The aim of this study was to comprehensively assess the gait parameters in patients who had undergone treatment of pilon fractures by the Ilizarov method. We analyzed gait parameters in patients who had undergone treatment for pilon fractures by the Ilizarov method; 20 patients aged 47.0 years (25.2–78.6) were included in the study. The control group consisted of 32 healthy volunteers. Gait examination was performed using the pedobarographic platform. Statistically significant differences in the following gait parameters: maximum forefoot force (%), step length (cm), and step time (s) were found between the study group and the control group, between the nonoperated leg, and both the operated leg and the dominant limb. Statistically significant differences in the study group between the treated lower limb and the healthy lower limb were only observed in the case of the maximum forefoot force parameter (%). Healthy subjects from the control group obtained significantly higher values during locomotion for stride time, cadence step, and velocity than the patients, with stride time being statistically significantly shorter and the velocity and the cadence step higher. We observed symmetry in the gait parameters after treating pilon fractures by the Ilizarov method. This method of stabilization allows the restoration of gait parameters, with results similar to those obtained after the treatment of other motor organ pathologies described in the literature, although different from those observed in healthy subjects. In particular, the biomechanics of the lower limbs remain disturbed.
Background: The purpose of our study was to analyze kinematic parameters following pilon fracture treatment with the Ilizarov method. Methods: Our study assessed kinematic parameters of gait in 23 patients with pilon fractures treated with the Ilizarov method. Patients had completed their treatment 24–48 months prior to measurements. The range-of-motion values in the non-operated limb (NOL) and operated limb (OL) were compared. Kinematic parameters were measured using the Noraxon MyoMOTION System. Results: We observed no significant differences in hip flexion, hip abduction, or knee flection between the OLs and NOLs in patients after treatment with the Ilizarov method. We observed significant differences in the ranges of ankle dorsiflexion, inversion, and abduction (p < 0.001; p < 0.001; p < 0.003, respectively) between the OLs and the NOLs. Conclusion: Following pilon fracture treatment with the Ilizarov method, we observed no differences in terms of knee or hip joint mobility between the OL and the NOL, whereas the range of motion in the ankle joint of the OL was significantly limited. The treatment of pilon fractures with the Ilizarov method does not ensure the complete normalization of ankle joint kinematic parameters. Therefore, intense personalized rehabilitation of the ankle joint is recommended.
Introduction: Long-term oxygen therapy (LTOT) is the only treatment that improves prognosis in patients with chronic respiratory failure in the course of chronic obstructive pulmonary disease (COPD). This effect depends on the duration of oxygen use during the day and night. The aim of this study was to evaluate the daily use of oxygen concentrator and to analyze factors that promote patient compliance. Material and methods: The study enrolled patients seen at the Long-Term Oxygen Therapy Center of the Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, Poland. Qualification for LTOT was in accordance with the guidelines of the Polish Respiratory Society and the European Respiratory Society (ERS). All patients were instructed to use oxygen therapy for at least 15 hours a day using a stationary oxygen concentrator. The duration of oxygen concentrator use was evaluated on the basis of the concentrator counter reading performed by visiting nurses. The visits were run on the monthly basis. Results: The study group involved 30 subjects (77% of COPD patients). The mean age was 67 ± 9 years, mean FEV1 was 46 ± 18% predicted, RV/TLC was 64 ± 16% and PaO2 was 50 ± 6 mm Hg. The mean duration of the daily oxygen therapy for the entire study group was 12.5 ± 4.6 hours. Eleven (37%) patients complied with the treatment during the follow-up period with the mean duration of daily oxygen therapy 17.4 ± 2.6 hours. The mean oxygen therapy use in the non-compliant group of patients averaged 9.6 ± 2.7 hours. We found that highest percentage of patients (48%) used oxygen for an appropriate period of time in the # first month of the treatment. The second month the number decreased to about 30% and remained at this level until the end of the follow-up period. The analysis of the COPD patients showed that in case of the compliant subjects the values of total lung capacity (TLC) (100 ± 19% predicted v. 152 ± 36% predicted, p = 0.001) and PaCO2 (38 ± 6 mm Hg v. 47 ± 8 mm Hg, p < 0.05) were significantly lower in comparison to the group of patients who used the oxygen therapy for less than 15 hours a day. Fourteen (47%) patients reported a considerable increase in electricity consumption and seven (23%) patients complained about the noise of the oxygen concentrator. The daily oxygen use of this group was significantly lower in comparison to the patients who were not annoyed with the sound of the concentrator (9.0 ± 3.7 h/24 h v. 13.5 ± 4.4 h/24 h, p = 0.02). Conclusions: Our study show that the patients’ compliance was the highest during the first month of the treatment only, and that the monthly home visit did not influence the patients’ self-discipline to use LTOT properly. The use of an alternative source of oxygen, such as liquid oxygen, which would not generate any noise or electricity consumption, may positively influence the patient’s compliance.
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