Dr. Addulshakor Sandel Abaker Ali is a British Trauma and Orthopaedic Doctor with extensive clinical experience within the NHS. He holds an MBBS from the University of Al Fashir, an MSc in Medical Visualisation and Human Anatomy from the UK, and is a Full Member of the Royal College of Surgeons of England. He has worked across leading UK hospitals, including John Radcliffe Hospital, NHS Grampian, and Manchester Foundation NHS Trust, with experience in trauma, orthopaedics, general surgery, and cardiothoracic surgery. Dr. Ali has a strong interest in orthopaedic trauma, surgical education, rehabilitation, and patient safety. He has contributed to several audits and research projects and has published in journals including Cureus, JPRAS, and the European Society of Medicine. His academic work includes research on orthopaedic rehabilitation, radiation protection, bone tumour care, and virtual 3D medical education. He has also presented his research at national and international conferences and actively contributes to surgical education and academic discussions.

Enhancing Safe Orthopaedic Rehabilitation: Evaluating Documentation Practices for Mobilization and Weight-Bearing Protocols Background: Accurate documentation of mobilization and weight-bearing status is critical for safe rehabilitation following orthopaedic surgery or musculoskeletal injury. Poor or inconsistent recording can lead to miscommunication between teams, inappropriate rehabilitation prescriptions, and adverse patient outcomes. In August 2024, the British Orthopaedic Association (BOA) introduced updated standards to standardize terminology and enhance clarity across multidisciplinary teams. By auditing current practice against these BOA standards, this study identifies gaps in documentation and proposes targeted interventions to promote consistency, improve patient safety, and strengthen multidisciplinary care. This audit was conducted at a major trauma centre in the UK. Aim: The objectives of this study are to evaluate compliance with BOA standards in documenting weight-bearing status and mobilization plans for orthopaedic patients and to implement targeted educational interventions aimed at improving documentation practices, with their effectiveness assessed in a subsequent audit cycle. Methods: A retrospective audit was conducted on 248 patients aged ≥16 years with operative or nonoperative orthopaedic conditions affecting the pelvis, upper limbs, or lower limbs. Patients with spinal injuries or aged <16 years were excluded. Documentation was assessed against BOA criteria, including terminology use, clinical justification, quantification of limitations, duration of status, and rehabilitation protocols. Data were analysed descriptively to determine compliance rates across documentation domains. Results are presented as proportions with 95% CIs. Results: Of the 248 cases, only 95 (38.3%, 95% CI: 32.2-44.7) used standard BOA terminology: seven cases (3.0%, 95% CI: 1.2-6.0) documented “Unrestricted Weightbearing”, 30 cases (12%, 95% CI: 8.4-16.8) used “Limited Weightbearing” (LWB), and 58 cases (23%, 95% CI: 18.4-29.1) recorded “Non Weightbearing” (NWB). The remaining 153 cases (62%) used non-standard terms, with “Full Weightbearing” (FWB) being the most frequent at 104 cases (42%, 95% CI: 35.8-48.2). Out of the 248 cases audited, 119 patients (48%) required documentation to justify either NWB or LWB status. Among these, clinical justification was provided in 77 cases (65%), while 42 cases (35%) lacked appropriate documentation (95% CI: 57.0-72.5%). Quantification of LWB limitations was documented in 52 cases (68%), with 24 cases (32%) missing this detail (95% CI: 60.0-76.0%). From the total 248 cases, 118 patients required documentation specifying the duration of their NWB status. Of these, duration was recorded in 109 cases (92%), while nine cases (8%) lacked this information (95% CI: 87.0-96.5%). Additionally, among the 53 cases where documentation of walking aids and rehabilitation protocols was required, this information was recorded in 51 cases (96%) and absent in two cases (4%, 95% CI: 92.0-99.0%).Conclusion: Initial compliance with BOA documentation standards was suboptimal, particularly regarding terminology and justification for restricted weight-bearing. Statistically significant gaps were identified across multiple domains. Targeted education and visual prompts may enhance documentation consistency and promote safer rehabilitation planning.