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Weight-bearing

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In orthopedics, weight-bearing is the amount of weight a patient puts on an injured body part. Generally, it refers to a leg, ankle or foot that has been fractured or upon which surgery has been performed, but the term can also be used to refer to resting on an arm or a wrist. In general, it is described as a percentage of the body weight, because each leg of a healthy person carries the full body weight when walking, in an alternating fashion.[citation needed]

After surgery of the hip, or of the bones of the leg, ankle, or foot, it is of the utmost importance for recovery to get the right amount of weight-bearing when moving around with crutches or frames.[1]

The grades of weight bearing for each phase of recovery will be determined by the surgeon. The Anti-Gravity Treadmill can allow testing of weight bearing by lowering effective body weight in 1% increments from 100 to 20% of body weight.[2]

Grades

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  • Non-weight-bearing (NWB): The leg must not touch the floor and is not permitted to support any weight at all.[3] The patient may hop on the other leg or use crutches or other devices for mobility. In this grade, 0% of the body weight may be rested on the leg.
  • Touch-down weight-bearing or Toe-touch weight-bearing: The foot or toes may touch the floor (such as to maintain balance), but not support any weight.[3] Do not place actual weight on the affected leg. Imagine having an egg underfoot that one is not to crush.
  • Partial weight-bearing: A small amount of weight may be supported by the affected leg.[3] The weight may be gradually increased up to 50% of the body weight, which would permit the affected person to stand with his body weight evenly supported by both feet (but not to walk).
  • Weight-bearing as tolerated: Usually assigned to people that can support from 50 to 100% of the body weight on the affected leg, the affected person independently chooses the weight supported by the extremity.[3] The amount tolerated may vary according to the circumstances.
  • Full weight-bearing: The leg can now carry 100% of the body weight, which permits normal walking.[3]

References

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  1. ^ Warren, Jared; Sundaram, Kavin; Anis, Hiba; McLaughlin, John; Patterson, Brendan; Higuera, Carlos A.; Piuzzi, Nicolas S. (October 2019). "The association between weight-bearing status and early complications in hip fractures". European Journal of Orthopaedic Surgery & Traumatology. 29 (7): 1419–1427. doi:10.1007/s00590-019-02453-z. ISSN 1633-8065.
  2. ^ Henkelmann, Ralf; Palke, Lisa; Schneider, Sebastian; Müller, Daniel; Karich, Bernhard; Mende, Meinhard; Josten, Christoph; Böhme, Jörg (January 2021). "Impact of anti-gravity treadmill rehabilitation therapy on the clinical outcomes after fixation of lower limb fractures: A randomized clinical trial". Clinical Rehabilitation. 35 (3): 356–366. doi:10.1177/0269215520966857. ISSN 0269-2155.
  3. ^ a b c d e Pierson, F. Principles and Techniques of Patient Care, Third Edition, p.208, WB Saunders Company, 2002.