Proefschrift

Patient-reported quality of life and pain after PWB in surgically treated tibial plateau fractures 79 Over and under-loading may lead to prolonged and complicated recovery. A certain minimum level of loading is required to elicit micro-movements between adjacent bony fracture components, stimulating biological processes that enhance fracture consolidation and minimizing effects of immobilization.28,29 To optimize recovery with the lowest number of complications we want to set out a treatment that is near to the upper boundary of the therapeutic bandwidth regarding weight bearing, yet safe enough to avoid complications regarding overloading. Our study, the first study comparing PWB with RWB, adds evidence in support of the use of PWB in patients with surgically treated tibial plateau fractures. However, limitations in our study include the retrospective nature of the study and, due to this retrospection, not taking into account surgeon-oriented functional outcome scores (e.g. knee function) or generic patient satisfaction scores. Furthermore, no radiological controls have been done to investigate the alignment of the fractures. Another limitation of the study is the lack of monitoring patient compliance. To mitigate these limitations, we have started a prospective cohort study in patients with fractures of the lower extremities.30 Conclusion This retrospective cohort study shows that permissive weight bearing after surgically treated tibial plateau fractures is safe and is related to a significant reduced time to full weight bearing with no significant differences in patient-reported quality of life and pain or complication rates.

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