Postoperative Outcomes with Unrestricted or Restricted Immediate Weight Bearing Status After Operatively Treated...

The functional recovery of unstable pelvic ring injuries patients relies heavily on their ability to mobilize post-operatively and immobility is associated with a multitude of negative outcomes. The purpose of this study was to examine the restricted (NWB) and unrestricted (WB) immediate postoperative weight bearing protocols for patients who have undergone unstable pelvic ring injury fixation and evaluate trends in postoperative outcomes.

A retrospective review of medical charts and radiographs were performed on adult patients from 1/2012 through 6/2022 at a level one trauma center. Outcomes examined time to fracture healing, time to full weight bearing, postoperative complications, and reoperation between groups.

151 patients (50 females, 101 males) met the eligibility criteria. Eighty-six patients (mean age 46 years, 71% men) were designated NWB group, and 65 patients (mean age 46 years, 62% men) were designated WB group. The most common injury mechanism was motor vehicle collision (MVC) (n=60, 40%) followed by fall from height (n=29, 19%). The most common injury patterns were lateral compression (n=87, 58%), followed by anteroposterior compression (n=47, 31%) and vertical shear (n=17, 11%). 54 (36%) patients who had postoperative complications with seven (5%) patients having both fracture-related and no-fracture-related complications noted. The NWB group had a mean fracture healing time of 17 weeks, 14 fracture related complications, 21 nonfracture related complications, 23 reoperations, and a mean full weight bearing time of 12 weeks. The WB group had a mean fracture healing time of 16 weeks, 14 fracture related complications, 13 non-fracture related complications, 15 reoperations, and a mean full weight bearing time of nine weeks. The mean duration of the initial weight bearing restriction for the NWB group was 9.7±3.4 weeks. No statistically significant difference found between these two groups (healing time: p=0.73; fracture related complication: p=0.41; non-fracture related complication: p=0.38; reoperation: p=0.61; full weight bearing time: p=0.73).

This study shows unrestricted postoperative weight bearing protocols achieved similar postoperative outcomes as restricted postoperative weight bearing protocols. The choice of restricted or unrestricted postoperative weight bearing protocols after surgical treated unstable pelvic ring injuries patients could not significantly affect the postoperative outcomes.

IV.