From the Research
The recommended duration for wearing an airboot (air cast boot) for a small avulsion fracture on the lateral edge of the 1st proximal metatarsal is typically 6-8 weeks, as this timeframe allows for optimal bone healing and minimizes the risk of complications, as suggested by the most recent and highest quality study available 1.
Key Considerations
- The healing process for avulsion fractures can be unpredictable, and the duration of airboot wear may need to be adjusted based on individual patient factors and fracture severity.
- It is essential to follow the RICE protocol (Rest, Ice, Compression, Elevation) and take over-the-counter pain medications like acetaminophen or ibuprofen as needed for pain management.
- Gradual weight-bearing as tolerated is often recommended, but it is crucial to follow the healthcare provider's specific instructions.
- After the boot period, physical therapy exercises to restore strength and range of motion are typically recommended for 2-4 weeks to ensure complete functional recovery.
Evidence-Based Recommendations
- A study published in 2020 compared the use of a CAM-walker boot and a hard-soled shoe for treating zone 1 fractures of the proximal fifth metatarsal, finding that the CAM-walker boot resulted in faster bone healing 1.
- Another study from 2013 found that patients treated with a walking boot had improved pain and function outcomes compared to those treated with a short-leg cast 2.
- While these studies focused on fractures of the fifth metatarsal, the principles of treatment can be applied to avulsion fractures of the first metatarsal, as both require careful management to promote optimal healing and minimize complications.
Clinical Decision-Making
- The decision to use an airboot for a small avulsion fracture on the lateral edge of the 1st proximal metatarsal should be based on a thorough evaluation of the patient's overall health, fracture severity, and individual needs.
- Healthcare providers should consider the most recent and highest quality evidence available when making treatment decisions, as well as their own clinical experience and expertise.
- Regular follow-up appointments and monitoring of the patient's progress are essential to ensure optimal outcomes and adjust the treatment plan as needed.