[Mortality and functional outcome of hip fractures in the elderly]

Recently, the incidence of osteoporosis and its related fracture are increasing as the aging of population has been progressing in most developed countries, becoming a serious medical and social problem. Among osteoporosis-related fractures, especially, hip fracture might have a marked influence on survival prognosis as well as a restriction of patient's daily activity and the bed-ridden status. Thus, clinical significance of hip fracture has been increasing, but particularly in the extreme elderly, it is difficult to manage patients in most cases because of the peculiarity due to their extreme old age. For example, hip fracture in the extreme elderly is characterized as follows: (1) It occurs easily with a slight external force. (2) It often associates various complications. (3) Its physical differences among individuals are considerably large. (4) Rehabilitation after surgery is difficult in many cases because of complicated dementia. and (5) It is difficult for the patients to live independently at home. This article reviews the literature on survival prognoses and functional results in the extreme elderly with hip fracture. The data from the literature indicate that in the extreme elderly, preoperative general condition, walking ability, type of fracture, and the type of surgery are likely to be the significant predictors of survival prognosis, whereas the degree of dementia seems to be the significant predictor of the recovery of walking ability.