CAM boot

Disclaimer

These guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. They are not strict protocols, and they do not replace the judgement of a senior clinician. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline. 

Read the full PCH Emergency Department disclaimer.

Aim

The correct use of the Controlled Ankle Motion (CAM) boot for children with ankle fractures.

Background

CAM boots can be used for simple ankle fractures and avulsion fractures of the base of the fifth metatarsal.

Assessment

History

Fractures suitable for CAM boot use are usually sustained with inversion injuries of the ankle.

Examination

Swollen and tender lateral malleolus or base of fifth metatarsal.

Management

Patients can weight bear as tolerated whilst wearing the CAM boot.

The following fractures are suitable for CAM boot use and the follow up required.

See individual fracture guidelines for management of other fractures: lower leg, ankle joint, foot.  

 

Placeholder image

Avulsion fracture of distal fibula
  • No formal follow up required.

Salter Harris 1 fracture of fibia

Salter Harris I fracture of fibula

No formal follow up required.

Undisplaced Salter Harris 2 fracture of fibula

Undisplaced Salter Harris II fracture of fibula
  • Follow up GP 7-10 days for repeat x-ray
  • If displaced refer to Orthopaedic Fracture clinic
  • Complete GP letter to advise GP of the plan.

Undisplaced epiphyseal fracture of distal fibula
  • Follow up GP 7-10 days for repeat x-ray
  • If displaced refer to Orthopaedic Fracture clinic
  • Complete GP letter to advise GP of the plan.

 

Avulsion fracture at base of fifth metatarsal

 

Avulsion fracture of base of fifth metatarsal
  • Follow up Orthopaedic Fracture clinic 7- days
  • If fourth and fifth metatarsal joints involved (Jones Fracture) then plaster backslab is needed.

Procedure

Follow steps 1-6 to correctly apply the CAM Boot.

 

CAM boot, step 1: Measure the sole of the foot

 

1. Measure the sole of the foot and add an extra 1-2 cm.

 

CAM boot, step 2: Measure the sole of the CAM boot

 

2. Measure the sole of the CAM Boot to select the appropriate size. Open Velcro straps and remove excess padding.

 

CAM boot, step 3: Place feel firmly down the back of the CAM boot

 

3. Place the heel firmly down the back of the CAM Boot.

 

CAM boot, step 4: Place padding over the foot (if required) and fasten Velcro straps

 

4. Place padding over the foot (if required) and fasten Velcro straps.

 

CAM boot, step 5: Ensure the toes are within the firm sole of the boot

 

5. Ensure the toes are within the firm sole of the boot.

 

6. Depending on the injury:

 

  • Weight bear as tolerated
  • Partial weight bear with crutches
  • Non-weight bearing with crutches.

Management paperwork

Bibliography

  1. OSSUR Australia Prosthetics-Instructions on how to use Cam Boot
  2. Textbook of Paediatric Emergency Medicine 2nd Edition Cameron Elesevier 2012
  3. Nelson Textbook of Pediatrics: 20th Edition Robert M. Kliegman, Bonita M.D. Stanton, Joseph St. Geme, Nina F Schor Publisher: Elsevier 
 4. Place padding over the foot (if required) and fasten Velcro straps.
4. Place padding over the foot (if required) and fasten Velcro straps
4. Place padding over the foot (if required) and fasten Velcro straps

Endorsed by:  Director, Emergency Department  Date:  Aug 2017


 Review date:   Aug 2020


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