Hinge Knee Brace - Advice for Patients

• The hinge knee brace should be worn at all times, even at night, unless you are washing and dressing, unless your consultant/therapist advises otherwise. 
• The hinge knee brace should be applied to the skin. 
• You must remove the hinge knee brace two to three times daily to check the skin condition. 
• You must remove the hinge knee brace daily to wash your leg.  
• When putting the hinge knee brace back on, always ensure it is in a good position.  
• Ensure padding is covering any plastic to avoid this touching the skin.  
• Do not adjust the round dial (see diagram a below) that has been set by the team who applied your brace.

How to put the hinge knee brace on

• Lying in bed place brace under your bare leg.  
• Position hinge knee brace so the round dial is either side of the knee joint.  
• Secure the brace by starting with the two clips (see diagram c above) attached to the middle Velcro straps first (the straps just above & just below the knee joint). 
• If you need to tighten the Velcro straps, release the Velcro, pull and stick the Velcro back down. 
• Ensure you can get two fingers behind each strap. 

How to take the hinge knee brace off

When lying in bed to check skin:  

• Unclip all of the straps. 
• Check the skin condition. 
• Put the brace back following the instructions in this leaflet.  

When sitting on a chair for washing:

• Remove trousers/shorts. 
• With heel on the floor and leg straight, unclip brace. 
• Keep the affected leg straight throughout. 
• Wash leg and dry thoroughly. 
• Put the brace back following the instructions on this page.

If you have any or all of the following, please contact or return to the fracture clinic immediately for further advice. If not acted upon early, these can develop into more serious issues, such as pressure ulcers:

• Feeling of rubbing or blister-like pain or discomfort when the hinge knee brace is on. 
• A sensation like a new pair of shoes rubbing. 
• Presence of wet or sticky discharge/fluid. 
• Burning feeling in a particular area. 
• Offensive smell from the knee or brace. 
• You have a raised temperature or fever with symptoms from the knee.  
• The hinge knee brace is broken. 
• Excessive swelling or redness that does not improve within an hour, with elevation (resting with the affected leg positioned slightly higher than your hip).  
• Change in colour, temperature or sensation of the leg, including feeling icy cold, burning hot, pins & needles, numbness or stinging - that does not improve with elevation within an hour. 

The fracture clinic department contact details are at the bottom of this page. 

Out of hours (From 4:30pm to 8:30am) you should contact or attend the Accident and Emergency Department instead of the fracture clinic.

When wearing a hinge knee brace there is a small risk of reduced blood flow to the affected limb or developing a Deep Vein Thrombosis (blood clot in the leg) and Compartment Syndrome (extremely painful limb swelling).

If you experience any of the following symptoms, please contact or go to the Accident and Emergency Department immediately:

• Pain in the calf, thigh, or chest.
• Sudden feeling of shortness of breath with no physical exertion.
• Pain that does not respond to painkillers.
• Pain which is out of proportion to that expected by the injury.
• Intense pain on passive movement of extremities.
• You notice or experience the following in your toes:
  • they appear blue or white
  • are swollen or painful to touch
  • become numb or cold
  • you continue to experience the sensation of pins and needles.

What is a pressure ulcer?

Pressure ulcers are a type of injury that breaks down the skin and the tissue underneath the skin. In a small number of our high-risk patients there is a risk of developing a pressure ulcer. The information below tells you what steps you can take to reduce the risk. 

How do pressures ulcers develop?

Pressure ulcers can develop when pressure is applied to an area of the skin over a period of time. This includes when wearing a hinge knee brace. The extra pressure disrupts the flow of blood through the skin. Without blood supply, the affected skin becomes starved of oxygen and nutrients and begins to break down. This can lead to an ulcer forming. 

Patients that are most at risk

The risk of developing a pressure ulcer could be increased for people who are in a hinge knee brace or who are finding it difficult to move. This is common in people who need to lie in bed or who have to sit for long periods of time. Patients with a loss of normal sensation (neuropathy) are at increased risk of ulcers. This is most common in some patients with diabetes. 

To reduce risk, it is advised that you: 

• Remove the hinge knee brace at least twice a day to check your skin. 
• Make sure the hinge knee brace is not rubbing or leaving a red mark anywhere on your skin.  
• Change leg position regularly (at least every two hours) whilst wearing  the hinge knee brace. If you can stand safely take a few steps every 15-30 minutes. If you are unable to stand ensure you move your ankles up and down every 15-30 minutes.  
• When you are resting, place a pillow between your legs so the brace does not rub your other leg. 
• Drink plenty of fluids. 
• Contact the fracture clinic if you experience any discomfort from the hinge knee brace. 

IF IN DOUBT, CALL THE FRACTURE CLINIC

• DO NOT drive while wearing a hinge knee brace .
• Your insurance may not cover you while you are wearing a hinge knee brace. 
• Please refer to the DVLA “Driving with medical conditions” section for further advice.

Infection control is important to the wellbeing of our patients, so we have infection control procedures in place. Keeping your hands clean is an effective way of preventing the spread of infections. 

We ask our patients and any visitors to use the hand gel before coming into and leaving the clinical area/hospital. The hand gel is situated at the main door of the hospital and at the entrance of every clinical area. 

If you have any concerns regarding your treatment or injury please contact: 

Fracture clinic 

Lower Ground Level 

235 Euston Road 

London 

NW1 2BU 

Direct Number: 020 3447 3612 

Monday - Friday 08:30 - 16:30 

Main hospital switchboard: 020 3456 7890 

IN AN EMERGENCY: CONTACT THE ACCIDENT AND EMERGENCY DEPARTMENT