Safety of Immediate Weight-Bearing as Tolerated After Well-Reduced Geriatric Hip Fracture: An Observational Cohort Study

Abstract

Abstract BACKGROUND: Proximal femur fractures are major traumatic injuries in elderlypopulations; however,practical postoperative weight-bearing protocols are lacking. This study aimed to evaluate clinical outcomes and investigate whether early weight-bearing following proximal femur nail fixation is associated with loss of reduction. METHODS: This prospective single-center study included 14 proximal femur fracture cases (classified by AO/OTA 2018) that underwent intramedullary nail fixation. Clinical outcomes included Harris functional hip score and visual analog scores (VAS) to assess pain. Demographic data, radiological parameters, time to weight-bearing, mortality rate, medical and surgical complications, and final ambulation status were recorded. RESULTS: The mean patient age was 74.1 years. There was significant improvement in the Harris and pain scores between the time of first weight-bearing and at 12-months follow-up. Mean Harris score improved from 74.86 immediately postoperatively to 88.5 at 12 months follow-up. Mean VAS score improved from 3 immediately postoperatively to 0 at 1-month follow-up. Mean length of hospital stay was 5.6 days. No mortality was noted, and only patients withhelical blade oversliding requested implant removal after bone union. CONCLUSIONS: Early weight-bearing was associated with better hip functional score, a shorter hospital stay, and fewer medical complications without increasing the loss of reduction or any surgical complications at 12-months follow-up.