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European Journal of Orthopaedic Surgery & Traumatology

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01-10-2019 | Original Article • HIP - FRACTURES

The association between weight-bearing status and early complications in hip fractures

Authors: Jared Warren, Kavin Sundaram, Hiba Anis, John McLaughlin, Brendan Patterson, Carlos A. Higuera, Nicolas S. Piuzzi

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 7/2019

Abstract

Background

Early mobilization and weight-bearing have been proposed to improve hip fracture outcomes. This study aimed to compare early postoperative complications and outcomes of patients who underwent weight-bearing as tolerated (WBAT) on postoperative day one (POD1) with those that did not on: (1) 30-day mortality; (2) 30-day postoperative major and minor complications; (3) length of stay (LOS); and (4) discharge disposition after hip fracture management.

Methods

The NSQIP database was used to identify 7947 hip fracture patients managed with a hemiarthroplasty and internal fixation, sliding hip screw, or cephalomedullary nail, for a total of 5845 patients were allowed to WBAT on POD1. They were compared to patients who were non-WBAT using adjusted multivariate regression models to evaluate the effect of WBAT status on the outcomes above.

Results

Among the cephalomedullary nail patients, WBAT on POD1 was associated with a decreased likelihood of mortality. In the cephalomedullary nail and sliding hip screw treatment groups, patients were less likely to experience major and minor complications if they were WBAT on POD1. WBAT patients had shorter LOS in the sliding hip screw and cephalomedullary nail treatment groups. Patients were less likely to be discharged to a non-home facility when WBAT on POD1 regardless of treatment.

Conclusion

Early weight-bearing after surgical care of hip fracture seems to decrease morbidity and mortality; however, this effect is treatment dependent. These findings further support the need for early mobilization and rapid recovery programs in the care of hip fracture patients.

Level of evidence

Level III.

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Title: The association between weight-bearing status and early complications in hip fractures
Authors: Jared Warren
Kavin Sundaram
Hiba Anis
John McLaughlin
Brendan Patterson
Carlos A. Higuera
Nicolas S. Piuzzi
Publication date: 01-10-2019
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 7/2019
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02453-z

At a glance: The STEP trials

Springer Medicine

The association between weight-bearing status and early complications in hip fractures

Abstract

Background

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Level of evidence

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