Alternative Mobilization by Means of a Novel Orthesis in Patients after AmputationArticle in several languages: English | deutsch
04 June 2019 (online)
Introduction The mobilization of patients with diabetic foot syndrome after surgical treatment by debridement or partial amputation is usually difficult in daily practice and in inpatient care.
Aim and Method A case report – with a representative case showing the innovative possibilities of an alternative mobilization option by means of a new orthesis (“iWALK 2.0®”; IWALKFree® Inc., Mansfield, Ontario, Canada) after surgical therapy of diabetic gangrene, exemplified by the successful clinical course.
Results The inpatient admission of a 59-year-old male patient revealed septic gangrene of the right foot in insulin-dependent diabetes mellitus. After admission and initial diagnosis, the calculated antibiotics therapy and initial surgical rehabilitation of the right foot took place. After stabilization and control of the infection, the minor amputation was performed at the Bona-Jäger line without primary wound closure, wound care was provided by vacuum sealing. Complicated by pre-existing peroneal paralysis of the contralateral leg following herniated disc, mobilization could be accomplished out of the wheelchair using a novel “free-hand” orthesis “iWALK 2.0” and a walker with physiotherapeutic support. Thus, while simultaneously relieving the operated foot, self-sufficient mobilization at a later time was possible. This gave the patient a positive attitude to life in addition to more independence.
Conclusion The successful application of the “free-hand” site “iWALK 2.0” under the listed clinical constellation thus suggests that it is a clear alternative of “postoperative rehabilitation” in the diagnosis of a surgically treated diabetic foot gangrene after minor amputation with a consolidated wound while ultimately serving to achieve a more comprehensive level of experience for targeted use with a clearly defined indication.
- 1 Bause P, Schmieg H, Suren EG. Der Heilbronner Abrollschuh – Eine neuartige Vorfußentlastungsorthese nach biomechanischen Grundlagen. Orthopädie 2001; 30: 251-255
- 2 Starrost K, Lotze M. Folgen von Bettruhe und Immobilisation. Neuroreha 2015; 7: 105-108
- 3 Stumpf J. Schuhversorgung des diabetischen Fußes – State of the art. Diabetologe 2006; 2: 39-45
- 4 Philbin TM, Leyes M, Sferra JJ. et al. Orthotic and prosthetic devices in partial foot amputations. Foot Ankle Clin 2001; 6: 215-228
- 5 Janisse DJ, Janisse EJ. Shoes, orthoses, and prostheses for partial foot amputation and diabetic foot infection. Foot Ankle Clin 2010; 15: 509-523
- 6 Rambani R, Shahid MS, Goyal S. The use of a hands-free crutch in patients with musculoskeletal injuries: randomized control trial. Int J Rehabil Res 2007; 30: 357-359