast and if so how did that work. I’m going to ask my doctor tomorrow because my splint comes off and a cast goes on. Here is the study in a nutshell below:

Cetti R. Henriksen LO. Jacobsen KS. Clinical Orthopaedics & Related Research. (308):155-65, 1994 Nov. Sixty patients with acute rupture of the Achilles tendon were included in a prospective study and assigned randomly for operative treatment using a Á 4-string suture with either a new mobile cast (30) or a rigid below-knee  cast (30). All patients were evaluated clinically for 1 year after surgery. During surgery, a radiographic monitor was placed in the Achilles tendon above and beneath the site of rupture. Radiographic evaluation of tendon behavior during healing was also performed on all patients for 1 year. Major complications were 1 rerupture in the mobile cast group and 2 reruptures and 1 infection in the rigid cast group. There were fewer minor complications in the mobile cast group. More patients in the mobile cast group resumed sports activities at the same level as before the rupture than in the rigid cast group. They also had better recovery of normal ankle movement plus faster and better recovery of plantar flexion strength. Fewer patients in the mobile cast group had calf atrophy, and * fewer had problems 1 year after the accident. Furthermore, patients treated with the mobile cast had a statistically significant shorter sick leave. Radiographic evaluation of the tendon monitor showed significantly Á less elongation of the tendon 1 year after rupture for patients in the mobile cast group. Operative treatment with a 4-string suture and use of a postoperative mobile cast proved safe and convenient and preferable to treatment with the traditional rigid below-knee cast. *

7 Responses to “Mobile cast vs Rigid below-knee cast”

  1. What is this ‘mobile cast’? Is it this infamous boot?

  2. The general rule in such studies is that the more aggressive rehabs have better recoveries, despite the common intuition that more cautious = safer. Of course, there is a limit to how aggressive you can be, but I suspect most ortho docs are nowhere near that point yet.


  3. Yes, it’s the boot.

  4. I don’t know if you’ll find a difference unless you’re unlucky enough to have this experience twice but Doug is carrying a significant amount of ‘right’ in his post. No matter which route you end up choosing just make sure you keep the blood flowing.

    My personal experience was splint/cast/boot and I don’t think i could have slept in the boot, the splint was bay far the most comfortable but the cast was way lighter.

  5. Having been a regular readre of this site for a few months now, I had started to suspect that the typical UK NHS approach was a bit on the old fashioned side, and the results of this study seem to support that view. Maybe it’s a funding thing? Casts cost about £40 each (that’s what the plaster room lady told me). So if I have, say, 4 of those that’s £160 which I suspect is rather less that the cost of a boot. You’d think the boots would be reusable, but apparently they’re not. I might wave this report under the nose of my orthopaedic surgeon friend and see what he thinks. Doctors must hate the internet - all their patients know far too much these days!

  6. smoley

    In Ontario the costs of the fibergalss casts were around $25 per, though covered by our provincial insurance.
    The aircast was partially covered, costing me $125 but I delayed my payment long enough to get a new bill from the hospital and they included the non-discounted cost on the form: $1250.
    The Aircast at least is reuseable, its just not returnable. Hygeine they say - I suppose it isn’t all that different from wearing someone else’s sock that they’ve worn for 6 weeks and couldn’t wash…

  7. assumptiodenied, I am shocked! I am in Ontario too, but had to pay 80$ for each fibreglass cast!!! Now explain me that. It depends on the hospital? I guess Toronto is better subsidized than surrounding small towns?? Is it not the same OHIP plan?

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