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Non-Weight-Bearing Status Compromises the Functional Level Up to 1 yr After Hip Fracture Surgery

Ariza-Vega, Patrocinio PhD; Jiménez-Moleón, José Juan PhD; Kristensen, Morten Tange PhD

American Journal of Physical Medicine & Rehabilitation: August 2014 - Volume 93 - Issue 8 - p 641–648
doi: 10.1097/PHM.0000000000000075
Original Research Articles

Objective The aim of this study was to examine the influence of weight-bearing (WB) status after hip fracture surgery on 1-yr functional outcome.

Design This was a prospective cohort study, carried out in a public acute hospital trauma service. The 194 patients (36 men and 158 women), with a mean (SD) age of 81.4 (6.1) yrs, were admitted with a hip fracture within 2009 and were followed for 1 yr thereafter. The influence of postoperative WB status on the 1-yr functional outcome was assessed using the Functional Independence Measure (18–126 points), adjusting for other known factors by multiple linear regression.

Results Seventy-five patients (39%) were not allowed WB for a period of 2–4 wks after surgery. Improved functional outcomes were associated positively with prefracture functional level and having a trochanteric fracture during the first year after fracture (P ≤ 0.01). Non-WB status, age, health status, and cognitive impairment of the patient were associated negatively with the 1-yr functional outcome (P ≤ 0.03). Prefracture functional level and non-WB status were the strongest determinants of functional level (β = 0.599 and −0.204, respectively; P < 0.001).

Conclusions WB status after surgery, in addition to prefracture function, cognitive status, health status, age and fracture type, was found to be an independent predictor of the 1-yr functional outcome in hip fracture patients.

From the Department of Rehabilitation, Rehabilitation and Traumatology Virgin de las Nieves University Hospital, and Department of Physical Therapy, University of Granada, Granada, Spain (PA-V); Department of Preventive Medicine and Public Health, University of Granada, CIBER of Epidemiology and Public Health, Granada, Spain (JJJ-M); and Physical Medicine and Rehabilitation Research–Copenhagen (PMR-C), Department of Physical Therapy and Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Denmark (MTK).

All correspondence and requests for reprints should be addressed to: Patrocinio Ariza-Vega, PhD, Rehabilitation and Traumatology Virgen de las Nieves University Hospital, Carretera de Jaén S/N, 18013, Granada, Spain.

Presented, in part, at the 13th Orthopedic Congress, EFORT, Berlin, May 23–25, 2012.

Supported by the Neurotraumatologic Hospital of Jaén. The ethics committee of the hospital of Jaén approved the study. The authors certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.