‘Wristwatch’ you put on your leg to f ix a broken ankle
AN £11 ‘wristwatch’ that sends out circulation-boosting electric shocks may help to speed healing of leg injuries, and get patients with broken bones into surgery sooner.
The neuromuscular electrostimulation device, known as the Geko, is able to reduce the swelling which interferes with wound-healing and increases complications that cause delays in operations.
Normally, up to 66 per cent of those who suffer a broken ankle need to be admitted to hospital – sometimes for long stays – in order to treat wounds or other trauma around the injury before surgery to fix the fracture.
About 75 per cent of patients who used the Geko, which looks like a wristwatch, were treated successfully and went home in one or two days.
Paul Baker, orthopaedic surgeon at South Tees Hospitals NHS Foundation Trust, who is testing the Geko, said: ‘We looked back at data from our trauma unit and saw patients had to stay in hospital an average three-and-a-half days before surgery to repair their ankle fractures was able to go ahead.’
Medics at the unit have been so impressed with Geko that its use is now standard practice for treating ankle fractures.
The self-adhesive, batterypowered device sticks to the leg just below the knee and sends an electrical impulse through the common peroneal nerve which supplies movement and sensation to the lower leg. As a result, calf muscles are activated, squeezing veins and increasing blood flow to the injury. This reduces swelling. The device can be worn for 24 hours, after which it is disposed of.
With the cost of occupying a hospital bed estimated at £400 a day and 15,000 people a year suffering ankle fractures that require surgery, reducing the delay in operating by even one day could save the NHS £6million, said Mr Baker.
After breaking her ankle as a result of missing a step on the bottom of her stairs at home in Northallerton, North Yorkshire, Kay Lambert, 65, was told she may need a week in hospital for the swelling around the injury to reduce before surgeons could insert pins to stabilise the fracture.
SHE said: ‘I hadn’t realised there was a break and had been walking on the injured leg for several days, so it really was swollen by the time I went to hospital where I was X-rayed and had my leg wrapped in a plaster cast.’ She was admitted to James Cook Hospital in Middlesbrough, part of the South Tees Hospitals NHS Trust.
She was fitted with the Geko and noticed the cast loosening away from her leg as the swelling quickly decreased.
‘It was the strangest feeling, like tiny, continual shocks,’ she says. ‘You could see my toes twitching, but you get used to it.’
She was operated on within three days of having the Geko fitted and discharged two days later.
Mr Baker says: ‘Normally we would treat the swelling by elevating the foot and using a foot pump which similarly squeezes veins to improve blood flow.
‘But the pump is attached to a large and noisy pneumatic machine that means the patient must stay in bed, while the Geko allows them to remain mobile.
‘The foot pump equipment costs hundreds of pounds, too, so we wouldn’t be able to send patients home with it.’
Mr Baker is looking to secure funding for another study investigating the potential for treating those with stable ankle fractures as outpatients. ‘The foot pump will be consigned to history,’ he predicts.
The Geko could also see the end of compression support stockings used routinely on wards pre- and post-operatively as the National Institute for Health and Care Excellence (NICE) supports the device’s use in reducing the risk of deepvein thrombosis.
Increasing blood flow also improves chronic wound healing in the lower limbs in patients with diabetes, who suffer circulation problems, and further trials are planned to extend the use of the Geko in this field.