unable to non weight bear- advice needed

[jane167]

hello,
I had a Jones fracture which eventually needed internal fixation last week. I have an aircast walker and am supposed to be non-weight bearing, the problem is that because of generalised severe OA i cannot comply- even with gutter crutches. I rest as much as possible but want to know if heel walking places less strain on fracture/ metalwork.
many thanks
Jane

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[gcoe]

If that is your instructions from the orthopaedic surgeon then you really must not weight bear. Given the difficulties you are having I would go back to the orthopaedic team and see if they can come up with something better or if not can give you advice on how to manage this.

Were you shown how to use the crutches?
Is the problem of not being able to weight bear through the arms? (eg shoulder OA)

[jane167]

hello gcoe
and thanks for advice.The ortho team do know that I really struggle with non wt bearing- I have OA in shoulder,spine and L hip, have had bilateral trapeziectomy. laminectomy and TKRs. The L knee (TKR) is becoming painful and is starting to feel unstable and other joints are painful and cannot take my weight.
Given that the team is aware of my problems I just need to know which is the lesser of the 2 evils- heel or toe pressure?
I am in the meantime resting as much as possible.
thanks
Jane
oh and yes I was shown how to use the crutches

[gcoe]

Hi Jane

Sorry if this sounds a bit elusive but the reason why I don't want to advise you on this is because I don't know the exact nature of your fracture, how the surgical intervention went. Only your surgeon really knows that. I would not wnat to adivise you if it could cause you harm.

From a biomechanical point of view there is probably not a huge amount of difference between heel weightbearing , toe weight bearing or flat foot weight bearing. It is more about:

1. The amount of weight taken through the leg
2. the nature of the forces taken - the more sharing forces and rotational forces may be more disruptive than a pure vertical force. So if your walking is very awkward and the weight bearing is not happening in a smooth controlled way this can create forces through the break that may be mrore disruptive. I don't know what your walking is like but this is common when you are having so many problems that you are experiencing.

So I really think you should go back to the Dr or the physio involved. You are clearly experiencing difficulty and it seems to me they have set you an impossible task. It might just be a case of a bit more problem solving or they may say taking a bit of weight is ok - but you should hear that from the horses mouth.

Here are a couple of possible solutions - if the non weight bearing is really crucial you may need to have a wheel chair for a while. If so you may also need to get some exercise that you can manage - to keep you strong and keep your joints and muscles in shape while you are not walking. Do you like the water? Hydrotherapy may be a good alternative as it is a very safe medium to exercise and the fracture can be well protected. Some land exercise to keep the strength of the muscles up might be good too.

[jane167]

hello again and thanks for your prompt and comprehensive reply.
I shall phone physio today and let yoy know the outcome.
regards
Jane

[jane167]

Me again,

not very practical advice- I must not weight bear( even though have been very honest and said that I am unable to comply) and should phone an ambulance and go to A&E which I really don't want to do.
Help!

[gcoe]

Well... the way I look at it if you can't manage the walking then you need help. I don't quite see what A&E are going to do. Still...perhaps you can see if they can help you out better.

[jane167]

Hi again,
Have found a mobility product online- a kneewalker, looks a little like a child's 4 wheeled scooter, has an elevated platform along which you rest the lower leg and handles for steering. There is a video clip of it in use on the site.
I don't know how I will get on with it but as weekly rental is very reasonable am willing to give it a go.
Will let you know.
Many thanks for your advice and prompt replies.
Regards
Jane

[jane167]

well, my knee walker arrived and it really is very good, my artificial knee gets sore after a while but this 'scooter' is far more helpful in my predicament. Apparently it's been available in the UK for 2 years and must admit to feeling disappointed that the physio at the hospital was not aware of this product.
thanks for your support
Jane

[gerryalton]

Crutch can be defined as support used by the disabled person as support in walking. These are generally designed to fit under the underarms and often used in pairs. Variations of popular armpit crutch have been constructed over the last 50 years.



good buy crutches

[jane167]

Crutch can be defined as support used by the disabled person as support in walking. These are generally designed to fit under the underarms and often used in pairs. Variations of popular armpit crutch have been constructed over the last 50 years.



good buy crutches

Hello Gerry,
it's interesting that in the UK armpit crutches are not normally available, presumably because of the risk of nerve damage. Personally I do feel that if used properly these crutches would have been more helpful than either the forearm or elbow styles which were supplied.
Thanks JAne