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Immediate Full Weight-Bearing Versus Partial Weight-Bearing After Plate Fixation of Distal Femur Fractures in Elderly Patients. A Randomized Controlled Trial

Paulsson, Martin ; Ekholm, Carl ; Jonsson, Eythor ; Geijer, Mats LU and Rolfson, Ola (2021) In Geriatric Orthopaedic Surgery and Rehabilitation 12.
Abstract

Introduction: After surgery for distal femur fractures in elderly patients, weight-bearing is commonly restricted. Immediate non-restrictive weight-bearing might have beneficial effects. There are no randomized studies on the topic. The purpose of this study was to compare the functional outcome between immediate full weight-bearing (FWB) as tolerated and partial weight-bearing (PWB) during the first 8 weeks following plate fixation of distal femur fractures in elderly patients. Methods: Patients aged 65 years or older with distal femur fractures of AO/OTA types 33 A2, A3, B1, B2, C1, and C2 were included. Exclusion criteria were impaired cognitive function, concomitant injuries, or inability to follow the postoperative regimen.... (More)

Introduction: After surgery for distal femur fractures in elderly patients, weight-bearing is commonly restricted. Immediate non-restrictive weight-bearing might have beneficial effects. There are no randomized studies on the topic. The purpose of this study was to compare the functional outcome between immediate full weight-bearing (FWB) as tolerated and partial weight-bearing (PWB) during the first 8 weeks following plate fixation of distal femur fractures in elderly patients. Methods: Patients aged 65 years or older with distal femur fractures of AO/OTA types 33 A2, A3, B1, B2, C1, and C2 were included. Exclusion criteria were impaired cognitive function, concomitant injuries, or inability to follow the postoperative regimen. Internal fixation was achieved with an anatomical lateral distal femur plate applied as a strictly bridge-plating construct. The primary outcome measure was the function index of the short musculoskeletal functional assessment (SMFA) after 52 weeks from injury. Results: Thirty-two patients were randomized to FWB (n = 11) or PWB (n = 21). After 16 and 52 weeks, there were no differences in the mean SMFA function index between FWB and PWB (36 vs 43, P =.42 and 52 vs 40, P =.18, respectively) nor in the mean EuroQol 5-dimension index or range of motion (ROM). Overall, the SMFA function index was higher at 52 weeks compared with before injury (44 vs 30, P =.001) as was the mean bothersome index (37 vs 21, P =.011). There was no clear difference in the occurrence of adverse events between the treatment groups. Conclusions: There were no differences in functional outcome, adverse events, or ROM between immediate FWB and PWB following plate fixation for a distal femur fracture in elderly patients. A distal femur fracture has a negative effect on the functional status of elderly patients that persists at least up to 1 year following injury.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bridge-plating, distal femur fracture, functional outcome, geriatric trauma, plate fixation, rehabilitation, weight-bearing
in
Geriatric Orthopaedic Surgery and Rehabilitation
volume
12
publisher
SAGE Publications
external identifiers
  • scopus:85120798263
  • pmid:35145761
ISSN
2151-4585
DOI
10.1177/21514593211055889
language
English
LU publication?
yes
id
31babdc8-0cc6-412a-92b7-6fe8c154da1a
date added to LUP
2022-02-01 13:38:51
date last changed
2024-06-16 01:10:19
@article{31babdc8-0cc6-412a-92b7-6fe8c154da1a,
  abstract     = {{<p>Introduction: After surgery for distal femur fractures in elderly patients, weight-bearing is commonly restricted. Immediate non-restrictive weight-bearing might have beneficial effects. There are no randomized studies on the topic. The purpose of this study was to compare the functional outcome between immediate full weight-bearing (FWB) as tolerated and partial weight-bearing (PWB) during the first 8 weeks following plate fixation of distal femur fractures in elderly patients. Methods: Patients aged 65 years or older with distal femur fractures of AO/OTA types 33 A2, A3, B1, B2, C1, and C2 were included. Exclusion criteria were impaired cognitive function, concomitant injuries, or inability to follow the postoperative regimen. Internal fixation was achieved with an anatomical lateral distal femur plate applied as a strictly bridge-plating construct. The primary outcome measure was the function index of the short musculoskeletal functional assessment (SMFA) after 52 weeks from injury. Results: Thirty-two patients were randomized to FWB (n = 11) or PWB (n = 21). After 16 and 52 weeks, there were no differences in the mean SMFA function index between FWB and PWB (36 vs 43, P =.42 and 52 vs 40, P =.18, respectively) nor in the mean EuroQol 5-dimension index or range of motion (ROM). Overall, the SMFA function index was higher at 52 weeks compared with before injury (44 vs 30, P =.001) as was the mean bothersome index (37 vs 21, P =.011). There was no clear difference in the occurrence of adverse events between the treatment groups. Conclusions: There were no differences in functional outcome, adverse events, or ROM between immediate FWB and PWB following plate fixation for a distal femur fracture in elderly patients. A distal femur fracture has a negative effect on the functional status of elderly patients that persists at least up to 1 year following injury.</p>}},
  author       = {{Paulsson, Martin and Ekholm, Carl and Jonsson, Eythor and Geijer, Mats and Rolfson, Ola}},
  issn         = {{2151-4585}},
  keywords     = {{bridge-plating; distal femur fracture; functional outcome; geriatric trauma; plate fixation; rehabilitation; weight-bearing}},
  language     = {{eng}},
  month        = {{11}},
  publisher    = {{SAGE Publications}},
  series       = {{Geriatric Orthopaedic Surgery and Rehabilitation}},
  title        = {{Immediate Full Weight-Bearing Versus Partial Weight-Bearing After Plate Fixation of Distal Femur Fractures in Elderly Patients. A Randomized Controlled Trial}},
  url          = {{http://dx.doi.org/10.1177/21514593211055889}},
  doi          = {{10.1177/21514593211055889}},
  volume       = {{12}},
  year         = {{2021}},
}