[Postoperative rehabilitation in patients with hip fractures]

The purpose of the present study was to determine the variables associated with the length of hospital stay and to evaluate the ability to reach prefracture ADL-status after operation on patients with proximal fractures of femur. One hundred patients with cervical and trochanteric fracture were operated with internal fixation and endoprosthesis during a two year period. The type of surgical procedure selection was made by the surgeons own decision as part of treatment routine. The data were collected using a structured interview, participating observation and content analysis. The follow-up period was six months. The mean hospitalization time was 31.5 days, when seven patients with extremely long hospitalization, due to waiting for a long term care, were excluded. Stepwise regression analysis was used to determine variables associated with a longer hospital stay. Variables that related to poor prognosis were age, sex of patient, operation delay, weightbearing, medication, dizziness, status post paralysis and circumstances of dwelling. A significant difference was found between internal fixation and endoprosthesis at patient with cervical fracture of femur regarding to the length of hospital stay and ability to reach prefracture ADL-status in two weeks after operation. Results of this study showed, that the objective, to discharge patients in two or three weeks, was not achieved. This study also showed, that all patients did not regain the prefracture ADL-status during a follow-up period. It is important to assure the effectiveness of treatment after discharge from hospital in primary care and to prevent proximal fractures of femur in the elderly.