Orthopedic surgeons frequently provide weight-bearing recommendations to guide patient recovery following lower extremity fractures. This article discusses the available literature regarding the effects of early weight bearing on fracture healing, patient compliance with weight bearing restrictions, and the effect of different weight bearing protocols following acetabular, tibial plateau, tibial plafond, ankle, and calcaneus fractures.
Key points
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There is some evidence that patients autoregulate weight bearing based on the amount of fracture healing.
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Current methods of evaluating weight-bearing status are unreliable.
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Patient compliance with existing weight-bearing restrictions is poor.
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Studies of early weight bearing for acetabular, tibial plateau, tibial plafond, ankle, and calcaneus fractures demonstrate no increased risk for loss of reduction or nonunion compared with restricted weight bearing.
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Early weight bearing may return patients to function earlier.
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