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Objectives and questions: Approximately 80,000 femoral neck fractures occur annually in Germany, representing a significant source of morbidity and mortality. These fractures often lead to immobility and associated complications such as nosocomial infections, muscle wasting, and venous thrombosis. The most vulnerable patients are frail individuals within the orthogeriatric population, for whom hemiarthroplasty is the standard treatment. Although early weight-bearing is the goal, it is frequently hindered by postoperative pain and psychological barriers.

Material and methods: This study investigates the impact of intraoperative local infiltration analgesia (LIA), comprising adrenaline, ropivacaine, and morphine, on postoperative mobilisation. In a preliminary analysis of 23 patients (65% female, mean age: 82.48 ± 5.78 SD) – 11 receiving LIA and 12 controls. We assessed quantitative and qualitative postoperative mobilisation through the Parker Mobility Score, Barthel Index and insole gait analysis.

Results: Those in the LIA group demonstrated significantly higher Parker Mobility Scores at 7 days (mean: 2.10 vs. 1.25; p = 0.0445) and a trend toward higher Barthel Index Scores (mean: 72.50 vs. 60.45; p = 0.0838). Additionally, quantitative gait analysis indicated greater weight-bearing on the affected limb in the LIA group (mean: 76.04% vs. 70.58% of body weight, p = 0.3388).

Discussion and conclusions: These findings suggest that intraoperative LIA may enhance postoperative mobility and thus, reduce immobility-related complications in orthogeriatric patients following femoral neck fractures.