Evidence map›Paper›PMID 41194216›Full record

ArticlePilot and feasibility studies2025

Immediate versus delayed weight bearing for fractures of the pelvis, acetabulum, distal femur, and proximal and distal tibia: a feasibility randomized controlled trial.

Peter N Mittwede, Vivian Li, David O Okhuereigbe, Alice C Bell, Casey Loudermilk, Haley K Demyanovich, Joshua E Lawrence, Kristin E Turner, Murali Kovvur, Jordan P Brand and 10 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pilot and feasibility studies, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05595148 (Randomized Feasibility Trial for Immediate vs Delayed Weightbearing for Surgically Treated Fractures), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05595148 naenrolling by invitationnot on this map

Randomized Feasibility Trial for Immediate vs Delayed Weightbearing for Surgically Treated Fractures

TypeinterventionalSponsorUniversity of Maryland, BaltimoreRan2023 to 2026Enrolled100ConditionsRehabilitationArmsImmediate WBAT, No Intervention: Delayed WBAT
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Peter N MittwedeDepartment of Orthopaedic Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA. pmittwede@gmail.com.ORCID http://orcid.org/0000-0002-1200-9067
Vivian LiDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
David O OkhuereigbeDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Alice C BellDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Casey LoudermilkDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Haley K DemyanovichDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Joshua E LawrenceDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Kristin E TurnerDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Murali KovvurDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Jordan P BrandCovenant Healthcare, Saginaw, MI, USA.
Daniel J CunninghamDepartment of Orthopedic Surgery, Prisma Health, Columbia, SC, USA.
Daniel J JohnsonDepartment of Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Aresh SepehriDepartment of Orthopaedics, The University of British Columbia, Vancouver, BC, Canada.
Marcus F SciadiniDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Jason W NasconeDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Mark J GageDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Eric C HempenDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Nathan N O'HaraDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Gerard P SlobogeanDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
Robert V O'TooleDepartment of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.

Funding

AO North America 171408-FEL2022
6 · The paper itself

Abstract

backgroundEarly weight bearing is frequently allowed and encouraged following fixation of hip and femoral and tibial shaft fractures, while pelvis, acetabulum, and lower extremity periarticular fractures are often prescribed 6-12 weeks of restricted weight bearing. Our objective was to perform a feasibility randomized trial of immediate versus delayed weight bearing as tolerated (WBAT) for fractures of the pelvis, acetabulum, distal femur, and proximal and distal tibia.

methodsA parallel two-arm pilot feasibility trial was performed at one academic level I trauma center in the United States. Patients with a fracture of the pelvis, acetabulum, distal femur, proximal tibia, or distal tibia were eligible. Patients were randomized to either immediate WBAT or delayed (≥ 6 weeks) weight bearing after surgery. Our feasibility criteria included the following: (1) 25% overall enrollment (surgeon and patient agreement to participate in 50% eligible cases), (2) > 90% follow-up at 3 months), (3) 100% correct documentation of weight bearing status, and (4) 100% correct documentation of secondary outcome (reoperation).

resultsSurgeons allowed inclusion of 64/133 (48.1%) of eligible patients (by fracture type, 76% of pelvis; 43% of acetabulum; 38% of distal femur; 45% of proximal tibia (39% of tibial plateau); and 56% of distal tibia fractures). 50/64 (78%) of these patients agreed to participate in the study, for an overall enrollment of 38% (50/133). The follow-up rate was 46/50 (92%) at the 3-month follow-up. Correct documentation of postoperative weight bearing status and the secondary outcome of reoperation was achieved in all cases 50/50 (100%). There were two reoperations (one hardware failure and one wound infection) in the immediate WBAT group, and none in the delayed weight bearing group.

conclusionAll four of the feasibility criteria were met. While we did not meet our target of 50% of patients whom surgeons were willing to randomize, we did exceed the target of 25% overall patient enrollment. This feasibility trial demonstrates that a randomized controlled trial of early versus delayed weight bearing would be feasible for certain fracture types, and these findings will be used to help design future studies in this realm.

trial registrationClinicalTrials.gov identifier: NCT05595148.

Indexed as

Early weight bearingFeasibilityFracturesRandomized controlled trial

Identifiers

PMID41194216
PMCPMC12587496

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.