Proefschrift

Chapter 5 52 of the forces relative to the line(s) of fracture.10,11 However, functional outcome after fracture rehabilitation not only depends on mechanical stability, but also on an intricate complex of bio-psycho-social processes, involving physical tissue damage characteristics of the bone and other surrounding soft tissue, existing co-morbidities, and patients’ age, gender, physical and mental condition, as well as their cognitive abilities and coping styles.12-14 In ICF terms (International Classification of Functioning, Disability and Health),15 this means that aftercare treatment should not only focus on the patients’ functioning, but also on their activity and participation levels. To date, the literature has reported no comprehensive, ICF-based protocol for the aftercare of patients with a surgically treated fracture that systematically addresses patient’s aftercare assessment, selection and provision of aftercare modalities, monitoring of therapy intensity, and evaluation of aftercare. Figure 5.1 Schematic overview of the consequences of loading in the consolidation process. The aim of the present paper is to describe a comprehensive protocol for permissive weight bearing (PWB) during allied health therapy and to report on both the time to full weight bearing and the number of complications in patients with surgically treated fractures of the pelvis and lower extremities who undergo PWB.

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