- Volume 22 Issue 3
DOI QR Code
Efficacy of a Knee Walker for Foot and Ankle Patients: Comparative Study with an Axillary Crutch
족부 족관절 환자에서 Knee Walker의 유용성: 액와 목발(Axillary Crutch)과의 비교 연구
- Song, Jae Hwang (Department of Orthopedic Surgery, Konyang University School of Medicine) ;
- Kang, Chan (Department of Orthopedic Surgery, Chungnam National University School of Medicine) ;
- Kim, Sang Bum (Department of Orthopedic Surgery, Konyang University School of Medicine) ;
- Heo, Youn Moo (Department of Orthopedic Surgery, Konyang University School of Medicine) ;
- Won, You Gun (Department of Orthopedic Surgery, Konyang University School of Medicine) ;
- Jung, Sang Jin (Department of Orthopedic Surgery, Konyang University School of Medicine) ;
- Chung, Hyung Jin (Department of Orthopedic Surgery, Chungnam National University School of Medicine)
- 송재황 (건양대학교 의과대학 정형외과학교실) ;
- 강찬 (충남대학교 의과대학 정형외과학교실) ;
- 김상범 (건양대학교 의과대학 정형외과학교실) ;
- 허윤무 (건양대학교 의과대학 정형외과학교실) ;
- 원유건 (건양대학교 의과대학 정형외과학교실) ;
- 정상진 (건양대학교 의과대학 정형외과학교실) ;
- 정형진 (충남대학교 의과대학 정형외과학교실)
- Received : 2018.07.30
- Accepted : 2018.09.10
- Published : 2018.09.15
Purpose: An axillary crutch is the most commonly used assistive device in foot and ankle patients who require nonweightbearing. On the other hand, its use frequently induces axillary or wrist pain and critical neurovascular injuries have been reported in several studies. This study compared the clinical outcomes of patients using the knee walker and axillary crutch. Materials and Methods: A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a nonweightbearing ambulatory aid for 62 foot and ankle patients treated between November 2016 and March 2018. A comparative study of the two orthosis could be performed because all the patients temporarily used an axillary crutch before or after the use of a knee walker. A demographic study and comparative analysis based on the visual analogue scale (VAS) satisfaction score (0~100), complications, and fall down history were evaluated. Furthermore, under the assumption of having retreatment, their preference of orthosis between the knee walker and axillary crutch was investigated. Results: The mean age of the patients was 36.5 and the mean duration of ambulation with a knee walker and axillary crutch were 5.2 and 2.4 weeks. The VAS satisfaction score of the knee walker and crutch was 88.8 and 27.5, respectively (p<0.05). The most frequent complications of the knee walker and crutch were ipsilateral knee pain (6 cases) and axillary or wrist pain (56 cases), respectively. No case of falling down occurred during knee walker ambulation, but there were two cases of crutch ambulation. Fifty-eight patients (93.5%) preferred the knee walker and four patients (6.5%) preferred a crutch. Conclusion: Compared to the axillary crutch, the knee walker afforded lower complication and higher satisfaction. Most patients preferred the knee walker to a crutch. Therefore, the knee walker is an efficient and safe orthosis for foot and ankle patients who require nonweightbearing.
- ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the sixminute walk test. Am J Respir Crit Care Med. 2002;166:111-7. https://doi.org/10.1164/ajrccm.166.1.at1102
- VanSwearingen JM, Brach JS. Making geriatric assessment work: selecting useful measures. Phys Ther. 2001;81:1233-52.
- Faruqui SR, Jaeblon T. Ambulatory assistive devices in orthopaedics: uses and modifications. J Am Acad Orthop Surg. 2010;18:41-50. https://doi.org/10.5435/00124635-201001000-00006
- Russell JN, Hendershot GE, LeClere F, Howie LJ, Adler M. Trends and differential use of assistive technology devices: United States, 1994. Adv Data. 1997;(292):1-9.
- Ogunlusi JD, Davids T, Edward S, Codrington K, Fausette G. Bilateral wrist drop complicating axillary crutches mobilization in a young adult. West Indian Med J. 2013;62:548-51.
- Raikin S, Froimson MI. Bilateral brachial plexus compressive neuropathy (crutch palsy). J Orthop Trauma. 1997;11:136-8. https://doi.org/10.1097/00005131-199702000-00014
- Malkan DH. Bilateral ulnar neuropraxia: a complication of elbow crutches. Injury. 1992;23:426. https://doi.org/10.1016/0020-1383(92)90028-Q
- Poddar SB, Gitelis S, Heydemann PT, Piasecki P. Bilateral predominant radial nerve crutch palsy: a case report. Clin Orthop Relat Res. 1993;(297):245-6.
- Murphy MT, Journeaux SF. Case reports: long thoracic nerve palsy after using a single axillary crutch. Clin Orthop Relat Res. 2006;447:267-9. https://doi.org/10.1097/01.blo.0000205880.27964.a3
- Abbott WM, Darling RC. Axillary artery aneurysms secondary to crutch trauma. Am J Surg. 1973;125:515-20. https://doi.org/10.1016/0002-9610(73)90092-5
- Brooks AL, Fowler SB. Axillary artery thrombosis after prolonged use of crutches. J Bone Joint Surg Am. 1964;46:863-4. https://doi.org/10.2106/00004623-196446040-00021
- Basilio MdR, Cantador AA, Molinari GJDP, Menezes FH. Crutchrelated acute arterial thrombosis in upper limb: case report. J Vasc Bras. 2014;13:340-4. https://doi.org/10.1590/1677-5449.0101
- de Luccia N, Albers M, Wolosker M. [Axillary artery aneurysm due to the use of crutches]. Rev Paul Med. 1979;94:87-9. Portuguese.
- Schramek A, Hashmonai M, Abrahamson J. Axillary artery thrombosis due to crutch trauma. Angiology. 1974;25:467-9. https://doi.org/10.1177/000331977402500707
- Konishi T, Ohki S, Saito T, Misawa Y. Crutch-induced bilateral brachial artery aneurysms. Interact Cardiovasc Thorac Surg. 2009;9:1038-9. https://doi.org/10.1510/icvts.2009.219832
- Moon IS, Hwang JK, Kim JI. Recurrent upper extremity embolism due to a crutch-induced arterial injury: a different cause of upper extremity embolism. Ann Vasc Surg. 2010;24:554.e7-12.
- Furukawa K, Hayase T, Yano M. Recurrent upper limb ischaemia due to a crutch-induced brachial artery aneurysm. Interact Cardiovasc Thorac Surg. 2013;17:190-2. https://doi.org/10.1093/icvts/ivt121
- Kocher BK, Chalupa RL, Lopez DM, Kirk KL. Comparative study of assisted ambulation and perceived exertion with the wheeled knee walker and axillary crutches in healthy subjects. Foot Ankle Int. 2016;37:1232-7. https://doi.org/10.1177/1071100716659748
- Coughlin MJ. Arthrodesis of the first metatarsophalangeal joint with mini-fragment plate fixation. Orthopedics. 1990;13:1037-44.
- Goh JC, Toh SL, Bose K. Biomechanical study on axillary crutches during single-leg swing-through gait. Prosthet Orthot Int. 1986;10:89-95.
- McFall B, Arya N, Soong C, Lee B, Hannon R. Crutch induced axillary artery injury. Ulster Med J. 2004;73:50-2.
- Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: sixminute walk test, berg balance scale, timed up & go test, and gait speeds. Phys Ther. 2002;82:128-37. https://doi.org/10.1093/ptj/82.2.128
- Utter AC, Robertson RJ, Green JM, Suminski RR, McAnulty SR, Nieman DC. Validation of the adult OMNI scale of perceived exertion for walking/running exercise. Med Sci Sports Exerc. 2004;36:1776-80. https://doi.org/10.1249/01.MSS.0000142310.97274.94
- Wilken JM, Darter BJ, Goffar SL, Ellwein JC, Snell RM, Tomalis EA, et al. Physical performance assessment in military service members. J Am Acad Orthop Surg. 2012;20 Suppl 1:S42-7. https://doi.org/10.5435/JAAOS-20-08-S42