Prognostic Factors and Outcome of Elderly Patients with Hip Fracture

Among the elderly, hip fracture is the most common outcome of osteoporosis. The main aim of this study was to investigate the clinical characteristics, treatment, complications, long-term outcome and mortality of elderly hip fracture patients, aged 90 years and over. MATERIAL AND METHODS: We retrospectively analyzed 44 patients admitted between 1994 and 1998 with femoral neck or trochanteric fracture. The age of the patients ranged between 90 and 99 years and all 44 patients were surgically managed with one exception who died during the preoperative hospitalization. Hemiarthroplasty was most often used for medial (subcapital and transcervical) fractures. Internal fixation with either Ender nails or a compression hip-screw with a plate was used for lateral (per-, inter- and sub- trochanteric) fractures. RESULTS AND CONCLUSIONS: Most fractures (98%) were due to low energy trauma. Overall, mortality was 29.6% during the first year, being higher in patients with greater severity of pre-existing medical illness and in patients with difficulty in walking before the operation. In addition, if hemiarthroplasty was performed, the rate of death was higher. Rehabilitation was difficult if the patient had severe dementia or had difficulty in walking before the operation.