1100 Fragility Fractures Post-Operative Mobilisation - A Major Trauma Centre Audit

Abstract

Abstract Introduction Fragility fractures occur as a result of "low energy trauma" often from fall from standing height or less that would not normally result in fracture. Early post-operative mobilisation is the key for successful rehabilitation. BOAST guidelines suggest, all surgery in frail patients should be performed, to allow full weight-bearing (FWB) for activities required for daily living and within 36 hours of admission. The purpose of this audit is to determine the weightbearing practice of operatively managed fragility fractures in the setting of Major Trauma Centre. Method Retrospective data collection, from July 1st to September 30. Inclusion criteria: Aged 60 years and older, isolated lower limb fragility fractures managed operatively. Exclusion criteria: Fractures from high energy mechanisms, multiple injuries, associated, with infection/metastasis. Fragility fractures which were managed non-operatively. Results A total of 157 patients [mean age 82 years (SD 9.5), 135 having a hip fracture, 22 non-hip fractures] were included. Overall, 146 patients (93%) were allowed FWB, of which 133 (98.5%) were hip fractures and 12 (54.5%) were non-hip fractures. Mean days of restricted weight bearing was 42 (range 28 to 56). Conclusions Surgeons are confident to allow hip fracture patients to bear full weight post-operatively; however only 54.5% of non-hip fracture patients are allowed the same. We pose a question that even though the national guidelines mandate FWB post-operatively, is it still valid to limit weightbearing for fragility fracture patients when the benefits of early mobilisation are significant? The routine use of frailty assessments would aid the surgeons to assess this population.