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Hip fractures – Treatment and functional outcome. The development over 25 years

Turesson, Emma LU ; Ivarsson, Kjell LU ; Thorngren, Karl Göran LU and Hommel, Ami LU (2018) In Injury 49(12). p.2209-2215
Abstract

Background: Nearly 18,000 individuals suffer from hip fracture in Sweden each year. The choice in operation method for femoral neck fractures has changed over the years as well as the overall management. Functional outcome after hip fracture is affected by several factors and the overall functional level for old people in Sweden has improved over the last decades. Objective: To describe and analyse the functional outcome and choice of operation method for hip fracture patients between 1988 and 2012. Patients and methods: All patients with cervical or trochanteric hip fracture treated at Lund University Hospital from 1988 until 2012 were collected from the National Quality Register for hip fracture patients, RIKSHÖFT. Patients younger... (More)

Background: Nearly 18,000 individuals suffer from hip fracture in Sweden each year. The choice in operation method for femoral neck fractures has changed over the years as well as the overall management. Functional outcome after hip fracture is affected by several factors and the overall functional level for old people in Sweden has improved over the last decades. Objective: To describe and analyse the functional outcome and choice of operation method for hip fracture patients between 1988 and 2012. Patients and methods: All patients with cervical or trochanteric hip fracture treated at Lund University Hospital from 1988 until 2012 were collected from the National Quality Register for hip fracture patients, RIKSHÖFT. Patients younger than 50 years and those with pathological fractures were excluded. Data regarding patient characteristics, fracture type, operation method and housing, walking ability and use of walk aids prefracture and at 4-months follow-up was retrieved and analysed. Results: For this study 8723 patients were included with a mean age of 81.6 (men 79.3, women 82.5). The mean age significantly increased over the period studied. Sliding hip screw dominates as method of choice for the trochanteric fractures. For the cervical fractures there is a clear shift from osteosynthesis to arthroplasty. There is a significant decrease in functional outcome at follow-up compared to prefracture. No significant trend change can be seen over 25 years. Functional outcome are worse for the patients with trochanteric fracture. Conclusion: Although there have been changes in operation methods for hip fractures and the management has developed, our study does not show any effect on functional outcome over a 25-year period. The medical condition of these patients with increasing age seems to counteract efforts to improve the care.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Functional outcome, Hip fracture, Operation method, Rehabilitation
in
Injury
volume
49
issue
12
pages
2209 - 2215
publisher
Elsevier
external identifiers
  • scopus:85055086098
ISSN
0020-1383
DOI
10.1016/j.injury.2018.10.010
language
English
LU publication?
yes
id
5ae22a27-b85d-4be5-868f-4b98b1e52c48
date added to LUP
2018-11-20 12:00:42
date last changed
2019-10-15 06:50:48
@article{5ae22a27-b85d-4be5-868f-4b98b1e52c48,
  abstract     = {<p>Background: Nearly 18,000 individuals suffer from hip fracture in Sweden each year. The choice in operation method for femoral neck fractures has changed over the years as well as the overall management. Functional outcome after hip fracture is affected by several factors and the overall functional level for old people in Sweden has improved over the last decades. Objective: To describe and analyse the functional outcome and choice of operation method for hip fracture patients between 1988 and 2012. Patients and methods: All patients with cervical or trochanteric hip fracture treated at Lund University Hospital from 1988 until 2012 were collected from the National Quality Register for hip fracture patients, RIKSHÖFT. Patients younger than 50 years and those with pathological fractures were excluded. Data regarding patient characteristics, fracture type, operation method and housing, walking ability and use of walk aids prefracture and at 4-months follow-up was retrieved and analysed. Results: For this study 8723 patients were included with a mean age of 81.6 (men 79.3, women 82.5). The mean age significantly increased over the period studied. Sliding hip screw dominates as method of choice for the trochanteric fractures. For the cervical fractures there is a clear shift from osteosynthesis to arthroplasty. There is a significant decrease in functional outcome at follow-up compared to prefracture. No significant trend change can be seen over 25 years. Functional outcome are worse for the patients with trochanteric fracture. Conclusion: Although there have been changes in operation methods for hip fractures and the management has developed, our study does not show any effect on functional outcome over a 25-year period. The medical condition of these patients with increasing age seems to counteract efforts to improve the care.</p>},
  author       = {Turesson, Emma and Ivarsson, Kjell and Thorngren, Karl Göran and Hommel, Ami},
  issn         = {0020-1383},
  keyword      = {Functional outcome,Hip fracture,Operation method,Rehabilitation},
  language     = {eng},
  number       = {12},
  pages        = {2209--2215},
  publisher    = {Elsevier},
  series       = {Injury},
  title        = {Hip fractures – Treatment and functional outcome. The development over 25 years},
  url          = {http://dx.doi.org/10.1016/j.injury.2018.10.010},
  volume       = {49},
  year         = {2018},
}