Hip-Flexor-Suppressing Pendular Gait Strategy Facilitates Walking Recovery After Lesser Trochanter Fracture in an Elderly Patient: A Case Report.

Delayed recovery of limb advancement is a common challenge after lesser trochanter fractures due to impaired hip flexor function. We report a case of an elderly patient who regained walking ability using a hip-flexor-suppressing pendular gait strategy. A 79-year-old man sustained a femoral neck fracture with concomitant lesser trochanter avulsion. Postoperatively, active hip flexion was limited, and conventional gait patterns were difficult. Instead, the patient adopted a compensatory strategy characterized by trunk forward inclination and pelvic rotation, enabling pendular advancement of the affected limb without active hip flexion. Gait observation revealed a reduced step length and a prolonged stance phase on the affected limb, suggesting its role as a stable pivot for limb advancement. This strategy minimized pain and mechanical stress at the iliopsoas insertion while facilitating functional ambulation. This case highlights that limb advancement during gait does not necessarily depend on active hip flexion. Rehabilitation strategies focusing on movement adaptation rather than muscle strengthening alone may be effective in elderly patients with lesser trochanter fractures.