Partial weight bearing and long-term survival outcomes in extracapsular hip fractures treated with trochanteric Gamma3 nails
Abstract Background Benefits of partial weight bearing (PWB) in operated extracapsular hip fractures (ECF) have not been proved. We have assessed influence of PWB on long-term survival and the final mobility achieved, dependence and mortality-related factors. Methods Retrospective cohort study of os...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-02-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-024-08043-3 |
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| Summary: | Abstract Background Benefits of partial weight bearing (PWB) in operated extracapsular hip fractures (ECF) have not been proved. We have assessed influence of PWB on long-term survival and the final mobility achieved, dependence and mortality-related factors. Methods Retrospective cohort study of osteoporotic ECF in ≥ 65-year-old patients who underwent surgery with trochanteric Gamma3 nails in 2014 (n = 218), followed in the long-term (consolidation or stabilisation). According to Baumgaertner-Fogagnolo classification (138 good, 71 acceptable and 9 poor) a postoperative protocol was applied. 116 cases bore weight before discharge (Immediate Partial Weight Bearing, IPWB = 116; Not-IPWB = 102), and 118 did it after a month (Early PWB, EPWB = 118; Not-EPWB = 100). Variables were collected from medical records and complementary studies. We used FMS (Fracture Mobility Score) and the National Mortality Database from the Spanish Ministry of Health at > 5 years. EPWB and Not-EPWB were comparable, except for hospital stay and dependence. We used the Cox method for mortality. < 0.05 p-values were significant. Results Survival improved in IPWB earlier than in EPWB, although there was no statistical significance. The final FMS was significantly favourable only in EPWB. Not-EPWB showed greater dependence. Age (per year of increment), moderate Charlson comorbidity index (not age-modified) and greater immediate post-operative estimated blood loss were independent factors for mortality, but we did not find radiological factors implied. Conclusions Postoperative PWB in ECF may increase mid-term and long-term survival rates, but considerably delayed in EPWB. Only EPWB improved final mobility. Not-EPWB presented with greater dependence. Only clinical factors were independently related to mortality, but no radiological factors were. |
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| ISSN: | 1471-2474 |