Early weightbearing after classical internal fixation of medial fractures of the femoral neck.

This study is a survey of a series of 446 patients, treated in the city of Turku, Finland, between 1964 and 1971, for medial fractures of the femoral neck. Fractures were treated by means of the classical nailing method (nail placed along the central axis of the femoral neck, ad modum Smith-Petersen). An unselected group of patients were treated in such a way that they were already allowed to bear weight on the injured limb 2 weeks post-operatively (120 patients). The remaining patients were not allowed to bear weight on the injured limb until 12-14 weeks after nailing (261 patients). The progress of recovery was studied retrospectively, a comparison being made between the early and late weightbearers. Without reference to the type of fracture (according to the classifications of Garden or Pauwels) or to the method of fixing (Smith-Petersen nail, with or without side-plate) bone union was relatively more frequent and failures were relatively less frequent among early weightbearers than among late weightbearers. Early weightbearing had a beneficial effect upon the healing of the fracture and there was no evidence in the case of early weightbearers of any additional complications. A comparative study of the whole patient group on the basis of the time-lag between the accident and the operation--some were nailed 1-3 days, some 4-7 days and some more than a week after the fracture had taken place--revealed no significant differences.