Proefschrift

Is the AO guideline for postoperative treatment of tibial plateau fractures still decisive? 29 respondents indicated “standing on one leg of the affected side”, 20 (18.0%) respondents mentioned “walking with crutches” and 10 (9.0%) respondents considered “100% weight bearing” to be “running, jumping, climbing a staircase”. Table 3.2 Level of weight bearing (percentage) patients are allowed to start with. Maximal weight bearing (%) Direct/Early weight bearing After 2 weeks After 6 weeks After 12 week (AO-guideline) Depends on type # and OSM 10-25% 10 4 21 0 0 50% 1 0 27 1 0 75% 0 0 1 0 0 100% Weight bearing without % 1 0 7 6 14 Total 13 5 62 17 14 # = fracture; OSM = osteosynthesis material Figure 3.4 Definition of “100% weight-bearing” used by surgeons. Most surgeons (N=48, 43.2%) told their patients that weight bearing should increase gradually over a fixed number of weeks, expressed in kilograms or percentage of body weight. Twenty-nine (26.0%) surgeons recommended gradually increasing weight over a fixed number of weeks to a level of 100%, based on how much weight bearing the patient could tolerate. Twenty-nine (26.0%) surgeons recommended permissive weight bearing, which means surgeons let patients and therapists decide how to build up the weight bearing as tolerated (Figure 3.5). Of the 29 (26.0%) respondents who recommended permissive weight bearing, N=12 (10.8%) were orthopaedics and N=17 (15.3%) were trauma surgeons. Eight (7.2%) respondents who recommended permissive weight bearing had a work experience of 0-5 years, N=14 (12.6%) 5-15 years and N=7 (6.3%) more than 15 years. In this group N=9 (8.1%)

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