This article is more than 5 years old. Information may no longer be current.
Noncompliance seen with non-weight bearing restrictions high despite instructions, education
Click Here to Manage Email Alerts
LONG BEACH, Calif. — There is considerable noncompliance with postoperative non-weight bearing following major foot and ankle reconstruction surgery despite patients being provided instructions and education about the possible complications associated with noncompliant, according to study results presented here at the American Orthopaedic Foot & Ankle Society Annual Meeting.
“We had a high rate of noncompliance of non-weight bearing. Warmer weather was associated with decreased compliance,” Christopher P. Chiodo, MD, of Boston, said.
Christopher P. Chiodo
Chiodo and colleagues examined the patient compliance with a period of non-weight bearing following major foot and ankle reconstructions using embedded pressure sensitive film. They embedded the film into the short leg casts of 51 adult foot and ankle surgery patients who were instructed to be non-weight bearing. The sensors were retrieved at average of 24 days after cast placement and researchers analyzed them for force distribution and magnitude.
Noncompliance was defined as 50% of the film exposed to maximum pressure, which was 85 pounds per square-inch.
Overall, based on the measurements, 27% of patients were deemed noncompliant with the non-weight bearing restrictions. The study was not powered for adverse events, Chiodo said. Based on the results, gender, age, ethnicity, BMI, weight, height, language spoken and the length of non-weight bearing period did not affect compliance rates. However, patients who were instructed to be non-weight bearing from June to October were less compliant than patients who were instructed to do so from November to March.
Chiodo said orthopedic surgeons should consider new approaches to improve compliance. From this study, most of his patients are now prescribed preoperative gait training to learn how to be non-weight bearing rather than giving them crutches in the recovery room, when they are on opioid medications, and having nurses instruct them at that time. – by Kristine Houck, MA, ELS
Reference:
Chiodo CP. Patient compliance with postoperative lower extremity non-weight bearing restrictions. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 15-18, 2015; Long Beach, Calif.
Disclosure: Chiodo reports no relevant financial disclosures.