Weight Bearing Protocols Following Subtrochanteric Fracture Fixation with Intramedullary Implants, a Retrospective Cohort Study

Aim: Subtrochanteric femur fractures are commonly managed with operative fixation. However, they have a high complication rate due to cortical comminution and stress concentration during stance. This study evaluates the effects of immediate weight bearing in the recovery of subtrochanteric femur fractures treated with intramedullary fixation when compared to a traditional, limited weight bearing protocol. Materials and Methods: 69 consecutive subtrochanteric femur fractures were retrospectively reviewed at two level-I trauma centers, evaluating for postoperative hospital length of stay in relation to their respective weight bearing rehabilitation protocol. All femur fractures were treated between August 2009 and November 2015. Results: Our study identifies a decreased length of stay in weight bearing as tolerated groups for both the overall sample (4.5 vs 5.9 days; p < 0.01) and those that experienced a high-energy injury (5.1 vs 7.0 days; p < 0.001), with no significant difference in postoperative complications (2 vs 3; p = 0.43). Conclusions: This study provides preliminary evidence for the adoption of immediate weight bearing as tolerated as a viable postoperative rehabilitation protocol in the setting of subtrochanteric femur fractures treated with intramedullary fixation.