Non-Weight-Bearing Status Compromises the Functional Level Up to 1 yr After Hip Fracture Surgery

Abstract

WB status after surgery, in addition to prefracture function, cognitive status, health status, age and fracture type, was found to be an independent predictor of the 1-yr functional outcome in hip fracture patients.

Factors Predicting Mobility and the Change in Activities of Daily Living After Hip Fracture

“…Patients with a poor prefracture functional status and cognitive impairment were also more likely to become unable to walk. Consistent with our findings, a limited prefracture level of walking ability and ADL, [2][3][4][5][6]8,22,[27][28][29] comorbidities, 3,8,28 and a poor cognitive status 3,6,10 has been previously identified as negative outcome predictors. In our cohort of patients, non-weight-bearing status after surgery was also associated with a significant decrease in the functional level of the patient at 4 months and, to a lesser extent, at the 1-year follow-up.…”

“…As in our study, restricted weightbearing after surgery for hip fracture is more frequently prescribed to patients who have undergone osteosynthesis rather than arthroplasty. 3,30 Consistently, fracture instability, 31 suboptimal osteosynthesis, 32 and osteoporosis 31,32 have been associated with mechanical complications of implants used to fix intertrochanteric fractures. Another reason for not allowing all of our patients to bear full weight on their operated limb was that our study included patients with cognitive impairment-a condition that can negatively impact the early postoperative resumption of full weight-bearing.…”

“…1 Several factors including age, 2-6 prefracture functional status, 2-8 comorbidities, 3,8,9 cognitive status, 3,4,6,8,10 weight-bearing status after surgery, 3,6 and postdischarge rehabilitation 6,7 have all been shown to influence the functional recovery after this injury. Other possible determinants, such as the type of fracture or the specific treatment used, have for the most part been underreported in observational studies of hip fractures.…”

“…11 The few studies investigating the relationship between the functional outcomes and the type of hip fracture involved have only drawn variable conclusions. 3,4,12 Therefore, a comprehensive prospective assessment of results based on a precise radiographic classification of the type of fracture would be of utmost importance. Moreover, the effect on functional outcomes of complications and medical condition after surgery or possible reoperations has seldom been investigated to date.…”

Predictors of Long-Term Mortality in Older People With Hip Fracture

“…The influence of early WB and mobilization on the postoperative functional outcome after a hip fracture has been evaluated in a number of studies. [35][36][37] Yet, there is a lack of knowledge about the influence of the WB status specifically on mortality after hip fracture. Several studies 4,20 have explored complications such as respiratory disease as a risk factor of mortality, but it is not known whether these complications could be due to late WB and mobilization.…”