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Evidence to Improve Care

8

Weight-Bearing as Tolerated

Patients with hip fracture are mobilized to weight-bearing as tolerated within 24 hours following surgery.


Surgery for hip fracture should be planned to allow patients to achieve weight-bearing as tolerated, without restriction, within 24 hours following surgery. Full weight-bearing enables early mobilization, supports patients’ return to their pre-fracture level of mobility, and reduces the risk of adverse events associated with restricted weight-bearing and prolonged immobility. All modern hip fracture implants are designed to facilitate full weight-bearing.

In rare situations where younger patients experience displaced femoral neck fractures and undergo reduction and fixation, a period of ‘toe-touch’ weight-bearing may be appropriate.

In any situation where a hip fracture patient is discharged from hospital without being capable of full weight-bearing, detailed orders, including the rationale for and duration of the patient’s weight-bearing status, should be clearly documented and communicated to the patient’s post–acute care providers.

For Patients

You should be able to put as much weight as is comfortable on the injured leg within 24 hours of your surgery.


For Clinicians

Plan surgery with the aim of enabling patients to achieve weight-bearing as tolerated within 24 hours of their operation.


For Health Services

Ensure protocols, pathways, medical directives, and standardized order sets are in place to facilitate patients achieving weight-bearing as tolerated within 24 hours following surgery.

Outcome Indicator

Percentage of hip fracture patients who achieve weight-bearing as tolerated within 24 hours following surgery

  • Denominator: total number of adults admitted to hospital with a primary diagnosis of fragility hip fracture who undergo surgery for hip fracture

  • Numerator: number of people in the denominator who achieve weight-bearing as tolerated within 24 hours following surgery

  • Data source: local data collection

Weight-bearing as tolerated

Weight-bearing as tolerated involves putting as much weight as is comfortable for the patient on the leg that is on the same side as the injured hip.

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