Proefschrift

Chapter 3 32 tibial plateau fractures. To answer this question, the authors recommend that both the AO guideline and current local institutional guidelines should be critically scrutinized to establish the optimal aftercare for these patients. In theory, it is normally the surgeon who decides which aftercare protocol should be followed. Most often, this is a restricted weight-bearing regime with a build-up time over a fixed number of weeks. In practice, such protocols are not followed very strictly. As 26% of the respondents would like to advocate using a customized permissive weight bearing protocol, as well as studies by Solomon et al and Segal et al which support individualized permissive weight bearing.13,17 However, high-quality prospective studies are needed to help identify which criteria and predictive factors are important for developing a (permissive) weight bearing protocol to optimize patients’ comfort and optimize the course of recuperation. Conclusion This study demonstrates that consensus about the weight bearing aftercare for tibial plateau fractures is limited. A large majority of surgeons do not follow the AO guideline or their own local protocol. More transparent criteria and predictors are needed to design optimal weight-bearing regimes for the aftercare of tibial plateau fractures.

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