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A prospective study on hip fractures in patients with previous cerebrovascular accidents
1Department of Orthopaedic Surgery, University of Hong Kong, Queen Mary Hospital.
Insights
Patients with cerebrovascular accidents (CVAs) who sustained proximal femoral fractures often had fractures on the hemiplegic side. Intensive physiotherapy improved walking ability, with outcomes correlating to discharge performance.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Neurology
Background:
- Proximal femoral fractures are common in elderly patients.
- Cerebrovascular accidents (CVAs) can impact mobility and increase fracture risk.
- Understanding outcomes for CVA patients with these fractures is crucial for rehabilitation.
Purpose of the Study:
- To analyze the characteristics and outcomes of patients with proximal femoral fractures and a history of cerebrovascular accidents.
- To evaluate the effectiveness of surgical treatment and intensive physiotherapy in this patient group.
Main Methods:
- Retrospective review of 1430 patients with proximal femoral fractures admitted between 1985 and 1990.
- Identification of patients with a history of cerebrovascular accidents (n=146).
- Analysis of fracture side, treatment methods, physiotherapy duration, and functional recovery.
Main Results:
- 10.2% of patients had a history of CVAs, with 82% experiencing fractures on the hemiplegic side.
- Most patients underwent surgical treatment followed by an average of 6 weeks of intensive physiotherapy.
- 60.9% regained or improved prefracture walking ability upon discharge.
- At 21 months follow-up, 31% had satisfactory walking and daily activities.
- A significant correlation was found between discharge performance and final walking ability.
Conclusions:
- Proximal femoral fractures in patients with a history of CVAs frequently occur on the hemiplegic side.
- Intensive physiotherapy following surgical intervention can lead to functional improvements.
- Patient performance at hospital discharge is a significant predictor of long-term walking ability and daily activity levels.
Abstract:
Of 1430 patients with proximal femoral fractures admitted into Queen Mary Hospital, Hong Kong from 1985 to 1990, 146 patients (10.2 per cent) had a history of previous cerebrovascular accidents. The fracture was on the hemiplegic side in 82 percent of patients. Most patients were treated by operation. Intensive physiotherapy was given to these patients for an average of 6 weeks. The prefracture walking ability was regained or even improved upon discharge in 60.9 per cent of patients. After an average follow-up of 21 months, 31 per cent had satisfactory walking and active daily activities. There was significant correlation of the performance upon discharge from the hospital with the walking ability at the final follow-up.