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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BMC
2025-02-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-08043-3 |
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| author | Carlos Hernández-Pascual José Ángel Santos-Sánchez Jorge Hernández-Rodríguez Carlos Fernando Silva-Viamonte Carmen Pablos-Hernández Pablo Alonso-Rodríguez José Antonio Mirón-Canelo |
| author_facet | Carlos Hernández-Pascual José Ángel Santos-Sánchez Jorge Hernández-Rodríguez Carlos Fernando Silva-Viamonte Carmen Pablos-Hernández Pablo Alonso-Rodríguez José Antonio Mirón-Canelo |
| author_sort | Carlos Hernández-Pascual |
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| description | 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. |
| format | Article |
| id | doaj-art-96585e46d0bd4a278d1ee2933dabb132 |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-96585e46d0bd4a278d1ee2933dabb1322025-02-09T12:04:27ZengBMCBMC Musculoskeletal Disorders1471-24742025-02-0126111610.1186/s12891-024-08043-3Partial weight bearing and long-term survival outcomes in extracapsular hip fractures treated with trochanteric Gamma3 nailsCarlos Hernández-Pascual0José Ángel Santos-Sánchez1Jorge Hernández-Rodríguez2Carlos Fernando Silva-Viamonte3Carmen Pablos-Hernández4Pablo Alonso-Rodríguez5José Antonio Mirón-Canelo6Department of Trauma and Orthopaedic Surgery, Hospital Universitario de SalamancaDepartment of Radiology, Hospital Universitario de SalamancaDepartment of Medical Physics and Radiation Protection, Hospital Universitario de SalamancaDepartment of Statistics, Faculty of Medicine, Universidad de Salamanca. Campus Miguel de Unamuno, Avda. Alfonso X El Sabio S/NDepartment of Geriatrics, Hospital Universitario de SalamancaDepartment of Rehabilitation, Hospital Universitario de SalamancaDepartment of Biomedical and Diagnostic Sciences. Preventive Medicine and Public Health, Faculty of Medicine, Universidad de Salamanca. Campus Miguel de Unamuno, Avda. Alfonso X El Sabio S/NAbstract 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.https://doi.org/10.1186/s12891-024-08043-3Hip fractureFracture fixationIntramedullaryPartial weight bearingDependenceMobility |
| spellingShingle | Carlos Hernández-Pascual José Ángel Santos-Sánchez Jorge Hernández-Rodríguez Carlos Fernando Silva-Viamonte Carmen Pablos-Hernández Pablo Alonso-Rodríguez José Antonio Mirón-Canelo Partial weight bearing and long-term survival outcomes in extracapsular hip fractures treated with trochanteric Gamma3 nails BMC Musculoskeletal Disorders Hip fracture Fracture fixation Intramedullary Partial weight bearing Dependence Mobility |
| title | Partial weight bearing and long-term survival outcomes in extracapsular hip fractures treated with trochanteric Gamma3 nails |
| title_full | Partial weight bearing and long-term survival outcomes in extracapsular hip fractures treated with trochanteric Gamma3 nails |
| title_fullStr | Partial weight bearing and long-term survival outcomes in extracapsular hip fractures treated with trochanteric Gamma3 nails |
| title_full_unstemmed | Partial weight bearing and long-term survival outcomes in extracapsular hip fractures treated with trochanteric Gamma3 nails |
| title_short | Partial weight bearing and long-term survival outcomes in extracapsular hip fractures treated with trochanteric Gamma3 nails |
| title_sort | partial weight bearing and long term survival outcomes in extracapsular hip fractures treated with trochanteric gamma3 nails |
| topic | Hip fracture Fracture fixation Intramedullary Partial weight bearing Dependence Mobility |
| url | https://doi.org/10.1186/s12891-024-08043-3 |
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