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Postoperative Weight-bearing Status Is Not Associated With Patient Mortality After Geriatric Distal Femur Fracture
Justin M Haller1, Christopher Lee, Dane Brodke
1From the Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT (Haller and Marchand), the Department of Orthopedic Surgery, University of California, Los Angeles, Los Angeles, CA (Lee), the Department of Orthopedic Surgery, Oregon Health Science University, Portland, OR (Brodke, DeKeyser, and Working), the Department of Orthopedic Surgery, Virginia Commonwealth University, Richmond, VA (Perdue), Division Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT (Zhang), the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco, CA (El Naga), the Department of Orthopedic Surgery, University of California, Los Angeles-Harbor, Los Angeles, CA (Shymon and Fairres), the Department of Orthopedic Surgery, University of Mississippi, Jackson, MS (Walters, Gillon, and Morellato), the Department of Orthopedic Surgery, Baylor University, Houston, TX (Atassi), and the Department of Orthopedic Surgery, University of Maryland, Baltimore, MD (O'Toole).
Immediate weight-bearing after distal femur fracture surgery does not impact mortality or complications. This study found no association between weight-bearing status and patient outcomes within 90 days.
Area of Science:
- Orthopedic Surgery
- Geriatric Trauma
- Reconstructive Surgery
Background:
- Distal femur fractures are common in geriatric patients.
- Postoperative weight-bearing status is a critical factor in recovery.
- Limited data exists on the impact of immediate weight-bearing on outcomes in this population.
Purpose of the Study:
- To investigate the effect of immediate weight-bearing (WB) on mortality in geriatric distal femur fracture patients.
- To determine the impact of WB status on surgical complications and 90-day ambulatory ability.
Main Methods:
- Retrospective review of geriatric patients (>60 years) with distal femur fractures (OTA/AO 33 A, 33C) undergoing surgical fixation.
- Comparison of outcomes (mortality, 90-day ambulatory ability, surgical complications) between non-weight-bearing (NWB) and weight-bearing (WB) groups.
- Propensity-weighted regression analysis to control for confounding variables.
Main Results:
- No association found between WB and mortality (HR, 1.50; P = 0.24).
- No significant association observed between WB and deep infections (HR, 2.86; P = 0.10) or nonunion surgery (HR, 1.7; P = 0.23).
- No association found between WB and ambulatory ability within 90 days (OR, 1.48; P = 0.35).
Conclusions:
- Prescribed postoperative weight-bearing status shows no association with patient mortality.
- Weight-bearing status is not linked to reoperations or impaired ambulatory ability within 90 days.
- Findings suggest current weight-bearing protocols may be adjusted for geriatric distal femur fracture patients.
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