Immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post hoc analysis

Abstract Background Early weight bearing is crucial for fracture healing after osteosynthesis for intertrochanteric fractures (ITFs). The optimal period to start weight bearing after surgery is still under debate. The aim of this study was to compare immediate weight bearing (IWB) as tolerated with...

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Main Authors: Ning Li, Kai-Yuan Cheng, Jing Zhang, Gang Liu, Li Zhou, Shi-Wen Zhu, Ming-Hui Yang, Xin-Bao Wu, Xie-Yuan Jiang
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-024-08172-9
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author Ning Li
Kai-Yuan Cheng
Jing Zhang
Gang Liu
Li Zhou
Shi-Wen Zhu
Ming-Hui Yang
Xin-Bao Wu
Xie-Yuan Jiang
author_facet Ning Li
Kai-Yuan Cheng
Jing Zhang
Gang Liu
Li Zhou
Shi-Wen Zhu
Ming-Hui Yang
Xin-Bao Wu
Xie-Yuan Jiang
author_sort Ning Li
collection DOAJ
description Abstract Background Early weight bearing is crucial for fracture healing after osteosynthesis for intertrochanteric fractures (ITFs). The optimal period to start weight bearing after surgery is still under debate. The aim of this study was to compare immediate weight bearing (IWB) as tolerated with delayed weight bearing (DWB) following intramedullary fixationin elderly ITF patients. Methods This post hoc analysis included patients aged ≥ 65 years with X-ray-confirmed ITFs who were admitted within 21 days after injury and who underwent intramedullary fixation surgery. The primary outcome was the EQ-5D score at 120 days after surgery. The secondary outcomes included the EQ-5D score at 30 days and 365 days after surgery, the complication rate and the mortality rate. Results Among 410 patients (190 IWB, 220 DWB), those in the IWB group had higher EQ-5D scores at 30 (P < 0.001) and 120 days (P = 0.002) but lower scores at 365 days (P = 0.012) than did those in the DWB group. There were no significant differences in the complication rates, reoperation rates, or one-year mortality rates between the groups. Conclusions Compared with delayed weight bearing, immediate weight bearing improves early functional outcomes without increasing the complication or mortality rates in elderly ITF patients.
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spelling doaj-art-6e0f1a8c21c748a180cf1337a0c747b02024-12-22T12:07:14ZengBMCBMC Musculoskeletal Disorders1471-24742024-12-012511910.1186/s12891-024-08172-9Immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post hoc analysisNing Li0Kai-Yuan Cheng1Jing Zhang2Gang Liu3Li Zhou4Shi-Wen Zhu5Ming-Hui Yang6Xin-Bao Wu7Xie-Yuan Jiang8Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical UniversitySchool of Public Health, Harbin Medical UniversityDepartment of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical UniversityAbstract Background Early weight bearing is crucial for fracture healing after osteosynthesis for intertrochanteric fractures (ITFs). The optimal period to start weight bearing after surgery is still under debate. The aim of this study was to compare immediate weight bearing (IWB) as tolerated with delayed weight bearing (DWB) following intramedullary fixationin elderly ITF patients. Methods This post hoc analysis included patients aged ≥ 65 years with X-ray-confirmed ITFs who were admitted within 21 days after injury and who underwent intramedullary fixation surgery. The primary outcome was the EQ-5D score at 120 days after surgery. The secondary outcomes included the EQ-5D score at 30 days and 365 days after surgery, the complication rate and the mortality rate. Results Among 410 patients (190 IWB, 220 DWB), those in the IWB group had higher EQ-5D scores at 30 (P < 0.001) and 120 days (P = 0.002) but lower scores at 365 days (P = 0.012) than did those in the DWB group. There were no significant differences in the complication rates, reoperation rates, or one-year mortality rates between the groups. Conclusions Compared with delayed weight bearing, immediate weight bearing improves early functional outcomes without increasing the complication or mortality rates in elderly ITF patients.https://doi.org/10.1186/s12891-024-08172-9Intertrochanteric fractureWeight bearingEQ-5DComplicationMortality
spellingShingle Ning Li
Kai-Yuan Cheng
Jing Zhang
Gang Liu
Li Zhou
Shi-Wen Zhu
Ming-Hui Yang
Xin-Bao Wu
Xie-Yuan Jiang
Immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post hoc analysis
BMC Musculoskeletal Disorders
Intertrochanteric fracture
Weight bearing
EQ-5D
Complication
Mortality
title Immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post hoc analysis
title_full Immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post hoc analysis
title_fullStr Immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post hoc analysis
title_full_unstemmed Immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post hoc analysis
title_short Immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post hoc analysis
title_sort immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures a post hoc analysis
topic Intertrochanteric fracture
Weight bearing
EQ-5D
Complication
Mortality
url https://doi.org/10.1186/s12891-024-08172-9
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