Articles: weight-bearing.
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Multicenter Study Pragmatic Clinical Trial
Early versus delayed weight-bearing following operatively treated ankle fracture (WAX): a non-inferiority, multicentre, randomised controlled trial.
After surgery for a broken ankle, patients are usually instructed to avoid walking for 6 weeks (delayed weight-bearing). Walking 2 weeks after surgery (early weight-bearing) might be a safe and preferable rehabilitation strategy. This study aimed to determine the clinical and cost effectiveness of an early weight-bearing strategy compared with a delayed weight-bearing strategy. ⋯ National Institute for Health and Care Research (NIHR), NIHR Barts Biomedical Research Centre, and NIHR Applied Research Collaboration Oxford and Thames Valley.
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Ligamentous Lisfranc instability is commonly missed on unilateral radiographs. However, measurement protocols for bilateral weightbearing radiographs have not been standardized. The primary aim of this study was to investigate the optimal cut-off values for diagnosing Lisfranc instability by evaluating the side-to-side differences of preoperative bilateral weightbearing radiographs among patients with surgically-confirmed ligamentous Lisfranc instability. A secondary aim was to investigate whether the midfoot measurements for detecting Lisfranc injury could also be used in patients with a pre-existing bilateral Hallux Valgus (HV) deformity by evaluating whether the Lisfranc measurements could be affected by a foot deformity as HV. ⋯ Level III, retrospective comparative study.
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Eur J Trauma Emerg Surg · Feb 2020
Randomized Controlled Trial Multicenter StudyWeight-bearing or non-weight-bearing after surgical treatment of ankle fractures: a multicenter randomized controlled trial.
The goal of this study was to assess if unprotected weight-bearing as tolerated is superior to protected weight-bearing and unprotected non-weight-bearing in terms of functional outcome and complications after surgical fixation of Lauge-Hansen supination external rotation stage 2-4 ankle fractures. ⋯ Unprotected weight-bearing and mobilization as tolerated as postoperative care regimen improved short-term functional outcomes and led to earlier return to work and sports, yet did not result in an increase of complications.
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Multicenter Study
Orthopedic treatment and early weight-bearing for bimalleolar ankle fractures in elderly patients: Quality of life and complications.
Non-operative treatment of Weber's type B ankle fractures is essential in elderly patients. However, there is controversy in the post-reduction management of the fracture between the use of early weight-bearing or traditional treatment and non-weight-bearing for 6-8 weeks. There is limited evidence available regarding which rehabilitation regimen should be included. This study aimed to compare the quality of life and the number of complications between the two types of intervention (weight-bearing and non-weight-bearing). ⋯ Early weight-bearing improves the quality of life and functionality in elderly patients with Weber type B fracture without increasing complications.
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Osteoarthr. Cartil. · Oct 2017
Multicenter StudyJoint loading and proximal tibia subchondral trabecular bone microarchitecture differ with walking gait patterns in end-stage knee osteoarthritis.
To (1) stratify patient subgroups according to their distinct walking gait patterns in end-stage knee osteoarthritis (OA); (2) compare measures of joint loading and proximal tibia subchondral trabecular bone (STB) microarchitecture among these gait subgroups. ⋯ Within the confines of the limited sample size, data suggests that different mechanisms between the biphasic and flexor gait subroups may generate comparable loads upon the tibial plateau and corresponding bony responses, despite significantly lower KAM indices in flexors. Hence, in flexor gait OA patients, conservative treatments designed to reduce KAM, may not be appropriate. Understanding joint loading among walking gait patterns and relationships to bone microarchitecture may aid at identifying/improving management of persons at risk for developing knee OA.