Proefschrift

Chapter 2 20 outcome in trauma patients with peri- and intra-articular fractures of the lower extremities, compared to a non- or restricted weight bearing protocol. 6. To compare the cost-effectiveness and the cost-utility of the permissive weight bearing protocol to that of the non- or restricted weight bearing protocol, being care as usual. These six research objectives were addressed in the subsequent chapters of this thesis. As described in the introduction, rapid clinical recovery, the restoration of function and functionality and low complication rates are considered the most important conditions for using an early or permissive weight bearing protocol in surgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities. In chapter 3 of this thesis, the objective was to investigate the current state of practice among orthopaedic surgeons and trauma surgeons in choosing the criteria and the time period until weight bearing after surgically treated tibial plateau fractures. A web-based survey was distributed among members of the Dutch Trauma Society and Dutch Orthopaedic Society to identify the most commonly applied protocols in terms of the post-operative initiation and level of weight bearing in patients with tibial plateau fractures. The aim of the study in chapter 4 was to determine the economic impact of the (after)care of peri- and intra-articular fractures in the lower extremity, based on a prospective prevalence-based cohort study from health care and societal perspective. Surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities following a non- or restricted weight bearing protocol were included. This study was an economic burden study focusing on costs (in euros), Activities of Daily Living (ADL) as measured with the Lower Extremity Functional Scale (LEFS) and the Quality of Life (Qol) as measured with the EuroQol 5-Level EQ-5D (EuroQol) during 26 weeks follow-up. In chapter 5, the aim of the study was to describe a comprehensive protocol for permissive weight bearing during allied health therapy and to report on the time to full weight bearing as well as the number of complications in patients with surgically treated fractures of the pelvis and lower extremities undergoing permissive weight bearing. This study included surgically treated trauma patients with (peri)- and/or intraarticular fractures of the pelvis and lower extremities. A standardized permissive weight bearing protocol was used for all patients. Time to full weight bearing and number of complications were recorded. In a retrospective cohort study (chapter 6) the aim was to inventory potential differences in quality of life and pain, and number of complications in patients with

RkJQdWJsaXNoZXIy MjY0ODMw