Strategies in Trauma and Limb Reconstruction

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VOLUME 19 , ISSUE 1 ( January-April, 2024 ) > List of Articles


Do Patients Achieve “Full Weight-bearing” Immediately Following Application of Circular Frame Fixation of the Lower Limb?

Andy Craig, Elizabeth Barron, Hemant Sharma, Elizabeth Moulder

Keywords : Early ambulation, External fixators, Recovery of function, Rehabilitation, Tibial Frature, Weight-bearing

Citation Information : Craig A, Barron E, Sharma H, Moulder E. Do Patients Achieve “Full Weight-bearing” Immediately Following Application of Circular Frame Fixation of the Lower Limb?. 2024; 19 (1):40-44.

DOI: 10.5005/jp-journals-10080-1605

License: CC BY-NC 4.0

Published Online: 06-05-2024

Copyright Statement:  Copyright © 2024; The Author(s).


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), or • Treatment 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.

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