Proximal femur fractures in the elderly are associated with significant loss of independence, mobility, and quality of life. This prospective study aimed to: (1) investigate gait biomechanics in intertrochanteric fracture (ITF) patients (A1 and A2 AO/OTA) managed via femoral nailing at 6 weeks and 6 months postoperative and how these compared with similarly aged elderly controls; and (2) investigate whether femoral offset shortening (FOS) and lateral lag screw protrusion (LSP) were associated with changes in gait biomechanics at postoperative time points. Hip radiographs and gait data were collected for 34 patients at 6 weeks and 6 months postoperatively. Gait data were also collected from similarly aged controls. FOS and LSP were measured from radiographs. Joint angles, external moments, and powers were calculated for the hip, knee, and ankle and compared between time points in ITF patients and healthy controls using statistical parametric mapping. The relationship between radiographic measures with gait speed, step length, peak hip abduction, and maximum hip abduction moment was assessed using a Pearson correlation. External hip adduction moments and hip power generation improved in the first 6 months postoperative, but differed significantly from healthy controls during single limb stance. LSP showed a moderate correlation with maximum hip abduction moment at 6 weeks postoperative (r = −0.469, p = 0.048). These results provide new detail on functional outcomes after ITF and potential mechanisms that functional deficiencies may stem from. Lag screw prominence may be an important factor in maintaining functional independence and minimizing the risk of secondary falls after ITF in the elderly.

中文翻译：

---

股骨近端髓内钉治疗股骨粗隆间骨折后的步态生物力学


老年人股骨近端骨折与独立性、活动能力和生活质量的显着丧失相关。这项前瞻性研究的目的是：(1) 调查股骨粗隆间骨折 (ITF) 患者（A1 和 A2 AO/OTA）术后 6 周和 6 个月时的步态生物力学，以及与年龄相仿的老年对照组相比如何； (2) 研究股骨偏距缩短 (FOS) 和外侧拉力螺钉突出 (LSP) 是否与术后时间点步态生物力学的变化相关。收集 34 名患者术后 6 周和 6 个月的髋部 X 光片和步态数据。步态数据也从年龄相似的对照中收集。 FOS 和 LSP 通过射线照片测量。计算髋部、膝部和踝部的关节角度、外部力矩和力量，并使用统计参数映射在 ITF 患者和健康对照的时间点之间进行比较。使用皮尔逊相关性评估放射线照相测量与步态速度、步长、髋部外展峰值和最大髋部外展力矩之间的关系。术后前 6 个月内髋部外收力矩和髋部发电量有所改善，但在单肢站立期间与健康对照组存在显着差异。 LSP 与术后 6 周的最大髋关节外展力矩呈中度相关（ r = -0.469， p = 0.048）。这些结果提供了 ITF 后功能结果的新细节以及功能缺陷可能产生的潜在机制。拉力螺钉突出可能是保持功能独立性和最大限度降低老年人 ITF 后继发跌倒风险的重要因素。