Non-weight-bearing status compromises the functional level up to 1 yr after hip fracture surgery

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.