If you are interested in having foot surgery then try not be disappointed if your podiatrist recommends you to be n on-weight bearing (NWB). NWB means to place no weight whatsoever on the surgical limb. So, why not use a walking boot or a soft cast instead of completed NWB? The reason for this strict status is to help the body heal the affected limb. Plates, screws, and suture are used to hold whatever surgical correction was completed on the foot. If weight is applied then the bone or soft tissue that is healing may move out of place into an incorrect position. For example, if a ruptured Achilles’ tendon is surgically fixed and then walked on, the suture holding the tendon together will fail and the rupture will re-occur. Same applies to certain bunion procedures. Bunions that are fixated with screws and plates are subject to failure if weight is applied to the foot. Another reason for NWB is for proper incision healing. The more stress that is applied to an incision the greater chance of scar tissue and wound dehiscence. Wound dehiscence is when the incision is stressed and opens up before complete healing occurs. This can lead to infections and possible failure of the procedure. Pain and swelling are also decreased if the weight bearing instructions are followed correctly.
What types of devices can be used during a NWB status?
Many patients prefer axillary (under arm) crutches, which are used to keep the affected foot off the ground. The weight is transferred to each arm as opposed to the leg. Crutches come in a variety of sizes in order to accommodate all the different heights of patients. It is crucial to get fitted properly for crutches. First step is to set the crutches to your height using the pre-marked settings on the legs of the crutches. Next is to measure two finger breaths between your under arm and the crutch padding. The crease of your wrist should be aligned with the hand grips when your arms are hanging down on your sides.
My preferred device is a knee scooter. A knee scooter is essentially a padded platform which is connected to four wheels and has handle bars for steering. The patient rests the knee on the padded platform and propels forward by pushing off with the good foot. This device is very efficient and can increase NWB compliance. Patients need to be careful with device because sometimes the knee pad is slippery and can result in a fall. Also, the patient needs to turn the device without hopping the scooter. Patients when they are in tight spaces tend to bounce the knee scooter in the direction of their destination. This repetitive jumping of the scooter can cause stress fractures to the front of the leg and knee. This motion should therefore be avoided.
Wheelchairs or motorized scooters are typically reserved for the elderly NWB patient. This device is very effective but also cumbersome. The sheer weight of the device typically requires an assistant to help the patient in transferring in and out of the car. Some social services, depending of insurance and location of living, has special transport vans/bus that have wheel chair lifts. This would be the ideal way to travel but cost may be a factor.
Following the appropriate non-weight bearing instructions of your podiatrist is crucial to a healthy and happy surgical outcome. If you or a loved one is undergoing a procedure or would like to talk with a doctor about their surgical options please feel free to call our office at (813) 875-0555. The doctors will gladly cover all aspects of your treatment options from conservative to surgical treatment plans. Please call today!