British Casting Certificate
Registered Orthopaedic Technologist & Master Caster (USA)
Senior Orthopaedic Practitioner Royal Glamorgan Hospital
Originally Printed by: www.orthopaedicandtraumatimes.co.uk 25
About the Author:
Dave Parker, Senior Orthopaedic Practitioner at the Royal Glamorgan Hospital near Cardiff, discusses the advantages to patients that he has found in the use of a hands-free crutch system, invented and pioneered in Canada and now available in the UK. He also outlines the clinical research that has been carried out that supports his anecdotal experience with evidence that the use of the iWALKfree crutch can significantly improve patient mobility and reduce hospital stays.
One of the biggest challenges facing patients following an injury to the foot or ankle is keeping the weight off their affected leg while it heals. While patients generally appreciate that failure to do so can exacerbate the injury and impede their recovery, abiding by this requirement is often much more difficult in practice. Some of the problem is lifestyle-related: the patient may be used to leading an active life, have family commitments that require them to get around or be under pressure to get back to work. As a result, patients will often plead for a reduced time Non-weight- bearing (NWB) or Partial-weight-bearing (PWB) in the belief that they simply will not be able to survive for weeks without walking. Even for those patients that take a more stoical view, the reality of coping with their reduced mobility can cause issues with their recovery. The conventional approach to providing a level of mobility whilst avoiding putting weight on the affected lower leg by providing crutches can prove awkward and painful for many patients and offers only limited mobility, particularly on stairs. This sometimes causes the patient to ‘cheat’ by putting weight on the affected limb from time to time or discarding their crutches before the required period outlined by their Consultant/practitioner.
Furthermore, even for patients that do not fall into this category, conventional crutches do not preclude the user from putting weight on the injury if they are struggling to balance or impatient to get around. For NWB and PWB patients that have also suffered an upperbody or upper limb injury or have some weakness, conventional elbow crutches are not suitable at all. Not only is the resulting lack of mobility frustrating for the patient, it may also result in a prolonged hospital stay, which is a drain on resources and may even affect the patient’s feelings of well-being, and in turn, hold back their recovery. It has not been often in my 25 years of orthopedic practice thatI have come across a device that is straightforward in its concept, simple in its construction and use and yet proves so effective. I love smart, well thought out design, and the iWALKfree hands-free crutch seemed to tick all of the above boxes. Therefore, I decided to take a closer look at it.
I first became aware of it from a patient who demonstrated remarkable freedom when mobilizing with an injury treated in a below knee cast in our hospital. The device is designed to strap securely to the patient’s thigh and is fully adjustable to suit their individual requirements. Fabricated from lightweight polymer material with an extruded aluminum main beam, it has a platform to support the leg, transmitting the patient’s weight from the knee to the crutch. This robust and adjustable design means that it is suitable for almost any NWB or PWB patient, even if they also have upper-body injuries. Within a short space of time, most find that they can balance well on the crutch and are able to walk, go up and down stairs and even sit down without removing the device, giving them much more normal mobility. In brief, it means that they can, for the most part, get on with life while being NWB, thus their injuries heal which speeds up their recovery by improving their feelings of well-being. The hands-free crutch allows the injured lower leg to be rested on a molded shelf and strapped into position. This means that the device actively ensures that patients follow their NWB instruction and do not set back their recovery putting weight on the affected leg.
Please click here for the complete version of Dr. Parker’s research and references.