Bony Weight Bearing Disorder
Conditions
Keywords
fracture reduction, proximal femur fracture, geriatrics, early weight-bearing
Brief summary
Purpose: Proximal femur fracture is a major traumatic injury in elderly populations; however, practical postoperative weight-bearing protocols are lacking. Therefore, the purpose of the present study was to investigate whether early weight-bearing status after proximal femur nail fixation is associated with any loss of reduction and evaluate the clinical outcomes of this intervention. Patients and methods: For this prospective single-center clinical trial study, we recruited 60 geriatric proximal femur fracture cases, classified by AO/OTA 2018, receiving intramedullary nail fixation. The participants were assigned to the Early-weight-bearing group (n= 30) or the Weight-bearing restriction group (n = 30). Clinical outcomes included the Harris functional hip score and VAS pain score. Additionally, demographic data, radiological parameters, time to weight-bearing, mortality rate, medical and surgical complications, and final ambulation status were recorded.
Interventions
BEHAVIORALEarly-Weight bearing
The patients began early weight bearing under attending physician and physiotherapist surveillance within 48 hours after surgery. Patients were instructed to stand up near the bed, and muscle power, gait stability, and pain tolerance were recorded. The physiotherapist instructed the patients to perform early mobilization and weight bearing as tolerable by self-adjustment of body weight distribution over the bilateral lower extremities, and walking assistance was used to prevent repeat falling accidents.
Sponsors
Far Eastern Memorial Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients with AO/OTA type 31 fractures were included, and all fractures were classified using intraoperative fluoroscopy with traction on the fracture table.
Exclusion criteria
* Patients with pathological fractures, neurovascular insufficiency, ipsilateral lower extremity musculoskeletal injury, multiple fractures, or high risk of falling, including frequent falling accidents within 6 months, unsteady gait, ipsilateral neuropathy, limb weakness, and urinary incontinence were excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Harris Hip Functional score | Functional and radiographic evaluations was performed at week 1 postoperatively | The questionaire to patient. (HHS score 0-100,\<60 poor,\>80 good) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual analog pain score | Record at week 1 postoperatively | Independent assessor (VAS:0-10, higher scores mean a worse outcome) |
| Complication | Functional and radiographic evaluations were performed at week 1, months 1, 3, 6, and 12 postoperatively | Loss of reduction, malunion, nonunion or medical complications |
Countries
Taiwan
Contacts
Primary ContactYen Cheng Chen, Doctor
Outcome results
None listed