Early Weight Bearing after Distal Femur Fractures in the Elderly: A Prospective, Cohort Pilot Study

Abstract

Objectives: To determine if early weight bearing in distal femur fractures in the geriatric population maintains fracture reduction and allows early return to function.Design: Prospective Observational Pilot (NCT# #02475941)Setting: Multicenter trialParticipants: Patients 64-90 with an OTA 33 Distal femur fracture were eligible for inclusion. All patients were household ambulators or higher at time of the injury. The patients were treated with surgical stabilization.Intervention: Following surgery, the surgeon decided if patients would be weight bear as tolerated (EWB) or protected/non weight bearing (NWB).Main outcome Measures: Complications evaluated included infection, loss of fixation and nonunion. Additional data collected included the Oxford knee score.Results: There were 46 patients with an average age 75. 11 patients (24%) were in the EWB group. There were 37 33A, 2 33 B and 7 33C fractures. 5/11 in the EWB group and 18/35 in NWB group had periprosthetic fractures. In the NWB group, there were 2 hardware failures and the remaining patients were healed by 12 weeks. In the EWB group, all patients were healed at 12 weeks with no hardware failures. There were no significant differences between the groups in any outcome variables. The mortality rate was 6.5%. All patients who died had multiple medical co- morbidities and were in the NWB group.Conclusion: Our results suggest EWB can be safely done in a small cohort study for geriatric distal femur fractures with minimal complications. A randomized clinic trial could be useful in geriatric distal femur population.