Postoperative Improvement of Walking Capacity in Patients with Trochanteric Hip Fracture

Abstract

Between 1982-1985, 149 patients with trochanteric fractures were randomly selected for treatment with either Ender nails or a sliding nail plate. Ninety-two patients were able to perform walkway tests on an electronic walkway and were considered the best prospects for rehabilitation. Thirty-seven patients' fractures were stabilized with Ender nails and 55 with a sliding nail plate. Gait analyses were made at 3 and 6 months after surgery. Change in walking capacity based on four parameters (walking aids, walking distance, maximal vertical force, and single limb support) was compared to changes in clinical and radiographic parameters at 3 and 6 months after surgery. In all, less than half of the patients had achieved their preoperative status 3 months after surgery. Between 3 and 6 months postoperatively, 42 patients experienced less pain, 23 improved in range of hip motion, and 12 improved in strength. According to multivariate regression analysis, the significant factors associated with improvement in walking capacity during this period were an unstable fracture type (p = 0.003), improvement of hip strength (p = 0.006), and improvement of pain (p = 0.03). In conclusion, rehabilitation of patients with trochanteric fractures, particularly in those patients with unstable fractures, should be continued for more than 3 months after surgery.