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LONG TERM RESULTS OF MOBILITY AND MORTALITY IN ELDERLY PATIENTS WITH NECK OF FEMUR FRACTURE



Abstract

Introduction: It is commonly believed that there is deterioration of one grade of mobility with fracture neck of femur in elderly population. Several studies have been published in literature regarding outcome after operative management of fractures of proximal femur, but none of these focus on deterioration of mobility or its grades after the surgery.

Methods: A prospective pilot study of 50 consecutive patients with fracture neck of femur, who presented to the department were included in the study. Mobility and mortality was assessed at 6weeks and I year post operatively. We used a grading system of mobility with grades from I – VI, where grade I means fully independently mobile and grade VI stands for a bed ridden patient.

Results: Results showed that deterioration of mobility grade was much worse then conventionally thought. Out of 20 patients who were independently mobile without any aid preoperatively, only 5 patients were capable of walking with a stick. The overall mortality at 1 year post-op. was 40%. Patient’s age, residential status, MMS, ASA grade, preoperative mobility and mobility at 6weeks showed good prediction of post operative mortality in these patients.

Conclusion: Contrary to common belief much severe mobility deterioration was seen in patients following fracture neck of femur in elderly patients. Thus, deterioration of mobility becomes a very important factor to be considered in planning the management of these patients.

Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.