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All 441 cases of hip fracture admitted to Sahlgrenska sjukhuset, Göteborg, during a one-year period were followed in accordance with a form developed by the Swedish Medical Research Council. Osteosynthesis was the method used in over 97 per cent of the cases. There were 336 women, mean age 80.0 (+/- 9.9) years, and 105 men, mean age 77.1 (+/- 11.8). A rehabilitation programme for non-institutionalised patients (68 per cent of the total of 441) reduced the length of stay at the orthopaedic department from 22 days to an average of 15 days in 1986, and the proportion of patients able to return home was increased from 81 per cent in 1982 to 90 per cent in 1987-88. Thus, the use of rehabilitation or nursing home facilities was reduced, and the length of stay there was reduced. The findings of the study also showed the rehabilitation to be time-consuming, and that few hip fracture patients ever regain complete pre-fracture function. Therefore it is suggested that the follow-up should be extended to cover a longer period than four months. Otherwise, the form is well designed, and its use improves the comparability of different studies.

The aim of the Svalebo programme is improved rehabilitation and increased home discharge of patients with hip fractures, and a better use of health care resources. The programme includes contact with the hip fracture patients at the orthopaedic clinic, a rehab programme on an outpatient basis 1-3 days a week. As a result of the programme, the role of the day hospital has become clearer and the flow of patients through the orthopaedic department has increased, the mean duration of hospitalisation having decreased by 30 per cent. In a one-year follow up of 42 patients, it was found that in many cases hip function was incompletely restored. In general, our view is that the Svalebo programme assures good care and rehabilitation of the hip fracture patient, and decreased consumption of institutional care facilities.