Postoperative Weight-Bearing after a Fracture of the Femoral Neck or an Intertrochanteric Fracture

• Published in: Journal of bone and joint surgery. American volume Vol. 80; no. 3; pp. 352 - 6
• Main Authors: KOVAL, KENNETH J, SALA, DEBRA A, KUMMER, FREDERICK J, ZUCKERMAN, JOSEPH D
• Format: Journal Article
• Language: English
• Published: Boston, MA Copyright by The Journal of Bone and Joint Surgery, Incorporated 01.03.1998; Journal of Bone and Joint Surgery Incorporated; Journal of Bone and Joint Surgery AMERICAN VOLUME
• Edition: American volume
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Female; Femoral Neck Fractures - physiopathology; Femoral Neck Fractures - surgery; Hip Fractures - physiopathology; Hip Fractures - surgery; Hip Joint - physiology; Humans; Injuries of the limb. Injuries of the spine; Male; Medical sciences; Middle Aged; Postoperative Period; Traumas. Diseases due to physical agents; Treatment Outcome; Weight-Bearing; Human; Femoral neck; Postoperative; Femur; Prognosis; Diseases of the osteoarticular system; Lower limb; Support(construction); Exploration; Fracture; Trauma; Intertrochanteric fracture; Walking; Orthopedic surgery; Treatment; Bone; Elderly; Quantitative analysis
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/00004623-199803000-00007

Sixty patients who had had operative treatment of a fracture of the femoral neck or an intertrochanteric fracture were allowed to bear weight as tolerated on the injured limb. The average age was seventy-seven years. Computerized gait-testing was performed at one, two, three, six, and twelve weeks postoperatively to quantify weight-bearing. For the purpose of analysis, the patients were divided into three groups according to whether they had internal fixation of a stable fracture, internal fixation of an unstable fracture, or a primary hemiarthroplasty. Thirty-two patients completed the entire twelve-week study. The average amount of weight that these patients placed on the injured limb increased progressively with time. The average load supported by the injured limb was 51 per cent that of the uninjured limb at one week, and it gradually increased to 87 per cent at twelve weeks. During the first three weeks, the patients who had had internal fixation bore substantially less weight than those who had had a hemiarthroplasty. By six weeks, we could detect no significant differences, with the numbers available, among the groups with regard to weight-bearing or other measured gait parameters. We concluded that elderly patients who are allowed to bear weight as tolerated after operative treatment of a fracture of the femoral neck or an intertrochanteric fracture appear to voluntarily limit loading of the injured limb.