Weight bearing in patients with femoral neck fractures compared to pertrochanteric fractures: A postoperative gait analysis

Pfeufer, Daniel; Grabmann, Chiara; Mehaffey, Stefan; Keppler, Alexander Martin; Böcker, Wolfgang; Kammerlander, Christian; Neuerburg, Carl

doi:10.1016/j.injury.2019.05.008

Cited by 26 publications

(18 citation statements)

References 23 publications

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“…Furthermore, functional recovery did not always improve based on pre-THA values, suggesting that recovery of both ipsilateral loading and WBS is also pre-THA-dependent. Although insoles are not yet broadly used to quantify functional outcomes, such as in the THA cohort presented here, our findings support the general capability to quantify functional recovery during ADLs similar to those in other cohorts ( Pfeufer et al, 2019a ; Pfeufer et al, 2019b ; Pfeufer et al, 2020a ; Pfeufer et al, 2020b ; Renner and Queen, 2021 ). Such instrumented insoles appear to be a suitable technology for more accessible functional research in clinical environments.…”

Section: Discussionsupporting

confidence: 78%

“…Force platforms require subjects to cleanly step on the devices with each foot separately, which is challenging for THA patients to perform at pre- and post-surgery periods. Recently, load-sensing devices such as instrumented insoles that enable the assessment of lower limb loading in standard clinical settings have been developed ( Pfeufer et al, 2019a ; Pfeufer et al, 2019b ; Pfeufer et al, 2020a ; Pfeufer et al, 2020b ). However, their capacity to assess clinical functional deficits, for example, after THA, by identifying ipsilateral loading and WBS deficits, has so far not been investigated to our knowledge, particularly during different ADLs.…”

Section: Introductionmentioning

confidence: 99%

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The Recovery of Weight-Bearing Symmetry After Total Hip Arthroplasty Is Activity-Dependent

Alves

Preuße

Hommel

et al. 2022

Front. Bioeng. Biotechnol.

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This study aimed to characterize ipsilateral loading and return to weight-bearing symmetry (WBS) in patients undergoing total hip arthroplasty (THA) during activities of daily living (ADLs) using instrumented insoles. A prospective study in 25 THA patients was performed, which included controlled pre- and postoperative follow-ups in a single rehabilitation center of an orthopedic department. Ipsilateral loading and WBS of ADLs were measured with insoles in THA patients and in a healthy control group of 25 participants. Measurements in the THA group were performed at 4 different visits: a week pre-THA, within a week post-THA, 3–6 weeks post-THA, and 6–12 weeks post-THA, whereas the healthy control group was measured once. ADLs included standing comfortably, standing evenly, walking, and sit-to-stand-to-sit (StS) transitions. All ADLs were analyzed using discrete methods, and walking included a time-scale analysis to provide temporal insights in the ipsilateral loading and WBS waveforms. THA patients only improved beyond their pre-surgery levels while standing comfortably (ipsilateral loading and WBS, p < 0.05) and during StS transitions (WBS, p < 0.05). Nevertheless, patients improved upon their ipsilateral loading and WBS deficits observed within a week post-surgery across all investigated ADLs. Ipsilateral loading and WBS of THA patients were comparable to healthy participants at 6–12 weeks post-THA, except for ipsilateral loading during walking (p < 0.05) at the initial and terminal double-leg support period of the stance phase. Taken together, insole measurements allow for the quantification of ipsilateral loading and WBS deficits during ADLs, identifying differences between pre- and postoperative periods, and differentiating THA patients from healthy participants. However, post-THA measurements that lack pre-surgery assessments may not be sensitive to identifying patient-specific improvements in ipsilateral loading and WBS. Moreover, StS transitions and earlier follow-up time points should be considered an important clinical metric of biomechanical recovery after THA.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

The Recovery of Weight-Bearing Symmetry After Total Hip Arthroplasty Is Activity-Dependent

Alves

Preuße

Hommel

et al. 2022

Front. Bioeng. Biotechnol.

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“…According to research, a very common problem of patients is difficulties with full load on the operated limb. It is important to include this problem in the rehabilitation process [15].…”

Section: Discussionmentioning

confidence: 99%

Physiotherapeutic proceedings with patient after petrochanteric fracture

Babkiewicz

Szczypiór-Piasecka

Mińko

et al. 2021

J Educ Health Sport

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Introduction: The elderly are often affected by hip fractures. A trochanteric fracture is defined as when the fracture fissure is between the capsule and 3 cm below the lesser trochanter. The most common cause of these fractures is osteoporosis in the elderly. Treatment of a trochanteric fracture may be operative or conservative. The aim of this study was to define a plan of physiotherapeutic treatment in a patient after fixation of a trochanteric fracture with an intramedullary nail.Materials and methods: The work was written based on the medical history of a patient with a trochanteric fracture. The entire treatment procedure was carried out at the Department of Orthopedics, Traumatology and Oncology of the Musculoskeletal System, located at Unii Lubelskiej 1 in Szczecin.Results: Rehabilitation is an indispensable element in the treatment process of patients after a trochanteric fracture. It is implemented already from 1 day after the surgery in order to activate the patient as soon as possible. Such a procedure is to ensure faster activation of the patient and to avoid adverse changes resulting from too long immobilization.Conclusion: Rehabilitation is an indispensable element in the treatment of patients after a trochanteric fracture. Early patient activation reduces the risk of postoperative complications.

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“…Patients in whom weight-bearing as tolerated is allowed postoperatively after internal fixation with SHS or cephalomedullary nails, were less likely to be discharged to a non-home facility regardless of treatment [213]. Patients treated with internal fixation also struggle more than those treated with hip replacement to fully load the affected leg [214,215], and a shorter time between operation and first mobilization is associated with lower complication and mortality rates [215]. Regardless, patients with trochanteric fractures and patients treated with internal fixation seem to have worse functional outcomes [216,217].…”

Section: Extracapsular Hip Fracturesmentioning

confidence: 99%

Orthogeriatric Care: Reviewing Improvements in Outcomes

Tarazona-Santabalbina¹,

Ojeda-Thies²,

Rodríguez³

et al. 2021

Preprint

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Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Orthogeriatric co-management units have increased quality of care, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms “hip fracture”, “geriatric assessment”, “second hip fracture”, “surgery”, “perioperative management” and “orthogeriatric care”, in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.

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Weight bearing in patients with femoral neck fractures compared to pertrochanteric fractures: A postoperative gait analysis

Cited by 26 publications

References 23 publications

The Recovery of Weight-Bearing Symmetry After Total Hip Arthroplasty Is Activity-Dependent

The Recovery of Weight-Bearing Symmetry After Total Hip Arthroplasty Is Activity-Dependent

Physiotherapeutic proceedings with patient after petrochanteric fracture

Orthogeriatric Care: Reviewing Improvements in Outcomes

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