• Alexander M Keppler, Jenny Holzschuh, Daniel Pfeufer, Carl Neuerburg, Christian Kammerlander, Wolfgang Böcker, and Julian Fürmetz.
• Department for General, Trauma and Reconstructive Surgery, University Hospital LMU Munich, Germany. Electronic address: Alexander.keppler@med.uni-muenchen.de.
• Injury. 2020 Mar 1; 51 (3): 628-632.

BackgroundAn early postoperative mobilization shows beneficial effects in terms of complications and long-term mobilization scores in elderly adult fracture patients. The primary objective of this study was to evaluate the overall mobilization of orthogeriatric patients during the postoperative hospital stay based on a continuous accelerometry measurement. Secondly, the collected data was analyzed to detect fracture related differences. We hypothesized that upper extremity fractures come along with higher levels of physical activity compared to fractures of the lower extremity.MethodsThirty-one orthogeriatric patients with proximal femur fractures (PFF) and proximal humerus fractures (PHF) were enrolled consecutively in a maximum care hospital in a prospective study design (level of evidence 2). In the PFF study group 9 patients received hip arthroplasty and 11 patients intramedullary nailing (PFNA) and in the PHF group 10 patients received osteosynthesis of the proximal humerus. All patients worn a waist placed accelerometer during the length of hospitalization to quantify mobilization and physical activity.ResultsThe PFF group (n = 21) had a mean age of 80.86 years (SD ± 6.75), the PHF (n = 10) group had a mean age of 75.20 (SD ± 6.86). A significantly higher gait speed was observed in the PHF group of 0.52 m/s (SD ± 0.27) compared to the slower PFF group with 0.29 (SD ± 0.45); p = 0.0403. Quantitative mobility was measured by using the average number of daily steps. This showed a significantly lower number of steps in the PFF group (102.7; SD ± 188.1) compared to the PHF group (413.5; SD ± 287.7; p = 0.0002).ConclusionsOur data demonstrates that it is feasible and accepted by the patient to continuously measure the mobility including gait speed and characteristics of orthogeriatric patients using waist worn accelerometry based wearables. Postoperative mobility and gait speed was generally low in both groups. Actions to improve postoperative mobility of orthogeriatric patients are urgently needed. Level Of Evidence Prospective cohort study, Level of Evidence 2.Copyright © 2020. Published by Elsevier Ltd.

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