title: [A new continuous gait analysis system for ankle fracture aftercare].
abstract: BACKGROUND
  Correct aftercare following lower extremity fractures remains a controversial issue. Reliable, clinically applicable weight-bearing recommendations have not yet been defined. The aim of the current study was to establish a new gait analysis insole during physical therapy aftercare of ankle fractures to test patients' continuous, long-term compliance to partial weight-bearing restrictions and investigate whether patients can estimate their weight-bearing compliance.
  
  
  METHODS
  The postoperative gait of 14 patients after operative treatment of Weber B-type ankle fractures was monitored continuously for six weeks (OpenGO, Moticon GmbH, Munich). All patients were instructed and trained by physical therapists on how to maintain partial weight-bearing for this time. Discontinuous (three, six and twelve weeks) clinical (patient questionnaire, visual analogue pain score [VAS]) and radiographic controls were performed.
  
  
  RESULTS
  Despite the set weight-bearing limits, individual ranges for overall weight-bearing (range 5-107% of the contralateral side) and patient activity (range 0-366 min/day) could be shown. A good correlation between weight-bearing and pain was seen (rs= -0.68; p = <0.0001). Patients significantly underestimated their weight-bearing time over the set limit (2.3 ± 1.4 min/day vs. real: 12.6 ± 5.9 min/day; p < 0.01).
  
  
  CONCLUSIONS
  Standardized aftercare protocols and repeated training alone cannot ensure compliance to postoperative partial weight-bearing. Patients unconsciously increased weight-bearing based on their pain level. This study shows that new, individual and possibly technology-assisted weight-bearing regimes are needed. The introduced measuring device is feasible to monitor and steer patient weight-bearing during future studies.
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66421, Homburg, Deutschland. benedikt.braun@uks.eu.
authors.forename: B J
authors.initials: BJ
authors.lastname: Braun
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66421, Homburg, Deutschland.
authors.forename: N T
authors.initials: NT
authors.lastname: Veith
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66421, Homburg, Deutschland.
authors.forename: S C
authors.initials: SC
authors.lastname: Herath
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66421, Homburg, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Hell
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66421, Homburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Rollmann
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66421, Homburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Orth
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66421, Homburg, Deutschland.
authors.forename: J H
authors.initials: JH
authors.lastname: Holstein
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66421, Homburg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Pohlemann
mesh_terms: D000328:Adult; D000359:Aftercare / Q000379:methods*; D064386:Ankle Fractures / Q000534:rehabilitation*; D003199:Computer Systems; D004867:Equipment Design; D005260:Female; D000077107:Gait Analysis / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D010349:Patient Compliance; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D011446:Prospective Studies; D016474:Weight-Bearing / Q000502:physiology*; D055815:Young Adult
keywords: Aftercare; Ankle; Fracture; Gait analysis; Pedobarography