Identification of hip fracture patients at risk for postoperative mobilisation complications via handgrip strength assessment

Abstract

Introduction Treatment of older adult hip fracture patients can be challenging and requires early postoperative mobilisation to prevent complications. Simple clinical tools to predict mobilisation/weight-bearing difficulties after hip fracture surgery are scarcely available and analysis of handgrip strength could be a feasible approach. In the present study, we hypothesised that patients with reduced handgrip strength show incapability to follow postoperative weight-bearing instructions. Materials and methods Eighty-four patients aged ≥ 65 years with a proximal femur fracture (trochanteric, n = 45 or femoral neck, n = 39), who were admitted to a certified orthogeriatric center, were consecutively enrolled in a prospective study design. Five days after surgery (intramedullary nailing or arthroplasty), a standardised assessment of handgrip strength and a gait analysis (via insole forcesensors) was performed. Results Handgrip strength showed positive correlation with average peak force during gait on the affected limb (0.259), postoperative Parker Mobility Score (0.287) and Barthel Index (0.306). Only slight positive correlation was observed with gait speed (0.157). These results were congruent with multivariate regression analysis. Conclusion Assessment of handgrip strength is a simple and reliable tool for early prediction of postoperative mobilisation complications like the inability to follow weight-bearing instructions in older hip fracture patients. Follow-up studies should evaluate if these findings also match with other fracture types and result in personalised adjustment of current aftercare patterns. In addition, efforts should be made to combine objectively collected data as handgrip strength or gait speed in a prediction model for long-term outcome of orthogeriatric patients.

The Barthel Index for Predicting Postoperative Complications in Elderly Patients Undergoing Abdominal Surgery: A Prospective Single-center Study

“…The Barthel index has also been reported as a risk factor for postoperative complications in retrospective reports (8)(9)(10)(11), consistent with the present findings. However, the Katz index was not a significant indicator in the current analysis.…”

“…It is a simple and ). The Barthel index, which focuses on assessing physical function in the CGA, is helpful as a postoperative functional assessment in orthopedic surgery and as a predictor of postoperative complications in gastrointestinal surgery for certain diseases (8)(9)(10)(11). The Katz index has fewer evaluation items than the Barthel index and evaluates six functions, namely bathing, dressing, toileting, transferring, continence, and feeding (12,13).…”

Muscle strength is associated with fracture risk obtained by fracture risk assessment tool (FRAX) in women with breast cancer

“…This indicator is related not only to the risk and incidence of fractures, but also to the recovery of fractured individuals [39]. Patients with higher HGS show better recovery after hip fracture, which suggests that it can be used as a screening tool to identify those who need intensive rehabilitation [42][43][44]. Such a finding may contribute to the prognosis of these patients, since hip fractures are most serious and cause permanent disability in approximately 20% of survivors, with only about 40% of the afflicted individuals eventually attaining preinjury function levels [45].…”

High risks of failure observed for A1 trochanteric femoral fractures treated with a DHS compared to the PFNA in a prospective observational cohort study

“…Although intramedullary nails are sometimes generalized, no definitive conclusions can be drawn for any other types besides the PFNA from this study [ 14 , 29 ]. Using different methods to assess functionality or recovery, for example using the Barthel index instead of the Katz ADL, may yield different results [ 7 , 10 ].…”

Handgrip Strength as a Predictor of Successful Rehabilitation After Hip Fracture in Patients 65 Years of Age and Above

“…Thus, for example, some studies measured HGS as a continuous variable 10−12 and others as a categorical variable. [13][14][15] The Revised European Working Group on Sarcopenia (EWGSOP2) defined probable sarcopenia with a cut-off of 27 kg for men and 16 kg for women. 16 Perez-Rodriguez et al 17 used somewhat different definitions with cut-offs of 23 kg for men and 13 kg for women.…”