Early versus delayed weight bearing after surgical fixation of distal femur fractures: a non-randomized comparative study

Consigliere, Paolo; Iliopoulos, Efthymios; Ads, Tamer; Trompeter, Alex

doi:10.1007/s00590-019-02486-4

“…In addition, early mobilization is also able to accelerate the recovery process after patient undergoing hip surgery (9,10). The length of stay on patients with total knee arthroplasty (TKA) that undergo early mobilization are shorter than patients did not undergo early mobilization (10 daysversus 12 days) (11).Then, early mobilization of femur postoperative patients also showed an acceleration of the length of stay (19).…”

Section: Resultsmentioning

confidence: 99%

Effect of Early Mobilization on Hip and Lower Extremity Postoperative: A Literature Review

Aprisunadi¹,

Pandin²

2021

Preprint

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Background: The incidence of fracture and surgery of the hip and lower extremities is still high. Long postoperative bed rest has the potential to increase the incidence of various complications that may increase the morbidity and mortality rate of patients after hip and lower extremities surgery. Aim: This literature review aimed to identify the effects of early mobilization in hip and lower extremity postoperative. Method: Search for articles on several databases such as ProQuest, ScienceDirect, CINAHL, Medline, Wiley Online and Scopus, using the Boolean operator by combining several keywords according to the literature review topic, with inclusion criteria are published in the last 3 years (2019-2021), used a quantitative design, written in English and full text articles. A total of 435 articles were obtained, then screened and reviewed, so that there were 16 (sixteen) eligible articles.Result: There were 11 (eleven) effects of early mobilization, i.e. reducing length of stay, reducing the risk of deep vein thrombosis (DVT), reducing pulmonary infections (pneumonia), reducing urinary tract infections, reducing the risk of wound infection, improving extremity function and ability to walk, reducing postoperative pain, reducing the risk of pressure sores, reducing postoperative delirium, reducing readmission and lowering hospitalization costs. Conclusion: This literature review showed that early mobilization is safe and effective in postoperative patients to reduce the risk of complications and adverse events. Nurses and health workers who care for patients could implement early mobilization and motivate patients to be cooperative in undergoing early mobilization.

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“…5 These are promising results that may alter postoperative protocols, though larger studies are an area of future research. 2,7 There is a paucity of data regarding the use of DFR in the setting of trauma. Berend and Lombardi published their results of DFR for nononcologic indications, highlighting generally good outcomes; however, only 15 patients in this series of 39 had their procedures in the setting of trauma.…”

Section: Discussionmentioning

confidence: 99%

Distal Femoral Replacement for Fractures Allows for Early Mobilization with Low Complication Rates: A Multicenter Review

Stancil

¹

,

Romm

²

,

Lack

³

et al. 2021

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Periprosthetic fractures around a total knee arthroplasty (TKA), comminuted and intra-articular femur fractures, or fracture nonunions in osteoporotic bone represent technically challenging problems. This is particularly true when the fracture involves a loose femoral component or the pattern results in suboptimal fixation potential. These clinical indications often arise in an older and comorbid patient population in whom a principal goal of treatment includes allowing for early mobilization. Limited data indicate that arthroplasty via distal femoral replacement (DFR) is a reasonable alternative to open reduction and internal fixation, allowing for early ambulation with low complication rates. We performed a retrospective review of trauma and arthroplasty surgeries at three tertiary referral institutions. Adult patients treated for the above with a DFR were included. Patients with active infection, open and/or high-energy injuries and revisions unrelated to fracture were excluded. Patient demographics, treatment details, and outcomes were assessed. Between 2002 and 2017, 90 DFR's were performed for the above indications with a mean follow-up of 24 months. Postoperatively, 80 patients (88%) were allowed to weight bear as tolerated, and at final follow-up, 9 patients (10%) remained dependent on a wheelchair. The average arc of motion at final follow-up was 95 degrees. There were seven (8%) implant-related complications requiring secondary surgeries: two infections, one with associated component loosening; one fracture of the hinge mechanism and one femoral component failure in conjunction with a patellofemoral dislocation (both requiring revision); one case of patellofemoral arthrosis in a patient with an unresurfaced patella; one periprosthetic fracture with associated wound dehiscence; and one case of arthrofibrosis. In each of these cases, only modular components of the DFR were exchanged. All nonmodular components cemented into the femur or tibia were retained. DFR provides a viable reconstruction option in the treatment of acute distal femur fractures, periprosthetic femur fractures, and fracture nonunions. We noted that in an elderly patient population with high comorbidities, the complication and secondary surgery rates remained relatively low, while allowing for immediate weight bearing.

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“…The length of stay on patients with total knee arthroplasty (TKA) that undergo early mobilization are shorter than patients did not undergo early mobilization (10 days versus 12 days) (10). Then, early mobilization of femur postoperative patients also showed an acceleration of the length of stay (18).…”

Section: Methods Searching Strategymentioning

confidence: 96%

Effect of Early Mobilization on Hip and Lower Extremity Postoperative: A Literature Review

Aprisunadi¹,

Pandin²

2021

Preprint

0

View full text Add to dashboard Cite

Background: The incidence of fracture and surgery of the hip and lower extremities is still high. Long postoperative bed rest has the potential to increase the incidence of various complications that may increase the morbidity and mortality rate of patients after hip and lower extremities surgery. Aim: This literature review aimed to identify the effects of early mobilization in hip and lower extremity postoperative. Method: Search for articles on several databases such as ProQuest, ScienceDirect, CINAHL, Medline, Wiley Online and Scopus, using the Boolean operator by combining several keywords according to the literature review topic, with inclusion criteria are published in the last 3 years (2019-2021), used a quantitative design, written in English and full text articles. A total of 435 articles were obtained, then screened and reviewed, so that there were 16 (sixteen) eligible articles.Result: There were 11 (eleven) effects of early mobilization, i.e. reducing length of stay, reducing the risk of deep vein thrombosis (DVT), reducing pulmonary infections (pneumonia), reducing urinary tract infections, reducing the risk of wound infection, improving extremity function and ability to walk, reducing postoperative pain, reducing the risk of pressure sores, reducing postoperative delirium, reducing readmission and lowering hospitalization costs. Conclusion: This literature review showed that early mobilization is safe and effective in postoperative patients to reduce the risk of complications and adverse events. Nurses and health workers who care for patients could implement early mobilization and motivate patients to be cooperative in undergoing early mobilization.

show abstract

Early versus delayed weight bearing after surgical fixation of distal femur fractures: a non-randomized comparative study

Cited by 44 publications

References 36 publications

Effect of Early Mobilization on Hip and Lower Extremity Postoperative: A Literature Review

Effect of Early Mobilization on Hip and Lower Extremity Postoperative: A Literature Review

Distal Femoral Replacement for Fractures Allows for Early Mobilization with Low Complication Rates: A Multicenter Review

Effect of Early Mobilization on Hip and Lower Extremity Postoperative: A Literature Review

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