A Retrospective Evaluation of Risk Factors and Post-Operative Functional Outcome Assessment of Elderly Patients with Hip Fractures in a Tertiary Care Teaching Hospital of Eastern India

Abstract

Aim: The aim of the present study was to evaluate the post-operative functional recovery in elderly patients with hip fractures and also assessing the risks of not regaining to the pre-fracture mobility level.

Methods: This retrospective observational cohort study examined a sample of 250 consecutive patients aged 65 and above who were admitted to the hospital with hip fractures. The study received approval from the ethics committee at our institution. The study excluded patients who met the following criteria: having a contralateral hip fracture, experiencing a pathological fracture, being bedridden prior to the occurrence of the hip fracture, dying within six months after the operation, and being alive but lacking postoperative sixth-month follow-up data. The study incorporated the remaining 200 patients.

Results: 120 (60%) of the patients were female and 80 (40%) were male, with a mean age of 76.4±8.2 years. There were 120 (60%) intertrochanteric fractures and 80 (40%) femoral neck fractures. 104 (52%) patients underwent proximal femoral nail (PFN), 80 (40%) patients underwent hemiarthroplasty, 8 (4%) patients underwent dynamic hip screw (DHS) and 7 (2.5%) patients underwent total hip arthroplasty. It was determined that intertrochanteric fractures were more common in people who did not have normal mobility and who moved with the use of an aid, (p=0.002). In the analysis of the relationship between the fracture type and the postoperative sixth month mobility, it was found that the rate of moving with the use of an aid and immobile was higher in patients with intertrochanteric fractures than in patients with collum femoris fracture (p=0.001).

Conclusion: During the postoperative phase, a considerable increase in the deterioration of activities of daily living and restriction of mobility was observed among patients who underwent surgical intervention for hip fractures. Individuals diagnosed with intertrochanteric fractures, who undergo surgical intervention utilizing proximal femoral nail (PFN) implants, and who also present comorbidities such as cardiovascular disease or dementia, exhibit a higher propensity for functional incapacity to restore to their pre-fracture state.