Gait function progress in a patient with a femoral neck fracture who underwent rehabilitation during prolonged surgical waiting time: a case study.

Abstract

[Purpose] We report the case of an 81-year-old woman with a femoral neck fracture whose gait function improved with in-hospital physical therapy prior to surgery. [Participants and Methods] The patient's planned bipolar hip arthroplasty was postponed due to suspected metal allergy, and she commenced rehabilitation on hospital day 4. [Results] On day 7, the patient stood and was transferred with assistance. Subsequently, owing to pain, she only left her bed during rehabilitation. On day 10, the fracture was externally fixed using a soft-conforming lumbar immobilization orthosis, which relieved the pain. The patient was allowed to stand and was transferred under supervision. On day 22, surgery was scheduled after obtaining a negative metal patch test result. On day 23, the patient was able to walk 25 m using a walker. Bipolar hip arthroplasty was performed on day 28. On day 30, she walked 10 m using a walker with light assistance. On day 52, the patient walked independently using a cane. The patient was discharged on day 63. [Conclusion] External lumbar immobilization bandages effectively reduced motion-related fracture pain. The high frequency of rehabilitation while waiting for surgery effectively prevented perioperative complications and promoted early postoperative walking recovery.