Does delayed weight bearing in the surgical management of fractures of the upper end of the femur in the elderly lead to more complications? A prospective study

• Published in: Orthopaedics & traumatology, surgery & research surgery & research, 2022-11, Vol.108 (7), p.103381-103381, Article 103381
• Main Authors: Bouché, Pierre-Alban, Corsia, Simon, Biau, David, Anract, Philippe, Briot, Karine, Leclerc, Philippe, Auberger, Guillaume, Cailleaux, Pierre-Emmanuel
• Format: Article
• Language: English
• Subjects: Aged; Clinical score; Elderly subjects; Female; Femoral Fractures - complications; Femoral Fractures - surgery; Femur; Fracture Fixation, Internal - adverse effects; Fracture of the upper end of the femur; Humans; Male; Osteosynthesis technique; Prospective Studies; Traumatology; Treatment Outcome; Weight-Bearing
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2022.103381

Fractures of the upper end of the femur (FUEF) lead to increased mortality and dependence in the elderly. However, mechanical complications after surgery persist in up to 20% of cases, which may justify a delayed resumption of full weight bearing to protect the osteosynthesis during consolidation. Our hypothesis was that the late resumption of weight bearing in an elderly population after a FUEF would be limited by a higher frequency of medical complications. This was a prospective monocentric study including patients aged 80 or over with an isolated FUEF requiring osteosynthesis. The operator decided on the discharge. The primary endpoint was to show a difference in a medical complication score created for this study (APRETAR), between a group with, and a group without, weight bearing delayed by 45 days. Between 2016 and 2019, 254 patients (88±5.6 years, 77.6% women) were included, and of these, 70 (27.6%) had delayed weight bearing. The mean APRETAR at 45 days was greater in the delayed weight bearing group (5.9±8.6 vs. 5.7±11.0; p