Principles of Movement in Pediatric Patients with Fractures

 Principles of movement in the injured patient 

 

Weight bear status (WB) defines whether or not and how much weight the child can put on his or her affected extremity: 

• NWB – non-weight bearing, or no weight 
• WBAT – weight bear as tolerated or whatever the child will tolerate 
• PWB, TTWB, or TDWB – partial weight bear, toe touch weight bear, touch down weight bear – put only some weight on the extremity (used in older children who are able to understand) 

Supportive Devices

• Movement within these devices is based upon weight bear status as the device provides the necessary support when appropriately applied.  
• EXPECT initial discomfort with movement – however, the discomfort SHOULD NOT outweigh the need and benefits of movement. 
• Proper premedication when used can be very effective in positioning.  

 Disclaimer

These guidelines are not intended as a directive or to present a definitive statement of the applicable standard of patient care.  They are offered as an approach for quality assurance and risk management and are subject to (1) revision as warranted by the continuing evaluation of technology and practice; (2) the overall individual professional discretion and judgment of the treating provider in a given patient circumstance; and (3) the patient’s willingness to follow the recommended treatment. 

fractures, orthopaedics

Developed July 2017, reviewed 2020, 2024