Purpose: Proximal femur fracture is a major traumatic injury in elderly populations; however, practical postoperative weight-bearing protocols are lacking. Therefore, the purpose of the present study was to investigate whether early weight-bearing status after proximal femur nail fixation is associated with any loss of reduction and evaluate the clinical outcomes of this intervention. Patients and methods: For this prospective single-center clinical trial study, we recruited 60 geriatric proximal femur fracture cases, classified by AO/OTA 2018, receiving intramedullary nail fixation. The participants were assigned to the Early-weight-bearing group (n= 30) or the Weight-bearing restriction group (n = 30). Clinical outcomes included the Harris functional hip score and VAS pain score. Additionally, demographic data, radiological parameters, time to weight-bearing, mortality rate, medical and surgical complications, and final ambulation status were recorded.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
The patients began early weight bearing under attending physician and physiotherapist surveillance within 48 hours after surgery. Patients were instructed to stand up near the bed, and muscle power, gait stability, and pain tolerance were recorded. The physiotherapist instructed the patients to perform early mobilization and weight bearing as tolerable by self-adjustment of body weight distribution over the bilateral lower extremities, and walking assistance was used to prevent repeat falling accidents.
Far-Eastern Memorial Hospital
New Taipei City, Taiwan
RECRUITINGHarris Hip Functional score
The questionaire to patient. (HHS score 0-100,\<60 poor,\>80 good)
Time frame: Functional and radiographic evaluations was performed at week 1 postoperatively
Harris Hip Functional score
The questionaire to patient. (HHS score 0-100,\<60 poor,\>80 good)
Time frame: Functional and radiographic evaluations was performed at months 1 postoperatively
Harris Hip Functional score
The questionaire to patient. (HHS score 0-100,\<60 poor,\>80 good)
Time frame: Functional and radiographic evaluations was performed at months 3 postoperatively
Harris Hip Functional score
The questionaire to patient. (HHS score 0-100,\<60 poor,\>80 good)
Time frame: Functional and radiographic evaluations was performed at months 6 postoperatively
Harris Hip Functional score
The questionaire to patient. (HHS score 0-100,\<60 poor,\>80 good)
Time frame: Functional and radiographic evaluations was performed at months 12 postoperatively
Visual analog pain score
Independent assessor (VAS:0-10, higher scores mean a worse outcome)
Time frame: Record at week 1 postoperatively
Visual analog pain score
Independent assessor (VAS:0-10, higher scores mean a worse outcome)
Time frame: Record at months 1 postoperatively
Visual analog pain score
Independent assessor (VAS:0-10, higher scores mean a worse outcome)
Time frame: Record at months 3 postoperatively
Visual analog pain score
Independent assessor (VAS:0-10, higher scores mean a worse outcome)
Time frame: Record at months 6 postoperatively
Visual analog pain score
Independent assessor (VAS:0-10, higher scores mean a worse outcome)
Time frame: Record at months 12 postoperatively
Complication
Loss of reduction, malunion, nonunion or medical complications
Time frame: Functional and radiographic evaluations were performed at week 1, months 1, 3, 6, and 12 postoperatively
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