Andy Craig, Elizabeth Barron, Hemant Sharma, Elizabeth Moulder
{"title":"Do Patients Achieve \"Full Weight-bearing\" Immediately Following Application of Circular Frame Fixation of the Lower Limb?","authors":"Andy Craig, Elizabeth Barron, Hemant Sharma, Elizabeth Moulder","doi":"10.5005/jp-journals-10080-1605","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The decision to use circular frame fixation for lower limb trauma, or elective deformity correction, often accompanies the assertion that the patient will be able to fully weight-bear through the limb immediately following surgery.</p><p><strong>Materials and methods: </strong>About 53 patients underwent retrospective review. Included in the study were current attendees of adult specialist physiotherapy, following circular frame application to the lower leg at our Institution between August 2018 and January 2020. Cases with incomplete data, cases given postoperative status of non-weight-bearing, those with physiotherapy follow-up conducted elsewhere, or cases of polytrauma were excluded from the study.Weight-bearing assessment and rehabilitation supervision were at the discretion of the physiotherapy team. The clinical concept of 'full weight-bearing' is poorly defined, but was documented in the context of displaying a stable gait using elbow crutches and subsequently without walking aids. Comparative data was analysed using an unpaired, two-tailed Welch's <i>t</i>-test.</p><p><strong>Results: </strong>Mean postoperative time to full weight-bearing using crutches was 28.3 days (0-159) (<i>n</i> = 40).Mean postoperative time to independent full weight-bearing with no walking aids was 230.6 days (35-393), or 7.1 months (0-12) (<i>n</i>= 34).No significant differences were seen between:Frames for open injuries (<i>n</i>= 5) vs closed injuries (<i>n</i> = 17; <i>p</i> > 0.4).Joint-spanning constructs (<i>n</i>= 18) vs non-spanning constructs (<i>n</i> = 21; <i>p</i> > 0.6), orTreatment of intra-articular injuries (<i>n</i> = 14) vs extra-articular injuries (<i>n</i> = 17; <i>p</i> > 0.2).Interpretation of these results should be made with caution due to sample size.</p><p><strong>Conclusion: </strong>The ability to permit patients to fully weight-bear immediately after surgery is often a distinct advantage of the circular frame over other fixation modalities, for a variety of indications. However, it does not follow that patients are capable of doing so; there is a long dependency on walking aids. This would appear to be the case irrespective of open/closed injuries, intra-/extra-articular injuries, or the use of a spanning construct across the knee or ankle.</p><p><strong>How to cite this article: </strong>Craig A, Barron E, Sharma H, <i>et al</i>. Do Patients Achieve \"Full Weight-bearing\" Immediately Following Application of Circular Frame Fixation of the Lower Limb? Strategies Trauma Limb Reconstr 2024;19(1):40-44.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"19 1","pages":"40-44"},"PeriodicalIF":1.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091893/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Strategies in Trauma and Limb Reconstruction","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-10080-1605","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The decision to use circular frame fixation for lower limb trauma, or elective deformity correction, often accompanies the assertion that the patient will be able to fully weight-bear through the limb immediately following surgery.
Materials and methods: About 53 patients underwent retrospective review. Included in the study were current attendees of adult specialist physiotherapy, following circular frame application to the lower leg at our Institution between August 2018 and January 2020. Cases with incomplete data, cases given postoperative status of non-weight-bearing, those with physiotherapy follow-up conducted elsewhere, or cases of polytrauma were excluded from the study.Weight-bearing assessment and rehabilitation supervision were at the discretion of the physiotherapy team. The clinical concept of 'full weight-bearing' is poorly defined, but was documented in the context of displaying a stable gait using elbow crutches and subsequently without walking aids. Comparative data was analysed using an unpaired, two-tailed Welch's t-test.
Results: Mean postoperative time to full weight-bearing using crutches was 28.3 days (0-159) (n = 40).Mean postoperative time to independent full weight-bearing with no walking aids was 230.6 days (35-393), or 7.1 months (0-12) (n= 34).No significant differences were seen between:Frames for open injuries (n= 5) vs closed injuries (n = 17; p > 0.4).Joint-spanning constructs (n= 18) vs non-spanning constructs (n = 21; p > 0.6), orTreatment of intra-articular injuries (n = 14) vs extra-articular injuries (n = 17; p > 0.2).Interpretation of these results should be made with caution due to sample size.
Conclusion: The ability to permit patients to fully weight-bear immediately after surgery is often a distinct advantage of the circular frame over other fixation modalities, for a variety of indications. However, it does not follow that patients are capable of doing so; there is a long dependency on walking aids. This would appear to be the case irrespective of open/closed injuries, intra-/extra-articular injuries, or the use of a spanning construct across the knee or ankle.
How to cite this article: Craig A, Barron E, Sharma H, et al. Do Patients Achieve "Full Weight-bearing" Immediately Following Application of Circular Frame Fixation of the Lower Limb? Strategies Trauma Limb Reconstr 2024;19(1):40-44.
期刊介绍：
Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
