None listed
Conditions
Brief summary
Injury resulting from falls is a significant contributor to hospitalisation of older Australians. Fractures resulting from falls can also lead to long term health consequences including decreased mobility and independence, reduced quality of life and even increase risk of death. While there is a great deal of research investigating effectiveness of different management strategies for healing of bones, there is limited knowledge on the overall effect of post-surgical management on health outcomes of patients following discharge from hospital. The current evidence does not clearly define which strategy is best in which patients, therefore the different treatment strategies under investigation are all part of current clinical practice. Frailty is defined as a state of reduced physiological reserve due to accumulated deficits which increases the individual’s vulnerability to adverse health outcomes. The current study aims to investigate the effect of different management strategies, during their hospital stay, for patients who have undergone surgery to repair a fracture of their lower limb on the likelihood they will develop frailty. Frailty will be measured using Frailty Index and hand grip strength. We will measure frailty soon after surgery and at 6 and 12 weeks following their surgery to investigate whether the type of treatment increases the likelihood of patients meeting the definition for frailty. This study will observe outcomes in patients grouped according to the treatment prescribed by their treatment team as 1. mobilisation (weight-bearing) 2. partial or 3. total immobilisation (non-weight bearing). The study will not affect the care of the participants.
Interventions
The study is an observational prospective cohort study aiming to determine whether a non-weight bearing post surgical management of lower limb fracture is associated with increased risk of frailty.
Patients that decide to participate in the study will be required to provide informed consent. After consent is obtained several questionnaires will be supplied, medical records will be reviewed and finally a physical test will be carried out.
Patients (community dwelling individuals above 65 years
The study is an observational prospective cohort study aiming to determine whether a non-weight bearing post surgical management of lower limb fracture is associated with increased risk of frailty. Patients that decide to participate in the study will be required to provide informed consent. After consent is obtained several questionnaires will be supplied, medical records will be reviewed and finally a physical test will be carried out. Patients (community dwelling individuals above 65 years old with fractures to the lower extremities and undergoing surgery) will be allocated to one of three groups based on the clinical management prescribed by the treating surgeons and physicians: - Non weight bearing (NWB):No weight can be placed on the operated leg. Therefore, assistive device such as walker or crutches is required. - Partial weight bearing (PWB): Allows the patient to place half of their weight on the operated leg. - Full weight bearing (FWB): Allows the patient to place all of their weight on the operated leg, there is no restrictions in the amount of weigth placed on the extremity, therefore, no assistive device is required. Patients will have follow up appointments 6 weeks and 12 weeks post-surgery. Each appointment will have a duration of approximately 1.5 hours. As this is an observational prospective cohort study, clinical management prescribed by treating physicians will not be affected by the involvement of the patient in this study.
Sponsors
Western Health
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Community dwelling • Age equal or greater than 65 • Admitted with fractures of lower extremities (hip, femur, tibia and fibula) • Surgical intervention for lower extremity fracture.
Exclusion criteria
• Patients with lower extremities fractures who are not considered for surgical management • Nursing home residents • Terminal illness • Presence of known active malignancy • Severe dementia, requiring full nursing care at home.
Outcome results
None listed