Weight-Bearing Approaches After Neck of Femur Fractures: A Narrative Review of Evidence and Outcomes

Neck of femur fractures, a prevalent injury among the elderly, significantly impair mobility, independence, and quality of life. The timing and extent of weight bearing post-surgery are critical to recovery, yet clinical practices vary widely. This narrative review synthesizes evidence on weight-bearing strategies following neck of femur fractures, focusing on their impact on functional outcomes, complications, and hospital stay duration. A comprehensive literature search was conducted using PubMed, Science Direct, and Google Scholar for studies published between 2012 and 2024. The keywords, along with the Boolean operators utilized, consisted of "Neck of femur fracture", OR "Hip fracture", AND "Weight bearing", AND "Mobilization", OR "Mobility", OR "Ambulation", OR "Gait training", to inculcate appropriate literature. The studies reported that early weight bearing (within 24 to 48 hours post-surgery) and full weight bearing are strongly supported for enhancing mobility, reducing hospital stays, and mitigating complications like pneumonia, pressure ulcers, and deep vein thrombosis. Partial weight bearing, while practiced, is less effective due to poor compliance in geriatric patients, often leading to immobility. Delayed and non-weight-bearing approaches are associated with prolonged recovery and increased complications. Fracture type, surgical approach, and patient characteristics influence optimal strategies. In conclusion, early full weight bearing is the preferred approach for geriatric patients' post-neck of femur fractures, promoting functional recovery and reducing complications. However, standardized protocols are needed to address practice variability.