Chapter 7 84 Abstract Background The aim of the present study was to investigate the effectiveness of a novel approach involving permissive weight bearing (PWB) in surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities. This paper reports on patients’ self-perceived outcome levels regarding activities of daily living (ADL), quality of life (QoL), pain and weight bearing compliance, in comparison to restricted weight bearing (RWB), over a 26-week post-surgery follow-up period. Methods This prospective comparative multicenter cohort study included surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities. Primary outcome: ADL. Secondary outcomes: QoL, pain, compliance as measured with insoles, and postoperative complications. Measurements were performed at 2, 6, 12 and 26 weeks post-surgery. Results This study included 106 trauma patients (N=53 in both the PWB and RWB groups). Significantly better ADL and QoL were found in the PWB group compared to the RWB group at 2, 6, 12 and 26 weeks post-surgery. There were no significant differences in postoperative complication rates between the PWB and RWB groups. Conclusion PWB is effective and is associated with a significantly reduced time to full weight bearing, and a significantly better outcome regarding ADL and QoL compared to patients who followed RWB regimen. Moreover, no significant differences in complication rates were found between the PWB and RWB groups.