Proefschrift

Effectiveness of PWB in surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities 91 Rehabilitation and postoperative outcome Of the total patient population, 77.4% (N=82) achieved full weight bearing within 12 weeks. The number of patients who achieved this was significantly higher in the PWB group than in the RWB group: 98.1% versus 56.6% (p<0.01). The median time from surgery to ascertainment of full weight bearing was significantly shorter in the PWB group than in the RWB group: 4.0 (2.1) weeks versus 12.2 (4.2) weeks (p<0.01). The incidence of postoperative complications in the total study population was 16.0%, with no significant differences between the PWB group and the RWB group (11.3% [N=6] versus 20.8% [N=11], respectively (p=0.19), see Table 7.2. Table 7.2 Rehabilitation outcome and postoperative complications in the PWB and RWB groups. PWB (N=53) RWB (N=53) Total (N=106) p Prescribed rehabilitation aftercare (%): PWB 6 weeks RWB 8 weeks RWB 12 weeks RWB 53 (100) 0 (0) 0 (0) 0 (0) 0 (0) 36 (67.9) 3 (5.7) 14 (26.4) 53 (50) 36 (34.0) 3 (2.8) 14 (13.2) - Rehabilitation outcome: Median OPD (IQR), in hours FWB within 12 weeks (%), N Median time to FWB (IQR), in weeks N who completed rehabilitation within 26 weeks (%) 25 (13.0-46.8) 52 (98.1) 4.0 (2.0-7.0) 30 (65.2) 41 (28.5-57.5) 30 (56.6) 13.0(9.0-15.0) 16 (34.8) 33 (18.5-52.0) 82 (77.4) 8.0 (4.0-13.0) 46 (43.4) 0.01 <0.01 <0.01 <0.01 Total post-operative complications (%) Non-unions Secondary dislocations Superficial wound infections Deep wound infections Removal of osteosynthesis material 6 (11.3) 0 (0.0) 1 (1.9) 3 (5.7) 1 (1.9) 1 (1.9) 11 (20.8) 1 (1.9) 2 (3.8) 6 (11.3) 1 (1.9) 1 (1.9) 17 (16.0) 1 (0.9) 3 (2.8) 9 (8.5) 2 (1.9) 2 (1.9) 0.19 Abbreviation: PWB, permissive weight bearing; RWB, restricted weight bearing; N, number of subjects; IQR, interquartile range; OPD, outpatient physiotherapy duration; FWB, full weight bearing. Weight bearing compliance The mean weight bearing and peak loading were not significantly different between the subjects who followed the PWB or RWB regimens, see Figures 7.4 and 7.5.

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