Roll C, Eder C, Behr K, Nerlich M, Kinner B
Abteilung für Unfallchirurgie, Klinikum der Universität Regensburg, Regensburg.
Z Orthop Ihre Grenzgeb. 2006 Mar-Apr;144(2):148-52. doi: 10.1055/s-2006-921571.
Bilateral foot injuries are not uncommon. Operative treatment usually requires partial weight bearing over several weeks. This is a challenge for physiotherapy especially for ambulation training. We describe a new rehabilitation aid allowing for bilateral limited weight bearing during ambulation.
Ambulation training was initiated in the early postoperative period using the Regensburg ambulation aid. A lift system allows for exact limitation of weight bearing on both sides controlled by balances integrated into the floor. Using a rail system a 15 m free walking distance is available. This study included 10 patients with bilateral foot fractures. The functional outcome was assessed using the AOFAS score and quality of life with the SF-36 score. Plain X-rays were used to evaluate loss of correction. The control group consisted of 20 patients where ambulation training was discontinued for at least 6 weeks postoperatively.
The system is very safe, during the entire period no complication was recorded. Acceptance among the patients was extremely high. Worries about unwanted weight bearing could be reduced. Patients mobilized with early ambulation training showed a better compensation of gait if compared to the control group. Secondary problems in the knee, hip or spine, as well as muscular deficiencies had a significantly lower incidence. No loss of correction could be seen in either of the two groups.
The presented ambulation aid is a significant contribution to the physiotherapy of bilateral foot injuries.
双侧足部损伤并不罕见。手术治疗通常需要在数周内部分负重。这对物理治疗尤其是步行训练来说是一项挑战。我们描述了一种新的康复辅助工具，可在步行时实现双侧有限负重。
术后早期使用雷根斯堡步行辅助工具开始步行训练。一个升降系统可通过集成在地面的天平精确限制双侧的负重。借助轨道系统，有15米的自由行走距离。本研究纳入了10例双侧足部骨折患者。使用美国足踝外科协会（AOFAS）评分评估功能结果，使用SF-36评分评估生活质量。通过普通X线片评估矫正丢失情况。对照组由20例患者组成，他们在术后至少6周停止步行训练。
该系统非常安全，在整个期间未记录到并发症。患者的接受度极高。对不必要负重的担忧得以减轻。与对照组相比，接受早期步行训练的患者步态代偿更好。膝关节、髋关节或脊柱的继发性问题以及肌肉缺陷的发生率显著更低。两组均未出现矫正丢失情况。
所介绍的步行辅助工具对双侧足部损伤的物理治疗有重大贡献。
