[Gait in patients with Parkinson's disease after surgically treated hip fracture]

The aims of this study were: 1) to evaluate the degree of walking of patients with Parkinson s syndrome after hip fracture surgically treated; 2) to reexamine the evidence for internal fixation versus endoprosthesis.

Forty-one patients with Parkinson s syndrome after hip fracture surgically treated have been studied. Twenty-four fractures (20 femoral neck, 4 subcapital) were treated by endoprosthesis, and 17 by internal fixation (pertrochanteric fractures). The average age of the patients was 76+/-7 years (7 male, 34 female); 97,5% patients could walk without any help before the fracture.

At the end of the rehabilitation period, 21.9% patients were unable to walk; 2.4% walked with assistance of two persons, 24.4% with assistance of one person, 19.4% with two canes, 17.1% with one cane, 14.8% without assistance and without cane. At discharge, 87.5% of patients went directly back home, while the remaining 12.5% were admitted to Geriatric hospitals. The degree of walking was higher in fractures treated by endoprosthesis (p<0.05). At the end of treatment, 62.5% fractures treated by endoprosthesis and 35.2% treated by internal fixation could walk without any help.

1) Parkinson s disease influences the recovery of walking after hip fracture; 2) At the end of rehabilitation, the parkinsonian patients with hip fractures treated by endoprosthesis showed better results than those treated by internal fixation.