The Caldwell Os Calcis Brace
Ray E. King, M.D.
Fractures of the os calcis frequently require prolonged periods of nonweight hearing until sufficient callus has formed to prevent further crushing or deformity of the fractured hone. A brace was recently developed by the late Dr. Gene Caldwell, with the cooperation of Snells Limb and Brace Co. of Shrevepoit, La., which permits early ambulation following os calcis fractures. (
Fig. 1
,
Fig. 2
) This brace consists of a moulded leather calf lacer attached to double upright supports, an adjustable walking bar and a shoe with the heel and counter removed.
In designing this brace it was necessary to have a molded calf lacer instead of bands about the upper and lower calf to place the posterior calf muscles at rest and reduce tension on the achilles tendon. The foot is also placed in a moderate equinus position, which further reduces pull on the posterior aspect of the os calcis. A comfortable position can be secured by the adjustable walking bar. In making this brace, it is essential that weight hearing fall anterior to the calcaneo-cuboid joint so that no weight hearing is borne on the os calcis. The double uprights and walking bar are placed at the level of the cuboid and on weight bearing no strain is placed on the os calcis.
Approximately 100 of these os calcis braces have been used during the past 5 years. Following reduction of the fracture and as soon as soft tissue reaction has subsided, weight bearing is permitted. The fractured os calcis is protected until healing is complete, when the brace is discarded and weight bearing in a shoe is permitted. This brace has been especially advantageous in cases of bilateral fracture of the os calcis permitting full weight beating approximate!) 2 weeks after reduction of the fractures. The brace is comfortable to wear if made properly and early ambulation has been found to be a definite advantage, reducing the convalescence period following fractures of the os calcis and allowing the patient to resume his regular occupation at an earlier date.
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