{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:01:40Z","timestamp":1789754500881,"version":"4.0.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,6,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>For elderly trauma patients, a basic goal is early mobilization, as immobilization can trigger various complications, such as venous thromboembolism, pneumonia, urinary tract infections, and pressure ulcers. Although partial weight-bearing has been shown to significantly increase mortality compared with unrestricted weight-bearing, it remains a frequent recommendation of aftercare following lower-extremity fracture fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>An insole force sensor was used to measure true postoperative weight-bearing by patients \u226575 years of age treated for hip fracture compared with patients 18 to 40 years of age treated for ankle fracture. Both groups were instructed to maintain partial weight-bearing on the affected limb (\u226420 kg) postoperatively. Following standardized physiotherapy training, gait analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>None of the patients in the elderly test group were able to comply with the weight-bearing restriction as recommended. We found that 69% (11 of 16) of the patients exceeded the specified load by more than twofold, whereas significantly more patients in the younger control group (&gt;75% [14 of 18]) achieved almost the entire weight-bearing restriction (p &lt; 0.001). Only 1 of the elderly patients was able to comply with the predetermined weight-bearing restriction, and only for a short period of time. In comparison, significantly more patients in the control group (89% [16 of 18]; p &lt; 0.001) maintained the partial load for nearly the entire time during gait analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Elderly patients seem to be unable to maintain weight-bearing restrictions. As early mobilization of geriatric trauma patients is an important element for a successful rehabilitation, the directive of postoperative partial weight-bearing for these patients should be abandoned.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level II<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.01222","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T14:30:53Z","timestamp":1528295453000},"page":"936-941","source":"Crossref","is-referenced-by-count":169,"title":["Inability of Older Adult Patients with Hip Fracture to Maintain Postoperative Weight-Bearing Restrictions"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6461-0663","authenticated-orcid":false,"given":"Christian","family":"Kammerlander","sequence":"first","affiliation":[{"name":"Department of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Munich, Germany"},{"name":"Department of Trauma Surgery, Medical University, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pfeufer","sequence":"additional","affiliation":[{"name":"Department of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard Adolf","family":"Lisitano","sequence":"additional","affiliation":[{"name":"Department of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Mehaffey","sequence":"additional","affiliation":[{"name":"Department of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"B\u00f6cker","sequence":"additional","affiliation":[{"name":"Department of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Neuerburg","sequence":"additional","affiliation":[{"name":"Department of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"10","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"e77807","DOI":"10.1371\/journal.pone.0077807","article-title":"In vivo hip joint loading during post-operative physiotherapeutic exercises","volume":"8","author":"Schwachmeyer","year":"2013","journal-title":"PLoS One."},{"issue":"7","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1001\/archinte.166.7.766","article-title":"Early ambulation after hip fracture: effects on function and mortality","volume":"166","author":"Siu","year":"2006","journal-title":"Arch Intern Med."},{"issue":"6","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/BF03327405","article-title":"Post-operative degree of mobilization at two weeks predicts one-year mortality after hip fracture","volume":"16","author":"Heinonen","year":"2004","journal-title":"Aging Clin Exp Res."},{"issue":"2","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/BOT.0b013e31821d6f55","article-title":"Aggressive surgical treatment of periprosthetic femur fractures can reduce mortality: comparison of open reduction and internal fixation versus a modular prosthesis nail","volume":"26","author":"Langenhan","year":"2012","journal-title":"J Orthop Trauma."},{"issue":"10","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.2106\/00004623-198870100-00003","article-title":"Intramedullary nailing of femoral shaft fractures. Part II: Fracture-healing with static interlocking fixation","volume":"70","author":"Brumback","year":"1988","journal-title":"J Bone Joint Surg Am."},{"issue":"328","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/00003086-199607000-00031","article-title":"Early, full weightbearing with flexible fixation delays fracture healing","author":"Augat","year":"1996","journal-title":"Clin Orthop Relat Res."},{"issue":"2","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.cger.2014.01.001","article-title":"Epidemiology of fragility fractures","volume":"30","author":"Friedman","year":"2014","journal-title":"Clin Geriatr Med."},{"issue":"10","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1007\/s00402-011-1313-6","article-title":"Long-term functional outcome in geriatric hip fracture patients","volume":"131","author":"Kammerlander","year":"2011","journal-title":"Arch Orthop Trauma Surg."},{"issue":"3","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d. A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J Psychiatr Res."},{"issue":"5","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1302\/0301-620X.75B5.8376443","article-title":"A new mobility score for predicting mortality after hip fracture","volume":"75","author":"Parker","year":"1993","journal-title":"J Bone Joint Surg Br."},{"key":"bib12-20230810","first-page":"61","article-title":"Functional evaluation: the Barthel index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md State Med J."},{"issue":"6","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1007\/s40520-017-0729-4","article-title":"\u201cBrain-muscle loop\u201d in the fragility of older persons: from pathophysiology to new organizing models","volume":"29","author":"Lauretani","year":"2017","journal-title":"Aging Clin Exp Res."},{"issue":"5","key":"bib14-20230810","first-page":"669","article-title":"Cognitive and physical function in relation to the risk of injurious falls in older adults: a population-based study","volume":"72","author":"Welmer","year":"2017","journal-title":"J Gerontol A Biol Sci Med Sci."},{"issue":"1","key":"bib15-20230810","first-page":"33","article-title":"Muscle disuse as a pivotal problem in sarcopenia-related muscle loss and dysfunction","volume":"5","author":"Bell","year":"2016","journal-title":"J Frailty Aging."},{"issue":"8","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1016\/j.apmr.2009.01.030","article-title":"Reducing risk of falling in older people discharged from hospital: a randomized controlled trial comparing seated exercises, weight-bearing exercises, and social visits","volume":"90","author":"Vogler","year":"2009","journal-title":"Arch Phys Med Rehabil."},{"issue":"3","key":"bib17-20230810","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci."},{"issue":"9978","key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1016\/S0140-6736(14)62409-0","article-title":"Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial","volume":"385","author":"Prestmo","year":"2015","journal-title":"Lancet."},{"issue":"1","key":"bib19-20230810","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.3928\/01477447-20131219-10","article-title":"Orthopedic inpatients\u2019 ability to accurately reproduce partial weight bearing orders","volume":"37","author":"Yu","year":"2014","journal-title":"Orthopedics."},{"issue":"2","key":"bib20-20230810","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.injury.2015.11.004","article-title":"A novel tool for continuous fracture aftercare - Clinical feasibility and first results of a new telemetric gait analysis insole","volume":"47","author":"Braun","year":"2016","journal-title":"Injury."},{"key":"bib21-20230810","first-page":"1856","article-title":"An insole sensor for recording weight bearing behavior during tibial fracture rehabilitation","volume":"2010","author":"North","year":"2010","journal-title":"Conf Proc IEEE Eng Med Biol Soc."},{"issue":"8","key":"bib22-20230810","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1007\/s00264-017-3481-7","article-title":"Weight-bearing recommendations after operative fracture treatment-fact or fiction? Gait results with and feasibility of a dynamic, continuous pedobarography insole","volume":"41","author":"Braun","year":"2017","journal-title":"Int Orthop."},{"issue":"7","key":"bib23-20230810","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/j.apmr.2007.03.029","article-title":"Factors affecting short-term rehabilitation outcomes of disabled elderly patients with proximal hip fracture","volume":"88","author":"Hershkovitz","year":"2007","journal-title":"Arch Phys Med Rehabil."},{"issue":"1","key":"bib24-20230810","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/2151458510378105","article-title":"The 1-year mortality of patients treated in a hip fracture program for elders","volume":"1","author":"Schnell","year":"2010","journal-title":"Geriatr Orthop Surg Rehabil."},{"issue":"10078","key":"bib25-20230810","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1016\/S0140-6736(17)30066-1","article-title":"Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial","volume":"389","year":"2017","journal-title":"Lancet."},{"issue":"12","key":"bib26-20230810","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/j.injury.2010.07.499","article-title":"Clinical comparison of the second and third generation of intramedullary devices for trochanteric fractures of the hip\u2014Blade vs screw","volume":"41","author":"Lenich","year":"2010","journal-title":"Injury."},{"issue":"2","key":"bib27-20230810","doi-asserted-by":"crossref","first-page":"146","DOI":"10.4055\/cios.2016.8.2.146","article-title":"Clinical results of internal fixation of subcapital femoral neck fractures","volume":"8","author":"Kang","year":"2016","journal-title":"Clin Orthop Surg."},{"issue":"5","key":"bib28-20230810","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s00402-016-2410-3","article-title":"Which factor is most important for occurrence of cutout complications in patients treated with proximal femoral nail antirotation? Retrospective analysis of 298 patients","volume":"136","author":"Turgut","year":"2016","journal-title":"Arch Orthop Trauma Surg."},{"issue":"1","key":"bib29-20230810","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.arth.2016.06.048","article-title":"Hemiarthroplasty for displaced femoral neck fractures in the elderly has a low conversion rate","volume":"32","author":"Grosso","year":"2017","journal-title":"J Arthroplasty."},{"issue":"Suppl 2","key":"bib30-20230810","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1016\/S0020-1383(16)47007-5","article-title":"The use of augmentation techniques in osteoporotic fracture fixation","volume":"47","author":"Kammerlander","year":"2016","journal-title":"Injury."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201806060-00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:24:44Z","timestamp":1787750684000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201806060-00005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,6]]},"references-count":29,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.17.01222","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,6]]}}}