The main research goal of this thesis was the comprehensive assessment in terms of activities of daily living (ADL), quality of life, pain, postoperative complications and costs of permissive weight bearing (PWB) versus the current standard restricted weight bearing aftercare (RWB) protocols in surgically treated trauma patients with fractures of the lower extremities. PWB is effective and cost-effective and can be used as a novel approach in the aftercare treatment in surgically treated trauma patients with fractures of the lower extremities. The PWB regimen led to the patients being able to bear full weight on their affected leg much sooner, with improved ADL and quality of life, compared to those who followed the current RWB regimen. No significant differences between the two treatment regimens were found in either postoperative complication rates or pain levels. Furthermore, total costs were lower in the PWB group in comparison to the RWB group. In terms of cost per improvement in ADL, the PWB group showed higher effects and lower costs. Therefore, these results show that PWB could be a promising aftercare treatment. This means, the PWB challenges the paradigm of the current RWB guidelines being the golden standard, which have remained unchanged for 60 years.