دورية أكاديمية
Temporary Partial Weight-Bearing Restriction in Elderly Patients Treated With a Plate Fixation After a Distal Femur Fracture had a Negative Long-Term Impact on Gait Recovery
| العنوان: | Temporary Partial Weight-Bearing Restriction in Elderly Patients Treated With a Plate Fixation After a Distal Femur Fracture had a Negative Long-Term Impact on Gait Recovery |
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| المؤلفون: | Paulsson, Martin, Ekholm, Carl, Rolfson, Ola, Geijer, Mats, Tranberg, Roy |
| المصدر: | Geriatric Orthopaedic Surgery and Rehabilitation; 14 (2023) ; ISSN: 2151-4585 |
| بيانات النشر: | SAGE Publications |
| سنة النشر: | 2023 |
| المجموعة: | Lund University Publications (LUP) |
| مصطلحات موضوعية: | Surgery, femoral fracture, fracture fixation, function recovery, gait analysis, internal, orthopaedic surgical procedure, weight-bearing |
| الوصف: | Background: Restricted weight-bearing is still used after lower extremity fracture surgery in elderly patients. The long-term effect on gait recovery in elderly patients with distal femur fractures (DFF) and their ability to comply with the restrictive weight-bearing regime is unknown. This study aimed to investigate the effect of restricted postoperative weight-bearing on gait recovery (actual weight-bearing and cadence) during a 1-year follow-up. Methods: This study evaluated secondary outcomes from a randomized controlled trial (32 patients ≥65 years, with a traumatic DFF). Internal fixation was achieved using an anatomical lateral plate. Patients were allocated to either immediate full weight-bearing (FWB) or partial weight-bearing (PWB) (30% of body weight) for 8 weeks. Pressure-sensitive sensors (F-scan™ system, Tekscan, Massachusetts, USA) were used to measure weight-bearing and cadence postoperatively and at 8-, 16-, and 52-week follow-ups. Twenty-six patients with at least 1 measurement were included. Results: There was a statistically significant difference in actual weight-bearing between the PWB and FWB groups postoperatively of 32.3% (95% confidence interval CI, −50.0; −13.0, P <.001) and at the 8-week follow-up of 36.8% (95% CI −61.0; −18.0, P =.01), but not at later follow-ups. The PWB group presented a consistently lower cadence compared to the FWB group, which was statistically significant at the 16-week follow-up with 9.0 steps/min (95% CI -16.2; −1.1, P =.047) and 52-week follow-up with 9.3 steps/min (95% CI −18.0; −3.9, P =.009). Conclusions: Restricting postoperative weight-bearing in elderly patients with a DFF had a significant effect on postoperative weight-bearing. The effect lingered with a delayed return to FWB and persistent significantly lower cadence in the PWB group. These findings suggest that even temporary weight-bearing restrictions most likely have negative long-term effects on gait function at 1 year and, therefore, cannot be recommended. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://lup.lub.lu.se/record/e9d17c54-335c-4f09-bc50-05d6f440a47eTest; http://dx.doi.org/10.1177/21514593231184945Test; pmid:37842343; scopus:85174168248 |
| DOI: | 10.1177/21514593231184945 |
| الإتاحة: | https://doi.org/10.1177/21514593231184945Test https://lup.lub.lu.se/record/e9d17c54-335c-4f09-bc50-05d6f440a47eTest |
| رقم الانضمام: | edsbas.E01F81A |
| قاعدة البيانات: | BASE |
| DOI: | 10.1177/21514593231184945 |
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