Article

Wearing an external fixator for several months can be expected to profoundly
affect the ability to walk, but, in principle, full weight-bearing is possible
during corrective procedures with the Taylor Spatial Frame (TSF). The present
prospective cohort study was conducted to assess whether patients are able to
walk with or without crutches during treatment with a TSF on the lower leg.
Twenty-four patients (10 girls,
14 boys; average age 11 years, range 6-17)
scheduled for fixator surgery with osteotomies in the lower leg and foot mounting
were included. Dynamic foot loading during free walking was measured with plantar
pressure measurements. The contact area, contact time and contact pressure on the
foot plate were recorded and normalized to body weight. In the first
postoperative week, all patients needed crutches and 67% showed partial
weight-bearing. At the second measurement, about 6 weeks after surgery, 21% of
the patients could walk without crutches and 58% were partially weight-bearing
with crutches. On the day before fixator removal, 50% of the patients were fully
weight-bearing without crutches and 38% were partially weight-bearing, but 12%
could not bear any weight or were unable to walk. When a ring fixator is used to
correct lower leg deformity and prevent equinus, there is minimal risk of
complete dependence and abasia. This study shows that up to 88% of the pediatric
patients are able to walk while wearing the fixator.
Already a few days after
surgery, two-thirds of the patients were partially weight-bearing with crutches,
and only 12% needed a wheelchair and were not able to walk with the fixator.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

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