Treatment of 5th Metatarsal Shaft Fracture using MIPO (Minimally Invasive Plate Osteosynthesis) Technique

Category: Lesser Toes, Trauma Introduction/Purpose: The standard treatment of 5th metatarsal shaft fracture is still not determined yet. Conservative treatment using cast immobilization can be applied for shaft fractures without displacement, but there are reports that open reduction is indicated for displacement more than 3 mm, rotational displacement, and angular displacement more than 30 degrees. In this study, we report the result of 5th metatarsal shaft fracture using MIPO technique, which can shorten recovery period by reducing soft tissue damage with minimal incision. Methods: This study consists of 25 patients who had undergone surgery for displaced 5th metatarsal shaft fracture from March 2013 to December 2015; 8 males and 17 females. Mean age at the time of surgery was 47.4(29~69) and mean follow period was 15.0(8~25) months. 11 cases were simple oblique fracture and 14 cases were comminuted fracture with fracture fragments. Mean fracture gap was 4.4(3.1~7.6)mm. MIPO technique with LCP Compact Hand Locking Condylar Plate 2.0(Depuy-Synthes, Zuchwil, Switzerland) was used for all cases. Partial weight bearing was allowed until 4th week post-op, then full weight bearing was allowed until 6th week post-op. Clinical and radiological follow-up was made at post-op week 2, 6, 12, 24. Clinical results were obtained using Visual Analogue Scale(VAS) and American Orthopedic Foot and Ankle Society(AOFAS) score. Results: VAS of 24 weeks post-op was decreased from 5.6 ± 0.8 (4~7) preoperatively to 1.2 ± 1.3 (0~4), and AOFAS score of 24 weeks post-op was increased from 42.0 ± 12.8 (24~54) preoperatively to 86.4 ± 7.7 (74~95), both showed significant difference. Anatomic reduction and complete bone union was noted in all cases. Mean union period obtained from follow-up radiograph was 6.0 week post-op. For 15 cases, plate removal was performed at 9.5(7~25) months post-op. Conclusion: Plate fixation can be the preferred option for 5th metatarsal shaft fracture, because 5th metatarsal shaft is surgically easily accessible and more stable fixation can be applied. Since it results complete bone union without any complications and enables early weight bearing, MIPO techinque for displaced 5th metatarsal shaft fracture can be considered as useful surgery technique.

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Distal Tibia Metaphyseal Fractures: Which is Better, Intra-medullary Nailing or Minimally Invasive Plate Osteosynthesis?

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.09.004 ◽

2018 ◽

Vol 24 (1) ◽

pp. 66-71

Author(s):

Kawalkar Abhijit Chandrakant ◽

Badole Chandrashekher Martand

Keyword(s):

Intramedullary Nailing ◽

Weight Bearing ◽

Distal Tibia ◽

Tibial Fractures ◽

Minimally Invasive Plate Osteosynthesis ◽

Early Weight Bearing ◽

Significant Difference ◽

Duration Of Surgery ◽

Tibia Fractures ◽

Distal Tibia Fractures

Introduction Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications.

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Early Weight Bearing on Weber C Fractures with Retained Syndesmotic Screws

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000067 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0000

Author(s):

Cristian Ortiz ◽

Andres Keller Díaz ◽

Pablo Mococain ◽

Pablo Wagner ◽

Ruben Radkievich ◽

...

Keyword(s):

Screw Fixation ◽

Weight Bearing ◽

Ankle Fractures ◽

X Rays ◽

Aofas Score ◽

Early Weight Bearing ◽

Clear Space ◽

Screw Breakage ◽

The Mean

Category: Ankle, Sports, Trauma Introduction/Purpose: There is no consensus about when to allow weight bearing in ankle fractures treated with syndesmotic screw fixation. There has been no evaluation of the radiographic fate of the syndesmosis when syndesmotic screws are retained and early weight bearing is encouraged, or the clinical result depending on the screw status, which can be intact, broken or loose. Our objective was to evaluate the radiographic and clinical parameters of patients who had a screw fixation of the syndesmosis and early weight bearing was allowed. Our hypothesis was that no difference would be observed on syndesmotic reduction or clinical function depending on the screw status. Methods: We analyzed 42 patients with ankle fractures treated with syndesmotic screws in which early weight bearing was allowed (3 weeks postoperatively). Weight bearing radiographs were obtained at 2 weeks, 2 months and at final follow up (41.2 months). Radiologically we measured medial clear space (MCS), tibiofibular overlap (OL), tibiofibular clear space (CS), talar shift (TS) and screw condition (intact, broken, loose). Clinical function was measured with the AOFAS score and stratified by the screw condition. Statistical analysis was performed with the SPSS software and a non-inferiority confidence interval for the mean was calculated. Results: At final follow up, 66,6% of the screws were broken, 30,9% showed significant loosening and only 1 patient (4,7%) had a screw that remained solid with no signs of osteolysis. MCS at 2 weeks, 2 months and at final follow up was 2,94 mm; 3,03 mm; 3,02, respectively. OL was 6,76 mm; 6,78 mm; 6,83 and CS was 4,26 mm; 4,66 mm; 4,6 mm. No TS was detected. There was no difference in measurements along time (p>0,05). Relative to clinical function, the mean AOFAS score was 95 points. No difference was found between the clinical scores of patients stratified by the screw condition (p>0,05). Conclusion: Early weight bearing on a fixed syndesmosis appears to be safe, with no measurable radiographic or clinical consequences regarding ankle joint function. Despite screw breakage or loosening on x-rays, loss of reduction is seldom observed. We suggest that routine removal of syndesmotic screws is not necessary in these group of patients.

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Low Risk of Displacement with Early Weight Bearing of the Isolated Weber B Fracture: Results of a New Treatment Protocol

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00341 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0034

Author(s):

N. Jane Madeley ◽

Nnamdi Obi ◽

Chinnasamy Senthil Kumar ◽

Lech Rymaszewski

Keyword(s):

Operative Treatment ◽

Weight Bearing ◽

Treatment Protocol ◽

Ligament Injury ◽

Post Injury ◽

Early Weight Bearing ◽

Fracture Clinic ◽

Early Results ◽

Significant Difference

Category: Trauma; Ankle Introduction/Purpose: Truly isolated Weber B distal fibula fractures are stable injuries that usually recover well following non- operative treatment, however the concern over the possibility of a medial ligament injury, and ankle instability has traditionally lead to regular surveillance in the fracture clinics to exclude delayed talar shift developing. After recent studies suggesting this risk is low we introduced a new functional treatment protocol and present our early results. Methods: 141 consecutive patients presenting acutely with isolated Weber B fractures without talar shift during a 12 months period were included. ED notes and radiographs were reviewed. All patients were splinted in a removable boot, and allowed to fully weight bear up to their comfort levels. Patients without signs of a medial ligament injury were then discharged from follow-up with advice to wear the boot for 6 weeks, an information leaflet and exercise sheet and a helpline number in case of difficulties. If they wanted clinic review this was organised. If signs of a medial ligament injury were documented, or the medial findings were not clear the patient was reviewed with up to date radiographs in the fracture clinic at 4 weeks post-injury. If talar shift developed the patient was to be converted to operative treatment. Olerud and Molander scores were collected between 6 and 12 months post- injury. Results: There were 51 patients without signs of medial ligament injury and of these 23 were discharged according to protocol and 28 patients attended fracture clinic. 89 patients had signs of medial ligament injury or no documented medial findings and of these 65 attended fracture clinic. One discharged patient re-accessed care. Of 93 patients reviewed in the fracture clinic none developed delayed talar shift. One underwent delayed ORIF for ongoing fibula discomfort and the remainder continued with non- operative treatment. 99 (70%) patients provided outcome scores. The mean Olerud and Molander score at a minimum of 6 months follow-up was 87 and the median score was 100. No significant difference was found between treatment arms. The scores were comparable to those in the published literature. Conclusion: We conclude the risk of delayed talar shift is low and satisfactory outcomes can be safely achieved with our functional protocol. Additional tests/imaging to establish the integrity of the medial ligament may be unnecessary.

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Mid-term outcomes of minimally invasive plate osteosynthesis for fresh and old calcaneal fractures with locked plate

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00224 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0022

Author(s):

Tatsuji Fujiwara

Keyword(s):

Minimally Invasive ◽

Plate Osteosynthesis ◽

Weight Bearing ◽

Calcaneal Fracture ◽

Minimally Invasive Plate Osteosynthesis ◽

Calcaneal Fractures ◽

Locked Plate ◽

Early Weight Bearing ◽

The Mean

Category: Trauma Introduction/Purpose: Since the mid-1990s, open reduction and internal fixation via an extended L-shaped lateral approach has been considered the gold standard for surgical treatment of displaced intraarticular calcaneal fractures. However, postoperative wound healing complications, including wound infection, skin edge necrosis, wound breakdown, and hematoma, remain a major concern. To minimize the incidence of and offer rigid stabilization of the calcaneal fracture fragments, we have performed minimally invasive plate osteosynthesis (MIPO) with locked plate for fresh and old calcaneal fractures. This study aims to assess the clinical and radiological mid-term outcomes in surgical treatment of the fresh and old calcaneal fractures using a minimally invasive technique and a locking plate to permit early weight bearing. Methods: A total of 29 fractures in 24 patients were found that met our inclusion criteria. 23 foots were fresh calcaneal fractures with an average age of 53.9 years (range, 17-80 years). We defined calcaneal fractures more than 6 weeks old as old calcaneal fracture. 6 foots were old calcaneal fractures with an average age of 43 years (range,35-52 years). Patients with fresh calcaneal fracture had been followed up for an average of 25.8 months (range, from 18-65 months). Patients with old calcaneal fracture had been followed up for an average of 29.4 months (range, from 24-48 months). The mean interval between injury and operation was 8.9 days (3-19 days) in fresh calcaneal fractures and 97 days (43-154 days) in old calcaneal fractures. There were 19 foots Sanders type II fractures, 9 foots Sanders type III and one Sanders type IV. Results: For fresh calcaneal fractures, the mean change in Böhler’s angle and width of the calcaneus from immediately after surgery to final follow-up were 0.5° and 0.7 mm, respectively. For old calcaneal fractures, the mean change in Böhler’s angle and width of the calcaneus from immediately after surgery to final follow-up were 3.4° and 1.7 mm, respectively. The reduction was graded as nearly anatomical (less than 2 mm residual articular displacement) in all fractures. One of the 22 foots had a blister. There were no events of osteomyelitis or infection or nonunion. Eight foots had revision surgery for symptomatic hardware removal. At final follow up the average American Foot and Ankle Society Score (AOFAS) were 82.8 for fresh calcaneal fractures and 83.2 for old calcaneal fractures. Conclusion: This study is first report to show that MIPO with locked plate and early weight bearing can be effectively treated for displaced intra-articular calcaneal fractures. Surgical preparation, reduction maneuvers, and fixation techniques can take time to master; however, with experience, all types of calcaneus fractures can be treated with this technique.

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Comparing durability of water- and land-based exercise benefits among older adults in South Korea: A randomized controlled trial with 1-year follow-up

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200109 ◽

2021 ◽

pp. 1-11

Author(s):

Se Jun Oh ◽

Sang Heon Lee

Keyword(s):

Exercise Intervention ◽

External Rotation ◽

Short Form ◽

Controlled Trial ◽

Weight Bearing ◽

Aquatic Exercise ◽

Step Test ◽

Sf 36 ◽

Partial Weight

BACKGROUND: Aquatic exercise can improve strength, flexibility, and aerobic function while safely providing partial weight-bearing support through viscosity and buoyancy. OBJECTIVE: The aim of the present study was to compare the effects of water-based exercise with land-based exercise before and after a 10-week exercise intervention and again at one-year follow-up. METHODS: Eighty participants aged 65 years and older were randomly assigned to either a water- or a land-based 10-week exercise program. Assessment included the Senior Fitness Test (SFT), the Modified Falls-Efficacy Scale, and the 36-Item Short-Form Health Survey (SF-36). Hip and knee strength was also measured. All assessments were completed at three time points: pre- (T1), post- (T2), and at 1-year follow-up (T3). RESULTS: Significant differences were observed between the two groups on three parameters: the SFT timed up-and-go test; lower hip muscle strength in extension, adduction, and external rotation; and quality of life (QoL) measured by the SF-36 (p< 0.05). No significant differences were observed in the SFT chair stand test, dominant arm curl test, two-minute step test, chair sit-and-reach test, back scratch test, and Modified Falls-Efficacy Scale. CONCLUSION: Aquatic exercise provided greater improvement of physical health and QoL among older people than land-based exercise.

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Differences in femoral component subsidence rate after THA using an uncemented collarless femoral stem: full weight-bearing with an enhanced recovery rehabilitation versus partial weight-bearing

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03913-0 ◽

2021 ◽

Author(s):

Franziska Leiss ◽

Julia Sabrina Götz ◽

Matthias Meyer ◽

Günther Maderbacher ◽

Jan Reinhard ◽

...

Keyword(s):

Risk Factors ◽

Enhanced Recovery ◽

Weight Bearing ◽

Femoral Stem ◽

Full Weight Bearing ◽

Partial Weight Bearing ◽

Fill Ratio ◽

Stem Subsidence ◽

Partial Weight

Abstract Background Femoral component subsidence is a known risk factor for early failure of total hip arthroplasty (THA) using cementless stems. The aim of the study was to compare an enhanced recovery concept with early full weight-bearing rehabilitation and partial weight-bearing on stem subsidence. In addition, the influence of patient-related and anatomical risk factors on subsidence shall be assessed. Methods One hundred and fourteen patients underwent primary cementless THA and were retrospectively analyzed. Sixty-three patients had an enhanced recovery rehabilitation with early full weight-bearing and 51 patients had rehabilitation with partial weight-bearing (20 kg) for 6 weeks. Postoperative subsidence was analyzed on standing pelvic anterior–posterior radiographs after 4 weeks and 1 year. Subsidence was measured in mm. Anatomical and prosthetic risk factors (stem size, canal flare index, canal fill ratio as well as BMI and demographic data) were correlated. Results Femoral stem subsidence rate was significantly higher for the group with an enhanced recovery concept compared to the group with partial weight-bearing at the first radiological follow up after 4 weeks [2.54 mm (SD ± 1.86) vs. 1.55 mm (SD ± 1.80)] and the second radiological follow up after 1 year [3.43 mm (SD ± 2.24) vs. 1.94 (SD ± 2.16)] (p < 0.001, respectively). Stem angulation > 3° had a significant influence on subsidence. Canal flare index and canal fill ratio showed no significant correlation with subsidence as well as BMI and age. Conclusion In the present study, cementless stem subsidence was significantly higher in the group with enhanced recovery rehabilitation compared to partial weight-bearing. Small absolute values and differences were demonstrated and therefore possibly below clinical relevance. Anatomical radiological parameters and anthropometric data did not appear to be risk factors for stem subsidence.

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Radiographic Recurrence of Hallux Valgus Based on Osteotomy Location

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00219 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0021

Author(s):

Andrew Federer ◽

Travis Dekker ◽

David Tainter ◽

Jordan Liles ◽

Mark Easley ◽

...

Keyword(s):

Hallux Valgus ◽

Weight Bearing ◽

Surgical Correction ◽

P Value ◽

Single Individual ◽

Hallux Valgus Angle ◽

Intermetatarsal Angle ◽

Valgus Angle ◽

Significant Difference

Category: Bunion Introduction/Purpose: Hallux valgus (HV) is one of the most common deformities of the foot resulting in pain and lifestyle modification of the patient. Recurrence rates of 10-47% have been documented in single individual osteotomy series. Unfortunately, surgical correction and recurrence are often defined as changes related to normal radiographs and not actually as the magnitude of correction lost with follow-up. Currently there have not been studies evaluating the percentage of recurrence of intermetatarsal angle (IMA) and hallux valgus angle (HVA). As there is substantial difference in starting IMA and HVA, as well as amount of surgical correction, our goal was to evaluate the percentage loss of correction over time comparing preoperative, initial postoperative and minimum of 2-year follow up radiographs among three different surgical correction techniques. Methods: This is a retrospective chart review study that examines the weight-bearing radiographic measurements of patients undergoing hallux valgus corrective surgery at a single institution over 5 years. Fifty-three patients were divided into first tarsometatarsal arthrodesis (i.e. Lapidus), mid-diaphyseal osteotomies (i.e. scarf), and distal metatarsal osteotomies (i.e. chevron). The preoperative, initial postoperative, and final follow up weight-bearing radiographs were measured for intermetatarsal angle (IMA) and hallux valgus angle (HVA). Primary outcome was percentage of recurrence of IMA and HVA, with the difference in angles between preoperative and initial postoperative weight-bearing films being considered 100% correction. The percentage of recurrence between initial postoperative and most recent follow up was then calculated (Figure 1A). A one-way analysis of variance (ANOVA) test and post-hoc Tukey-Kramer tests were used to compare preoperative IMA and HVA and percentage recurrence of IMA and HVA at most recent follow up. Results: There was no significant difference between Lapidus (14.3deg) and mid-diaphyseal osteotomies (12.7deg) in preoperative IMA (p-value=0.26). There was a significant difference between Lapidus (-0.3deg) and mid-diaphyseal (2.8deg) osteotomies for degree of hallux valgus recurrence as measured by IMA between initial postoperative films and final 2-year follow up (p-value=0.009). Lapidus procedure showed a greater magnitude decrease in IMA degrees from preoperation to final follow up compared to distal osteotomy (p-value=0.037) and trended toward significance compared to mid-diaphyseal (p-value=0.056). Mid-diaphyseal osteotomies (30%) showed a statistically significant higher percentage of IMA recurrence compared to Lapidus (-11%) (p-value=0.0014) (Figure 1B). When comparing percentage recurrence of HVA, distal osteotomies had a significantly smaller rate of recurrence when compared to the diaphyseal osteotomies (p-value=0.030). Conclusion: Though Lapidus and mid-diaphyseal osteotomies were performed for patients with a similar preoperative IMA, mid-diaphyseal osteotomies had a significantly higher percentage of recurrence at 2-year follow up compared to Lapidus procedures. Moreover, Lapidus procedures trended toward greater overall of IMA correction compared to mid-diaphyseal osteotomies. When either a Lapidus or mid-diaphyseal osteotomy is indicated, a Lapidus procedure may result in decreased rate of radiographic recurrence of hallux valgus at 2 years.

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A study of prospective analysis of unipolar versus bipolar hemiarthroplasty of hip joint in patients with fracture neck of femur

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211621 ◽

2021 ◽

Vol 7 (3) ◽

pp. 629

Author(s):

Raja X. ◽

Arjun Sarvesh ◽

Karthikeyen M. ◽

A. E. Manoharan

Keyword(s):

Femoral Neck ◽

Weight Bearing ◽

Femoral Neck Fractures ◽

Harris Hip Score ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Early Weight Bearing ◽

Group I ◽

Significant Difference ◽

Group Ii

Background: Femoral neck fractures occur most commonly in elderly females and are a major cause of morbidity and mortality in this age group and require immediate and appropriate management. Aim of the study was to compare the functional outcome of unipolar Austin Moore's prosthesis (AMP) hemiarthroplasty (HA) and bipolar (BHA) HA with femoral neck fractures using Harris hip score system.Methods: The study was conducted on 60 patients aged above 50 years with fractured neck of femur admitted in Vinayaka missions Kirupananda Variyar medical college and hospital from August 2017 to August 2019. Patients with femoral neck fracture were allocated randomly to have 30 cases of AMP.Results: Out of the 60 cases, the patients in the bipolar (nonmodular) HA group II showed better functional outcomes compared to unipolar (AMP) HA group I after six months follow-ups. At 12 months of follow-up, there was no significant difference between group I (AMP) and group II (BHA).Conclusions: Our study demonstrates, hemiarthroplasty of the hip for femoral neck fractures is a good option in elderly patients. The mortality and morbidity are not high, the operative procedure is simple, complications are less disabling, early weight-bearing and functional results are satisfactory and second surgery are less frequently required.

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Outcome of Ilizarov assisted ankle arthrodesis

International Surgery Journal ◽

10.18203/2349-2902.isj20180015 ◽

2018 ◽

Vol 5 (2) ◽

pp. 433

Author(s):

Priyajit Chattopadhyay ◽

Paras Kumar Banka ◽

Anindya Debnath ◽

Sanjay Kumar

Keyword(s):

Dynamic Compression ◽

Weight Bearing ◽

Major Complication ◽

Ankle Arthrodesis ◽

Time Interval ◽

Early Weight Bearing ◽

Ilizarov Fixator ◽

American Orthopaedic ◽

Second Procedure

Background: Among the various techniques used for ankle arthrodesis, Ilizarov technique has various advantages along with the potential for treating complex and failed cases.Methods: Eleven cases were undertaken for ankle arthrodesis using the Ilizarov fixator. Two rings were applied along the tibia and one at the talus/calcaneum. The articular cartilage was denuded, and dynamic compression applied. The clinical, functional and radiological outcome were evaluated. The goal was a stable fusion with a well aligned foot.Results: The mean follow-up period was 95 weeks. Fusion was achieved in all cases with no major complication. Only one case had a residual deformity. The average time interval for the ankle fusion was 140.8±25.7 days. The postoperative modified American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot score was 67.5±9.6 points.Conclusions: Ilizarov assisted ankle arthrodesis aids in early weight bearing, better alignment, and has good functional outcomes even in cases with previously failed procedures. It has the advantage of postoperative readjustment of the arthrodesis without the need of any second procedure with no major complications.

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How do orthopaedic surgeons and rehabilitation professionals interpret and assess ‘toe touch’ weight bearing and ‘partial’ weight bearing status in the rehabilitation setting?

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2017-000326 ◽

2018 ◽

Vol 4 (1) ◽

pp. e000326 ◽

Cited By ~ 1

Author(s):

Stephen G Thompson ◽

Rhodri D Phillip ◽

Andrew Roberts

Keyword(s):

Weight Bearing ◽

Total Body Weight ◽

Medical Rehabilitation ◽

Partial Weight Bearing ◽

Rehabilitation Centre ◽

Orthopaedic Surgeons ◽

Rehabilitation Professionals ◽

Wide Range ◽

Significant Difference ◽

Partial Weight

AimTo compare the interpretation of toe touch weight bearing (TTWB) and partial weight bearing (PWB) among orthopaedic surgeons, rehabilitation professionals and patients.Methodology78 consultant and middle-grade orthopaedic surgeons in the UK completed a questionnaire. 64 rehabilitation professionals (including physiotherapists) at Defence Medical Rehabilitation Centre Headley Court were also recruited. Both groups provided their interpretation of TTWB and PWB as a percentage of total body weight (%TBW). Each rehabilitation professional, then applied what they interpreted to be TTWB and PWB using a Lasar Posture weighing device. The predicted values were compared with the actual values demonstrated.ResultsThere was no significant difference between orthopaedic surgeons and rehabilitation professionals in their interpretation of TTWB and PWB, however there was a wide range of responses. There was a significant difference between the predicted %TBW and the actual values demonstrated by the ‘educated patient’ (mean difference 4.8 (TTWB) and 22.9 (PWB)).ConclusionHealthcare professionals vary greatly in their interpretation of the terms TTWB and PWB. Therefore, for a consistency in rehabilitation delivery the terms should not be used in isolation without a further descriptor. Static measures of weight application are lower than people think they are applying. We encourage the use of loading practice with a scale to reassure and educate patients.

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