Alternative Mobilization by Means of a Novel Orthesis in Patients after Amputation

Abstract

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.

Hands-Free Crutch Reduces The Muscle Atrophy Attributed to Non-Weight Bearing Injuries

“…Because it does not require the upper extremity during ambulation unlike crutches, routine daily activities that are either impractical or not possible using crutches are possible using the HFC. A randomized control trial with 80 patients with both upper and lower limb injuries showed that they were able to complete activities around the house using the HFC (Rambani et al, 2007) and patients had a more positive attitude to life due to the improved independence with the HFC (Barth et al, 2020). Another prior study showed that the HFC leads to less discomfort and perceived exertion compared to axillary crutches and that 90% of patients with lower limb injuries preferred the HFC over crutches (Martin et al, 2019).…”