{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:15:32Z","timestamp":1790201732833,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,5,16]],"date-time":"2021-05-16T00:00:00Z","timestamp":1621123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with lower limb fractures who are non-weight bearing are at risk of the complications of the associated immobility and disability, particularly people with frailty, but there is lack of clarity about what constitutes optimal care for such patients. A scoping literature review was conducted to explore what evidence is available for the management of this patient group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>MEDLINE (PubMed) CINAHL, EMBASE and the Cochrane databases of published literature and the HMIC and SIGLE sites for grey literature were searched for primary research studies and expert reports, using an iterative approach initially including the key term \u2018non-weight bearing\u2019. All study types were included. Analysis was by narrative synthesis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>No papers were identified from a search using the key phrase \u2018non-weight bearing\u2019. With this term removed, 11 indirectly relevant articles on lower limb fractures were retrieved from the searches of the electronic databases comprising three observational studies, five non-systematic review articles, a systematic review, an opinion piece and a survey of expert opinion that had relevance to restricted weight bearing patients. The observational studies indicated depression, cognition and nutrition affect outcome and hence have indirect relevance to management. The non-systematic reviews articles emphasised the importance of maintaining strength and range of movement during immobilisation and advised an orthogeriatric model of care. Fourteen UK and 97 non-UK guidelines relevant to fragility fractures, falls and osteoporosis management were found in the grey literature, but none made specific recommendations regarding the management of any period of non-weight bearing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>These findings provide a summary of the evidence base that can be used in the development of a clinical guideline for these patients but is not sufficient. We propose that, a guideline should be developed for these patients using an expert consensus process.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afab071","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T20:39:04Z","timestamp":1618864744000},"page":"1129-1136","source":"Crossref","is-referenced-by-count":14,"title":["Optimal management of older people with frailty non-weight bearing after lower limb fracture: a scoping review"],"prefix":"10.1093","volume":"50","author":[{"given":"Saleh","family":"Aloraibi","sequence":"first","affiliation":[{"name":"University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Booth","sequence":"additional","affiliation":[{"name":"University of Nottingham, Nottingham, UK"},{"name":"NIHR Nottingham Biomedical Research Centre (BRC), Nottingham, UK"},{"name":"Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Robinson","sequence":"additional","affiliation":[{"name":"University of Nottingham, Nottingham, UK"},{"name":"NIHR Nottingham Biomedical Research Centre (BRC), Nottingham, UK"},{"name":"Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor Katharine","family":"Lunt","sequence":"additional","affiliation":[{"name":"University of Nottingham, Nottingham, UK"},{"name":"NIHR Nottingham Biomedical Research Centre (BRC), Nottingham, UK"},{"name":"Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Godfrey","sequence":"additional","affiliation":[{"name":"Nottinghamshire Healthcare NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Caswell","sequence":"additional","affiliation":[{"name":"University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Kerr","sequence":"additional","affiliation":[{"name":"Member of PPI, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Ollivere","sequence":"additional","affiliation":[{"name":"University of Nottingham, Nottingham, UK"},{"name":"NIHR Nottingham Biomedical Research Centre (BRC), Nottingham, UK"},{"name":"Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam Lee","family":"Gordon","sequence":"additional","affiliation":[{"name":"University of Nottingham, Nottingham, UK"},{"name":"NIHR Nottingham Biomedical Research Centre (BRC), Nottingham, UK"},{"name":"NIHR Applied Research Collaboration (ARC) East Midlands, Nottingham, UK"},{"name":"University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J R F","family":"Gladman","sequence":"additional","affiliation":[{"name":"University of Nottingham, Nottingham, UK"},{"name":"NIHR Nottingham Biomedical Research Centre (BRC), Nottingham, UK"},{"name":"Nottingham University Hospitals NHS Trust, Nottingham, UK"},{"name":"NIHR Applied Research Collaboration (ARC) East Midlands, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,17]]},"reference":[{"key":"2021070901200960100_ref1","first-page":"720","volume-title":"Current Diagnosis & Treatment in Orthopedics","year":"2006","edition":"4th"},{"key":"2021070901200960100_ref2","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1136\/ip.2004.005843","article-title":"Epidemiology of lower limb fractures in general practice in United Kingdom","volume":"10","author":"Kaye","year":"2004","journal-title":"Inj Prev"},{"key":"2021070901200960100_ref3","volume-title":"Weight Bearing","author":"Anderson","year":"2019"},{"key":"2021070901200960100_ref4","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s00264-012-1487-8","article-title":"Optimal mechanical environment of the healing bone fracture\/osteotomy","volume":"36","author":"Mav\u010di\u010d","year":"2012","journal-title":"Int Orthop"},{"key":"2021070901200960100_ref5","volume-title":"AO principles of fracture management, books and DVD","author":"Ruedi","year":"2007"},{"key":"2021070901200960100_ref6","doi-asserted-by":"crossref","first-page":"666","DOI":"10.3113\/FAI.2009.0666","article-title":"Early mobilization of operatively fixed ankle fractures: a systematic review","volume":"30","author":"Thomas","year":"2009","journal-title":"Foot Ankle Int"},{"key":"2021070901200960100_ref7","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/j.injury.2015.03.029","article-title":"How long should patients be kept non-weight bearing after ankle fracture fixation? 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