Proefschrift

A protocol for permissive weight bearing during allied health therapy in pelvic and the lower extremities fractures 63 one implant failure and no secondary dislocations. The numbers and types of complications are presented in Table 5.4, specified for each fracture category. Table 5.3 Time to full weight bearing for specific fracture types. N=150 Pelvic/ acetabular fractures Distal femur fractures Tibial plateau fractures Distal tibia/ankle fractures Foot fractures Total population Median time to full weight bearing (Weeks ([IQR], [minmax])) 12.6 ([6.0, 18.9], [2-52]) 9.1 ([6.0, 17.3], [3-52]) 15.0 ([9.7, 20.0], [2-43]) 14.0 ([5.7, 24.0], [3-43]) 17.0 ([7.0, 24.8], [3-48]) 12.0 ([6.8, 19.2], [2-52]) Full weight bearing within 12 weeks 50.0% 61.9% 45.2% 45.2% 42.9% 52.0% IQR= interquartile range Table 5.4 Number of fractures and types of complications. Pelvic/ acetabular fractures (N=76) Distal femur fractures (N=42) Tibial plateau (N=31) Distal tibia/ankle fractures (N=31) Foot fractures (N=21) Total no. fractures (N=201) Total complications % per no. fractures % per no. (N=150) patients 3 (3.9%) (2.0%) 7 (16.7%) (4.7%) 3 (6.5%) (1.3%) 1 (3.2%) (0.7%) 1 (4.8%) (0.7%) 15 (7.5%) (10.0%) Type of complication -Non-union -Infection -Removal OSM -Avascular necrosis -Periprosthetic fracture -Implant failure 1 2 0 0 0 0 3 1 0 1 1 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 5 4 3 1 1 1 No.= number of. Discussion This pilot study found that 52% of the patients with surgically stabilized (peri)- or intraarticular fractures using a PWB regime according to our in-house PROMETHEUS protocol were able to walk with full weight bearing within 12 weeks, indicating a mean shortening of 4 weeks compared to the current AO- guidelines.2 The total complication rate with permissive weight bearing was 10.0%. The fact that about half of the patients in our study did not reach full weight bearing within 12 weeks might be due to hospitalization delay and the high comorbidity rate in our sample.

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