Paediatric Acute care Guidelines PMH Emergency Department

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 table lists the fractures suitable for CAM boot use and the follow up required.

Fracture X-Ray Follow up
Avulsion fracture of distal fibula   

Avulsion of distal fibula

No formal follow up required
Salter Harris I fracture of fibula  

Salter Harris I fracture of fibula

No formal follow up required
Undisplaced Salter Harris II fracture of fibula  

Salter Harris II fracture of distal fibula

Follow up GP 7-10 days for repeat X-Ray. If displaced, refer to Orthopaedic Fracture clinic.
Undisplaced epiphyseal fracture of distal fibula  

Undisplaced epiphyseal fracture of fibula

Follow up GP in 7-10 days for repeat X-Ray. If displaced, refer to Orthopaedic Fracture Clinic

 

Avulsion fracture of base of fifth metatarsal

If 4th and 5th metatarsal joint involved
(Jones Fracture)  – then needs plaster backslab)

 

Avulsion fracture of base of 5th metatarsal

Follow up Orthopaedic Fracture Clinic 7 days.

CAM Boot Application 

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

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

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3. Place the heel firmly down in the back of the CAM boot

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

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

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6. Depending on the injury: 

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

Management paperwork

CAM Boot Information GP letter

 

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