Nonweightbearing After Foot and Ankle Surgery: Not a Benign Order

Document Type

Conference Proceeding

Publication Date

2025

Publication Title

Foot & Ankle Orthopaedics

Abstract

Introduction/Purpose: After orthopaedic surgeries of the foot and ankle, patients are often madenonweightbearing on the affected extremity. Rationale for making patients nonweightbearing includes allowing for bony and soft tissue healing and to prevent early complications, particularly hardware failure. However, there is minimal literature regarding the consequences and complications of making patients nonweightbearing for a prolonged period of time. Our study sought to investigate incidence of falls as well as changes in patient reported outcome scores after falls in patients that underwent foot and ankle surgery and were subsequently made nonweightbearing. Methods: A prospective observational study of 165 patients undergoing surgeries of the foot and ankle was conducted. Patients were made nonweightbearing for anywhere from 2 to 12 weeks after surgery. Surveys were conducted to record both objective as well as patient reported outcomes at the first post-operative visit, usually at the two-week mark. Patient demographics that were recorded included age, sex, body mass index, region of surgery(ankle, hindfoot, mid-/forefoot), and number of falls in the six months prior to surgery. Outcomes measured included number of falls since being made nonweightbearing, visual analogue scale (VAS), and Patient-Reported Outcomes Measurement Information System (PROMIS) scores across multiple domains. Results: The mean age of our 165 patient cohort was 51.2 years old at time of surgery (standard deviation of 15.8years). 47.9% of patients were female. Mean BMI was 31.2 (standard deviation of 7.1). 28.5% of surgeries were at the ankle, 21.2% at the hindfoot, and 50.3% at the forefoot/ midfoot. 56 of the 165 patients reported at least one fall while they were nonweightbearing (33.9%). Patients that did have a postoperative fall reported significantly worse PROMIS scores for both anxiety as well as fatigue compared to those that did not fall (p-values of < 0.01 and 0.02 respectively). Patient baseline demographics including age and BMI had no correlation with incidence of falls. Conclusion: Our study demonstrates that postoperative falls are exceedingly common in patients that undergo foot and ankle surgery and subsequently are made nonweightbearing. Should a patient have a postoperative fall while being nonweightbearing, they are more likely to report lower patient-reported outcome measures. Future postoperative protocols will need to optimize the balance between early weightbearing and concern for complications in order to better optimize patient outcomes after foot and ankle surgery.

Volume

10

Issue

4

Comments

AOFAS (American Foot & Ankle Society) Annual Meeting, September 10-13, 2025, Savannah, GA

DOI

10.1177/2473011425S00350

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