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Archives of Orthopaedic and Trauma Surgery

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01-09-2019 | Trauma Surgery

Weight-bearing restrictions reduce postoperative mobility in elderly hip fracture patients

Authors: Daniel Pfeufer, Anne Zeller, Stefan Mehaffey, Wolfgang Böcker, Christian Kammerlander, Carl Neuerburg

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2019

Abstract

Background and purpose

Reduced mobility is a severe threat to the clinical outcomes and survival of elderly hip fracture patients. These patients generally struggle to comply with partial weight bearing, yet postoperative weight-bearing restrictions are still recommended by nearly 25% of surgeons. Therefore, we hypothesized that weight-bearing restrictions in elderly hip fracture patients merely leads to reduced mobility, while transposing full weight to the fractured extremity remains unaffected disregarding the prescribed aftercare.

Patients and methods

41 equally treated patients with pertrochanteric fractures were enrolled consecutively in a maximum care hospital in a pre–post study design (level of evidence 2). A study group of 19 patients was instructed to maintain partial weight bearing (PWB), whereas the control group of 22 patients was instructed to mobilize at full weight bearing (FWB). All patients were asked to participate in a gait analysis using an insole force sensor (loadsol^®, Novel, Munich, Germany) on the fifth postoperative day.

Results

The postoperative Parker Mobility Score in the PWB group compared to the FWB group was significantly reduced (3.21 vs. 4.73, p < 0.001). Accordingly, a significantly lower gait speed in the PWB group of 0.16 m/s vs. 0.28 m/s was seen (p = 0.003). No difference in weight bearing was observed in between the groups (average peak force 350.25 N vs. 353.08 N, p = 0.918), nor any differences in the demographic characteristics, ASA Score, Barthel Index or EQ5D.

Interpretation

Weight-bearing restrictions in elderly hip fracture patients contributed to a loss of mobility, while no significant differences in loading of the affected extremity were observed. Therefore, postoperative weight-bearing restrictions in elderly hip fracture patients should be avoided, to achieve early mobilization at full weight bearing.

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Title: Weight-bearing restrictions reduce postoperative mobility in elderly hip fracture patients
Authors: Daniel Pfeufer
Anne Zeller
Stefan Mehaffey
Wolfgang Böcker
Christian Kammerlander
Carl Neuerburg
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 9/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-019-03193-9

At a glance: The STEP trials

Springer Medicine

Weight-bearing restrictions reduce postoperative mobility in elderly hip fracture patients

Abstract

Background and purpose

Patients and methods

Results

Interpretation

At a glance: The STEP trials

Springer Medicine

Abstract

Background and purpose

Patients and methods

Results

Interpretation

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