Abstract：
BACKGROUND: Demographics of patients who sustain geriatric distal femoral fractures (DFF) match those of patients with neck-of-femur fractures but have limited evidence with which to support post-operative weightbearing protocols.
OBJECTIVE: This systematic review sought to identify any difference in outcomes for elderly patients with DFF who were allowed early versus delayed weightbearing postoperatively.
METHODS: DATA SOURCES: PubMed, Medline, Embase and The Cochrane Library, reference lists of retrieved articles.
METHODS: English language papers published between January 2010 and February 2023 with AO-OTA type 33A, B and C femoral fractures as well as Lewis and Rorabeck Type I and II periprosthetic DFF surgically treated with either a lateral locking plate or retrograde intramedullary nail and an average patient age of ≥ 60 years.
METHODS: Studies were assessed for inclusion by two authors and quality was assessed using the MINORS tool.
RESULTS: Sixteen studies were included, Meta-analysis of non-union, malunion, infection, delayed union and implant complications was performed using Microsoft Excel and the MetaXL extension. The data on return to mobility were presented in narrative form. The analyses demonstrated no difference between the early and delayed weightbearing groups.
CONCLUSIONS: There are no significant differences in complication rates between early versus delayed weightbearing after surgery for DFF in an elderly population. The study results are limited by high heterogeneity and low-quality studies. High quality, prospective studies are needed to determine the ideal postoperative weightbearing protocol.
METHODS: Level III, Systematic Review and Meta-analysis of Level III studies. International Prospective Register of Systematic Reviews registration-Prospero CRD42022371460.
OBJECTIVE: This systematic review sought to identify any difference in outcomes for elderly patients with DFF who were allowed early versus delayed weightbearing postoperatively.
METHODS: DATA SOURCES: PubMed, Medline, Embase and The Cochrane Library, reference lists of retrieved articles.
METHODS: English language papers published between January 2010 and February 2023 with AO-OTA type 33A, B and C femoral fractures as well as Lewis and Rorabeck Type I and II periprosthetic DFF surgically treated with either a lateral locking plate or retrograde intramedullary nail and an average patient age of ≥ 60 years.
METHODS: Studies were assessed for inclusion by two authors and quality was assessed using the MINORS tool.
RESULTS: Sixteen studies were included, Meta-analysis of non-union, malunion, infection, delayed union and implant complications was performed using Microsoft Excel and the MetaXL extension. The data on return to mobility were presented in narrative form. The analyses demonstrated no difference between the early and delayed weightbearing groups.
CONCLUSIONS: There are no significant differences in complication rates between early versus delayed weightbearing after surgery for DFF in an elderly population. The study results are limited by high heterogeneity and low-quality studies. High quality, prospective studies are needed to determine the ideal postoperative weightbearing protocol.
METHODS: Level III, Systematic Review and Meta-analysis of Level III studies. International Prospective Register of Systematic Reviews registration-Prospero CRD42022371460.
摘要：
背景：老年股骨远端骨折（DFF）患者的人口统计与股骨颈骨折患者的人口统计相符，但支持术后负重方案的证据有限。
目的：本系统评价旨在确定术后允许早期负重与延迟负重的老年DFF患者的预后差异。
方法：数据来源：PubMed,Medline,Embase和Cochrane图书馆,检索到的文章的参考列表。
方法：2010年1月至2023年2月发表的AO-OTA33A型英文论文，B和C股股骨骨折以及Lewis和RorabeckI型和II型假体周围DFF均采用外侧锁定钢板或逆行髓内钉手术治疗，患者平均年龄≥60岁。
方法：由两名作者对纳入研究进行评估，并使用MINORS工具对质量进行评估。
结果：纳入了16项研究，不愈合的荟萃分析，malunion,感染,延迟愈合和植入并发症使用MicrosoftExcel和MetaXL扩展进行.返回流动性的数据以叙述形式呈现。分析表明早期和延迟负重组之间没有差异。
结论：老年人DFF术后早期负重与延迟负重的并发症发生率无显著差异。研究结果受到高异质性和低质量研究的限制。高品质,需要前瞻性研究来确定理想的术后负重方案.
方法：三级，III级研究的系统评价和荟萃分析。国际前瞻性系统评价注册注册-ProsperoCRD42022371460。
目的：本系统评价旨在确定术后允许早期负重与延迟负重的老年DFF患者的预后差异。
方法：数据来源：PubMed,Medline,Embase和Cochrane图书馆,检索到的文章的参考列表。
方法：2010年1月至2023年2月发表的AO-OTA33A型英文论文，B和C股股骨骨折以及Lewis和RorabeckI型和II型假体周围DFF均采用外侧锁定钢板或逆行髓内钉手术治疗，患者平均年龄≥60岁。
方法：由两名作者对纳入研究进行评估，并使用MINORS工具对质量进行评估。
结果：纳入了16项研究，不愈合的荟萃分析，malunion,感染,延迟愈合和植入并发症使用MicrosoftExcel和MetaXL扩展进行.返回流动性的数据以叙述形式呈现。分析表明早期和延迟负重组之间没有差异。
结论：老年人DFF术后早期负重与延迟负重的并发症发生率无显著差异。研究结果受到高异质性和低质量研究的限制。高品质,需要前瞻性研究来确定理想的术后负重方案.
方法：三级，III级研究的系统评价和荟萃分析。国际前瞻性系统评价注册注册-ProsperoCRD42022371460。
