Fragility Fracture Network Position on Unrestricted Weight-Bearing After Hip Fracture Surgery

Ruqayyah Turabi^{1

2}, Frede Frihagen^{3

4}, Rhona McGlasson⁵, David Wyatt¹, Alex Trompeter⁶, Lauren Beaupre⁷, Luiz Fernando Cocco⁸, Matthew Costa⁹, José Luis Dinamarca-Montecinos¹⁰, Juan Carlos Viveros-García¹¹, Jae-Young Lim¹², Joon-Kiong Lee¹³, Hui Min Khor¹⁴, Cristina Ojeda-Thies^{15

16}, Monica Perracini¹⁷, Takeshi Sawaguchi¹⁸, Julie Switzer¹⁹, Irewin Tabu²⁰, Ronald Man Yeung Wong²¹, Wei Mao²², Katie Jane Sheehan²³

Affiliations

¹ Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, UK.
² Department of Physical Therapy, College of Nursing and Health Sciences, Jazan University, Saudi Arabia.
³ Department of Orthopaedic Surgery, Østfold Hospital Trust, Grålum, Norway.
⁴ Institute of Clinical Medicine, University of Oslo, Norway.
⁵ Fragility Fracture Network.
⁶ City St George's, University of London, St George's University Hospital, UK.
⁷ Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
⁸ Fragility Fracture Network Brasil (FFN Brazil), Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Brazil.
⁹ Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK.
¹⁰ Facultad de Medicina, Universidad de Valparaíso, Chile.
¹¹ Hospital Regional ISSSTE Léon, Guanajuato, Mexico.
¹² Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
¹³ Department of Orthopaedic Surgery, Beacon Hospital, Petaling Jaya, Malaysia.
¹⁴ Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹⁵ Department of Traumatology and Orthopedic Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain.
¹⁶ Department of Surgery, School of Medicine, Complutense University of Madrid, Spain.
¹⁷ Programa em Fisioterapia, Universidade Cidade de São Paulo, Brazil.
¹⁸ Department of Traumatology, Fukushima Medical University, Japan.
¹⁹ Department of Orthopaedic Surgery, University of Minnesota Twin Cities, Minneapolis, USA.
²⁰ University of the Philippines Manila, Manila, Philippines.
²¹ Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, China.
²² Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, China.
²³ Bone and Joint Health, Blizard Institute, Queen Mary University of London, UK.

PMID: 40606571
PMCID: PMC12217561
DOI: 10.1177/21514593251351136

Fragility Fracture Network Position on Unrestricted Weight-Bearing After Hip Fracture Surgery

Ruqayyah Turabi et al. Geriatr Orthop Surg Rehabil. 2025.

. 2025 Jul 1:16:21514593251351136.

doi: 10.1177/21514593251351136. eCollection 2025.

Authors

Affiliations

¹ Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, UK.
² Department of Physical Therapy, College of Nursing and Health Sciences, Jazan University, Saudi Arabia.
³ Department of Orthopaedic Surgery, Østfold Hospital Trust, Grålum, Norway.
⁴ Institute of Clinical Medicine, University of Oslo, Norway.
⁵ Fragility Fracture Network.
⁶ City St George's, University of London, St George's University Hospital, UK.
⁷ Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
⁸ Fragility Fracture Network Brasil (FFN Brazil), Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Brazil.
⁹ Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK.
¹⁰ Facultad de Medicina, Universidad de Valparaíso, Chile.
¹¹ Hospital Regional ISSSTE Léon, Guanajuato, Mexico.
¹² Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
¹³ Department of Orthopaedic Surgery, Beacon Hospital, Petaling Jaya, Malaysia.
¹⁴ Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹⁵ Department of Traumatology and Orthopedic Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain.
¹⁶ Department of Surgery, School of Medicine, Complutense University of Madrid, Spain.
¹⁷ Programa em Fisioterapia, Universidade Cidade de São Paulo, Brazil.
¹⁸ Department of Traumatology, Fukushima Medical University, Japan.
¹⁹ Department of Orthopaedic Surgery, University of Minnesota Twin Cities, Minneapolis, USA.
²⁰ University of the Philippines Manila, Manila, Philippines.
²¹ Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, China.
²² Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, China.
²³ Bone and Joint Health, Blizard Institute, Queen Mary University of London, UK.

PMID: 40606571
PMCID: PMC12217561
DOI: 10.1177/21514593251351136

Abstract

Objectives: This position paper from the Fragility Fracture Network (FFN) responds to the observed global variation in weight-bearing prescriptions after hip fracture surgery in older adults.

Methods: The paper summarises current guidelines and evidence regarding unrestricted weight-bearing after hip fracture surgery.

Results: The synthesis of available evidence supports the endorsement of unrestricted weight-bearing after surgery to enhance patient outcomes.

Conclusion: The FFN endorses unrestricted weight-bearing and recommends healthcare professionals, institutions, and policymakers re-evaluate practices favouring limited or non-weight-bearing prescriptions and establish a standardised system for monitoring and auditing, with clear justification and documentation of any restrictions.

Keywords: hip fracture; international collaboration; orthogeriatric care; rehabilitation; weight-bearing.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors are members of the Fragility Fracture Network.

Figures

**Figure 1.**
Response to ‘Most Frequent Weight-Bearing Prescription’ by Country

See this image and copyright information in PMC

References

1. Carpintero P, Caeiro JR, Carpintero R, Morales A, Silva S, Mesa M. Complications of hip fractures: a review. World J Orthoped. 2014;5(4):402-411. doi: 10.5312/wjo.v5.i4.402 - DOI - PMC - PubMed
1. Emmerson BR, Varacallo M, Inman D. Hip Fracture Overview. StatPearls Publishing; 2022. - PubMed
1. Ftouh S, Morga A, Swift C. Management of hip fracture in adults: summary of NICE guidance. BMJ (Int Ed). 2011;342:d3304. - PubMed
1. National Institute for Health and Care Excellence (NICE) . Hip fracture: management. 2023. https://www.nice.org.uk/guidance/cg124 - PubMed
1. O'Connor MI, Switzer JA. AAOS clinical practice guideline summary: management of hip fractures in older adults. JAAOS - Journal of the American Academy of Orthopaedic Surgeons. 2022;30(20):e1291-e1296. doi: 10.5435/jaaos-d-22-00125 - DOI - PubMed

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Fragility Fracture Network Position on Unrestricted Weight-Bearing After Hip Fracture Surgery

Affiliations

Fragility Fracture Network Position on Unrestricted Weight-Bearing After Hip Fracture Surgery

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources