Weightbearing

Weightbearing refers to the amount of a person’s body weight that is transmitted through a limb, usually via the foot, during standing or walking. In orthopedic practice, weightbearing status is used to describe how much load a limb may bear and is commonly categorized as nonweightbearing (NWB), toe-touch or touch-down weightbearing (TTWB), partial weightbearing (PWB) with a prescribed percentage or to tolerance, weightbearing as tolerated (WBAT), and full weightbearing (FWB).

Weightbearing status is chosen to protect healing tissues after fractures, surgical reconstruction, ligament or tendon injuries, or joint replacement, while still allowing gradual stimulation of bone and connective tissue and maintenance of muscle mass. The specific status depends on factors such as fracture stability, fixation, tissue healing, and surgeon judgment.

Management typically involves assistive devices such as crutches, a walker, or a cane, and a stepwise progression plan. Some protocols specify fixed weightbearing milestones (e.g., NWB to TTWB to 25–50% to 75–100%), while others use WBAT guided by pain, swelling, and radiographic evidence. Objective weighting devices may be used in certain settings, but progression largely relies on clinical assessment and patient feedback.

Risks include delayed healing or disuse atrophy with underloading, and potential hardware failure, malalignment, or re-injury with premature or excessive loading. Weightbearing plans may be adjusted for osteoporosis, neuropathy, or other comorbidities, and require close follow-up to optimize healing and function.