Weight bearing

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In orthopedics, weight bearing is the amount of weight a patient puts on the leg on which surgery has been performed. It is generally 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.

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.

The grades of weight bearing for each phase of recovery will be determined by the surgeon.

Grades of weight bearing

• Non weight bearing: The leg must not touch the floor. The patient must hop. This is a 0% of the body weight.
• Touch down weight bearing or Toe touch weight bearing: The weight of the leg on the floor while taking a step should be no more than 5% of the body weight.
• Partial weight bearing: The weight can be gradually increased from 30 to 50% of the body weight.
• Weight bearing as tolerated: Ranks from 50 to 100% of the body weight. The patient may increase the weight as he or she feels capable to do so.
• Full weight bearing: The leg can now carry a 100% of the body weight on a step.

Degrees of weight bearing

1. Non-weight bearing (NWB): the involved lower extremity can not be weight bearing (not permitted to touch the ground).^[1]

2. Toe touch weight bearing (TTWB): the client can rest the foot/toes of the involved lower extremity on the ground for balance BUT not for weight bearing.^[1]

3. Partial weight bearing (PWB): Permits transfer of a small amount/ limited amount of weight bearing through the involved lower extremity (even if it is up to 5 pounds of weight on the involved extremity)!^[1]

4. Weight bearing as tolerated (WBAT): the client determines the amount of weight bearing for the involved lower extremity, according to his/her tolerance.^[1]

5. Full weight bearing (FWB): the client is allowed to bear full weight on the involved lower extremity.^[1]

References

1. ^ ^{a b c d e} Pierson, F. Principles and Techniques of Patient Care, Third Edition, p.208, WB Saunders Company, 2002.