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Abstract Aim This study aims to evaluate adherence to NICE guidelines for postoperative mobilization after different distal femoral fracture fixation methods in elderly patients. We also explore the implications of guideline compliance, focusing on the timing and extent of weight-bearing. Method Retrospective data collection spanned six months at Hull University Teaching Hospitals, involving patient records and descriptive statistical analysis. Results Of the 18 identified patients, 16 were analysed (2 managed non-operatively). The mean age was 82.5 years (4 males, 12 females), with an average surgery delay of 3.4 days. Fracture types included intra-articular (4), extra-articular (4), and periprosthetic (8). Implants included 8 plate osteosynthesis, 6 intramedullary (IM) nails, and 2 dynamic femoral rods (DFRs). Post-surgery weight-bearing status: non-weight bearing (NWB): 7 (5 plates + 2 nails), Partial weight-bearing (PWB): 3 (2 plates + 1 nail), Full weight-bearing (FWB): 6 (2 DFRs + 1 plate + 2 nails). Weight-bearing by implant type: Plate: NWB: 5/8, PWB: 2/8, FWB: 1/8. Nail: NWB: 2/6, PWB: 1/6, FWB: 3/6. DFR: FWB 2/2. Five fatalities occurred: 4 in NWB and 1 in PWB groups; 4 with plate fixation and 1 with IM nail. Conclusions Only 37.5% initiated FWB in under a week. Encouraging early weight-bearing may reduce mortality following distal femur fractures in the elderly.
Elegbede et al. (2024) studied this question.