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Review
. 2025 May 27;17(5):e84932.
doi: 10.7759/cureus.84932. eCollection 2025 May.

Weight-Bearing Approaches After Neck of Femur Fractures: A Narrative Review of Evidence and Outcomes

Niketa Patel  1 , Mahima Chaudhari  1
Affiliations
Review

Weight-Bearing Approaches After Neck of Femur Fractures: A Narrative Review of Evidence and Outcomes

Niketa Patel et al. Cureus. .

Abstract

Neck of femur fractures, a prevalent injury among the elderly, significantly impair mobility, independence, and quality of life. The timing and extent of weight bearing post-surgery are critical to recovery, yet clinical practices vary widely. This narrative review synthesizes evidence on weight-bearing strategies following neck of femur fractures, focusing on their impact on functional outcomes, complications, and hospital stay duration. A comprehensive literature search was conducted using PubMed, Science Direct, and Google Scholar for studies published between 2012 and 2024. The keywords, along with the Boolean operators utilized, consisted of "Neck of femur fracture", OR "Hip fracture", AND "Weight bearing", AND "Mobilization", OR "Mobility", OR "Ambulation", OR "Gait training", to inculcate appropriate literature. The studies reported that early weight bearing (within 24 to 48 hours post-surgery) and full weight bearing are strongly supported for enhancing mobility, reducing hospital stays, and mitigating complications like pneumonia, pressure ulcers, and deep vein thrombosis. Partial weight bearing, while practiced, is less effective due to poor compliance in geriatric patients, often leading to immobility. Delayed and non-weight-bearing approaches are associated with prolonged recovery and increased complications. Fracture type, surgical approach, and patient characteristics influence optimal strategies. In conclusion, early full weight bearing is the preferred approach for geriatric patients' post-neck of femur fractures, promoting functional recovery and reducing complications. However, standardized protocols are needed to address practice variability.

Keywords: fracture neck of femur; hip fracture; mobilization; post-operative rehabilitation; weight bearing.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flowchart describing search strategy
PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analysis
Figure 2
Figure 2. Comparison of outcomes regarding early and delayed weight bearing
Image created by the authors.
See this image and copyright information in PMC

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References

    1. Medical management in the acute hip fracture patient: a comprehensive review for the internist. Bateman L, Vuppala S, Porada P, et al. https://pubmed.ncbi.nlm.nih.gov/22778674/ Ochsner J. 2012;12:101–110. - PMC - PubMed
    1. Weight bearing in patients with femoral neck fractures compared to pertrochanteric fractures: a postoperative gait analysis. Pfeufer D, Grabmann C, Mehaffey S, Keppler A, Böcker W, Kammerlander C, Neuerburg C. https://pubmed.ncbi.nlm.nih.gov/31128909/. Injury. 2019;50:1324–1328. - PubMed
    1. Bipolar hemiarthroplasty may reduce cerebrovascular accidents and improve early weight-bearing in the elderly after femoral neck fracture. Dubin J, Atzmon R, Feldman V, Farkash U, Nyska M, Rath E, Palmanovich E. Medicine (Baltimore) 2022;101:0. - PMC - PubMed
    1. Occurrence of fracture neck femur in the elderly Indian population. Chincholi S, K MP. Int J Orthop Sci. 2017;3:706–709.
    1. The clinical outcomes of early internal fixation for undisplaced femoral neck fractures and early full weight-bearing in elderly patients. Kim JW, Byun SE, Chang JS. https://pubmed.ncbi.nlm.nih.gov/24806536/. Arch Orthop Trauma Surg. 2014;134:941–946. - PubMed

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